MCLENA-2: A Phase II Clinical Trial for the Assessment of Lenalidomide in Patients With Mild Cognitive Impairment

NCT06177028 | Not Yet Recruiting Phase 2 DMC FDA Drug

• 1 other identifier: 2013717
• Study Type: interventional
• Target: 45
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a randomized, double-blind, placebo-controlled, parallel group study. The use of placebo is appropriate to minimize bias related to treatment expectations of the subject, study partner, and site investigator, as well as to changes in the relationship between the subject and study partner that might occur with the initiation of treatment and expectation of improvement in motor symptoms or cognition. Changes in subject/study partner interactions can impact subject mood and might introduce biases that cannot be quantified. The double-blind use of placebo will also prevent bias in the clinical and scientific assessments.

Conditions

Cognitive Impairment, Mild; Cognitive Dysfunction; Amyloid Plaque; Neurodegenerative Disease, Hereditary; Inflammation, Brain

Keywords

Alzheimer's disease; CSF; Biomarkers; Brain Imaging; Brain Amyloid; Memory Loss; Immunomodulation

Outcome Measures

Primary Outcomes (1)

• To assess the effect of lenalidomide

  To assess the effect of lenalidomide on inflammatory markers in CSF and blood, as well as safety and toxicity.

  After 26 weeks of treatment

Secondary Outcomes (1)

• To asses the effect of lenalidomide

  26 weeks of treatment

Study Arms (2)

Lenalidomide

EXPERIMENTAL

Lenalidomide 10 mg/day taken daily orally for 26 weeks of treatment followed by 4 weeks of washout. The trial will last up to 30 weeks in duration.

Drug: Lenalidomide 10 mg

Placebo

PLACEBO COMPARATOR

Placebo taken daily orally for 26 weeks of treatment followed by 4 weeks of washout. The trial will last up to 30 weeks in duration.

Drug: Lenalidomide 10 mg

Interventions

Lenalidomide 10 mg DRUG

Lenalidomide is a cancer drug, It is also known by it's brand name Revlimid.

Also known as: Lenalid

Lenalidomide; Placebo

Eligibility Criteria

• Age: 50 Years - 90 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male or female outpatients.
• At least 50 years of age, but less than 90 (89 at time of screening)
• Females must be surgically sterile (bilateral tubal ligation, oophorectomy, or hysterectomy) or postmenopausal for 2 years (no women at risk of pregnancy will be accepted in this study).
• Must have been diagnosed with amnestic MCI based on the most recent NIA-AA criteria (Albert et al., 2011), i.e. at both the screening and baseline visits (visits 1 and 2) have a documented Mini Mental State Exam (MMSE) score between 22-28.
• CT or MRI scan of the brain obtained during the course of the dementia must be consistent with the diagnosis and show no evidence of significant focal lesions or of pathology which could contribute to dementia. If neither a CT nor an MRI scan is available from the past 12 months, a CT scan fulfilling the requirements must be obtained before randomization.
• Vision and hearing must be sufficient to comply with study procedures.
• Be able to take oral medications.
• Hachinski ischemic score must be ≤ 4.
• Geriatric depression scale must be ≤ 10.
• Can be on stable doses of a cholinesterase inhibitor and/or memantine as long as it is stable for at least 90 days before screening and is expected to remain on a stable dose for the remainder of the study period; or have demonstrated intolerance to or lack of efficacy from these medications.
• Must have a collateral informant/study partner who has significant direct contact with the patient at least 10 hours per week and who is willing to accompany the patient to specified clinic visits, supervise administration of all study medication, and be available for telephone visits/interviews.
• If the patient has a legally authorized representative (LAR), the LAR must review and sign the informed consent form. If the patient does not have an LAR, the patient must appear able to provide informed consent and must review and sign the informed consent form. In addition, the patient's informant/study partner (as defined above) must sign an informed consent form. If the LAR and the patient's informant /study partner is the same individual, he/she should sign under both designations.
• Must reside in the community.
• Patients with stable prostate cancer may be included at the discretion of the Medical Monitor.
• Positivity for amyloid brain scan: Amyloid PET positive at SUVr of 1.05

You may not qualify if:

• Subjects will be excluded if they have any of the condition listed below:
• Current evidence or history within the last 3 years of a neurological or psychiatric illness that could contribute to dementia, including (but not limited to) epilepsy, focal brain lesion, Parkinson's disease, seizure disorder, head injury with loss of consciousness
• DSM IV criteria for any major psychiatric disorder including psychosis, major depression and bipolar disorder.
• Unwilling or unable to undergo a Lumbar Puncture.
• Known history or self-reported alcohol or substance abuse.
• Living alone.
• Poorly controlled hypertension. 7 .History of myocardial infarction or signs or symptoms of unstable coronary artery disease within the last year (including revascularization procedure/angioplasty).
• \. Severe pulmonary disease (including chronic obstructive pulmonary disease) requiring more than 2 hospitalizations within the past year.
• \. Untreated sleep apnea. 10. Any thyroid disease (unless euthyroid on treatment for at least 6 months prior to screening).
• \. Active neoplastic disease (except for skin tumors other than melanoma) within five years.
• \. History of multiple myeloma. 13. Absolute neutropenia of \<750/mm3, or a history of neutropenia. 14. History of or current thromboembolism (including deep venous thrombosis). 15. Any clinically significant hepatic or renal disease (including presence of Hepatitis B or C antigen/antibody or an elevated transaminase levels of greater than two times the upper limit of normal (ULN) or creatinine greater than 1.5 x ULN).
• \. Clinically significant hematologic or coagulation disorder including any unexplained anemia or a platelet count less than 100,000/μL at screening.
• \. Use of any investigational drug within 30 days or within five half-lives of the investigational agent, whichever is longer.
• \. Use any investigational medical device within two weeks before screening or after end of the present study.
• \. Females who are at risk of pregnancy or are of child bearing age. 20. Unwilling or unable to undergo MRI and PET imaging. 21. Cardiac pacemaker or defibrillator or other implanted device. 22. In the opinion of the investigator, participation would not be in the best interest of the subject

Sponsors & Collaborators

• St. Joseph's Hospital and Medical Center, Phoenix: lead
• Texas Tech University: collaborator

MeSH Terms

Conditions

Cognitive Dysfunction; Plaque, Amyloid; Heredodegenerative Disorders, Nervous System; Encephalitis; Alzheimer Disease; Memory Disorders

Interventions

Lenalidomide

Condition Hierarchy (Ancestors)

Cognition Disorders; Neurocognitive Disorders; Mental Disorders; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Neurodegenerative Diseases; Nervous System Diseases; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Brain Diseases; Central Nervous System Diseases; Neuroinflammatory Diseases; Dementia; Tauopathies; Neurobehavioral Manifestations; Neurologic Manifestations; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Phthalimides; Phthalic Acids; Acids, Carbocyclic; Carboxylic Acids; Organic Chemicals; Piperidones; Piperidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Isoindoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring

Central Study Contacts

Marwan N Sabbagh, M.D

CONTACT

602-406-7735; Marwan.Sabbagh@commonspirit.org

Sandy Quintanilla

CONTACT

602-406-7054; Sandy.Quintanilla@commonspirit.org

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Beside the clinical pharmacologist and biostatistician, all parties involved in the present study will be blinded until all data are collected, including medical staff, patients and his/her car giver, imaging staff, and scientists collecting data from biosamples. The blinding will be lifted only after all data are acquired, and before statistical analysis
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study will take place at a single site. We will enroll 45 male and female participants, 50-90 years of age, in general good health, with mild cognitive impairment due to AD. The trial will last up to 30 weeks in duration. Lenalidomide 10 mg/day vs. placebo taken daily orally (ratio 2:1). Participants completing the study will be involved for up to 45 weeks in duration, from screening to end of the study.

Study Record Dates

• First Submitted: December 11, 2023
• First Posted: December 20, 2023
• Study Start: June 1, 2025
• Primary Completion: January 2, 2026
• Study Completion (Estimated): January 2, 2027
• Last Updated: May 18, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Access Criteria: Papers will be accessible online Data and bio samples can be requested from the principal investigator 6 months after publication of the results of the study in peer-reviewed articles