Durvalumab With or Without Lenalidomide in Treating Patients With Relapsed or Refractory Cutaneous or Peripheral T Cell Lymphoma

Inclusion Criteria:

Documented informed consent of the participant and/or legally authorized representative
Registered into Revlimid REMS program
Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
Fully recovered from acute toxicities (except alopecia) of all prior therapies to Common Terminology Criteria for Adverse Events (CTCAE) =< grade 1
Relapsed/refractory disease
Failed >= 2 prior systemic therapies *NOTE: For systemic ALCL prior systemic therapy must also include progression on brentuximab vedotin

CUTANEOUS T-CELL LYMPHOMA (CTCL) ONLY

Histologically confirmed mycosis fungoides (MF) or Sezary syndrome (SS); Phase 1: >= stage IIB OR >= stage IB-IIA folliculotropic/transformed MF; Phase 2: >= stage IB

Stage of disease according to TNMB classification
Pathology report must be diagnostic or be consistent with MF/SS criteria
SS is defined as meeting T4 plus B2 criteria; where the biopsy of erythrodermic skin may only reveal suggestive but not diagnostic histopathological features, the diagnosis may be based on either node biopsy or fulfillment of B2 criteria
For MF where the histological diagnosis by light microscopic examination is not confirmed, diagnostic criteria that has been recommended by the International Society of Cutaneous Lymphomas (ISCL) should be used
Measurable disease per modified severity weighted assessment tool (mSWAT) and/or Sezary count
Baseline skin biopsy taken within 6 months available for central review submission

PERIPHERAL T-CELL LYMPHOMA (PTCL) ONLY

Histologically confirmed PTCL as defined by World Health Organization (WHO) 2008 criteria
Measurable and/or evaluable disease per Lugano Classification

Absolute neutrophil count (ANC) >= 1000/mm^3

* Growth factor is not permitted within 14 days of ANC assessment unless cytopenia is secondary to disease involvement

Platelets >= 100,000/mm^3

* Platelet transfusions are not permitted within 14 days of platelet assessment unless cytopenia is secondary to disease involvement

Total serum bilirubin =< 2.2 mg/dL
Aspartate aminotransferase (AST) =< 2 x upper limit of normal (ULN)
Alanine aminotransferase (ALT) =< 2 x ULN
Creatinine clearance of >= 60 mL/min per the Cockcroft-Gault formula

If not receiving anticoagulants: international normalized ratio (INR) AND prothrombin (PT) =< 1.5 x ULN

* If on anticoagulant therapy: PT must be within therapeutic range of intended used of anticoagulants

Female of childbearing potential: negative urine or serum pregnancy test

* If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required

Female of child bearing potential: willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 90 days after the last dose of study medication

* Childbearing potential defined as not being surgically sterilized or have not been free from menses for > 1 year

Male: use an adequate method of contraception starting with the first dose of study therapy through 90 days after the last dose of study therapy

Exclusion Criteria:

Immunotherapy with immune checkpoint inhibitors, cell-based therapies, or cancer vaccines
Lenalidomide, thalidomide or other immunomodulatory drugs (IMiDs)
Monoclonal antibody within 5 half-lives of the antibody prior to initiating protocol therapy
Any systemic therapy, including monoclonal antibody within 28 days or 5 half-lives (whichever is shorter) of initiating protocol therapy
Any skin-directed therapy within 14 days prior to initiating protocol therapy
Any radiation therapy within 21 days prior to initiating protocol therapy

Immunosuppressive medication within 14 days prior to the first dose of study treatment; the following are exceptions to this criterion:

Intranasal, inhaled, topical or local steroid injections (e.g., intra-articular injection) and are on stable dose for at least 28 days
Systemic corticosteroids at physiologic doses of < 10 mg/day of prednisone or equivalent
Live, attenuated vaccine within 30 days prior to the first dose of protocol therapy
History of pneumonitis (non-infectious) that required steroids or current pneumonitis

Disease free of prior malignancies for >= 5 years with the exception of:

Currently treated squamous cell and basal cell carcinoma of the skin
Carcinoma in situ of the cervix, or
Surgically removed melanoma in situ of the skin (stage 0) with histological confirmed free margins of excision or
Prostate cancer (T1a or T1b using the TNM [tumor, nodes, metastasis] clinical staging system) that has/have been surgically cured, or
Any other malignancy that has/have been curatively treated with surgery and/or localized radiation
Allergic reaction/ hypersensitivity to thalidomide or to the excipients contained in the formulation of durvalumab
Female only: pregnant or lactating
Prior stem cell transplantation
Acute infection requiring systemic treatment
Known history of human immunodeficiency virus (HIV) infection
Active hepatitis B or C infection
Conditions requiring chronic steroid or immunosuppressive treatment that likely need additional steroid or immunosuppressive treatments in addition to the protocol therapy
Current peripheral neuropathy >= grade 2
Renal failure requiring hemodialysis or peritoneal dialysis

Unstable cardiac disease as defined by one of the following:

Cardiac events such as myocardial infarction (MI) within the past 6 months
NYHA (New York Heart Association) heart failure class III-IV
Uncontrolled atrial fibrillation or hypertension
Major surgery (as defined by the investigator) within the 28 days prior to the first dose of study treatment

Active or prior documented autoimmune or inflammatory disorders requiring therapy within the past 3 years prior to the start of treatment; the following are exceptions to this criterion:

Vitiligo or alopecia;
Hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement; or
Psoriasis not requiring systemic treatment
History of primary immunodeficiency
Incidence of gastrointestinal disease that may significantly alter the absorption of lenalidomide
Any other condition that would, in the investigator's judgement, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures, e.g., infection/inflammation, intestinal obstruction, unable to swallow medication, social/psychological issues, etc
In the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)