Orelabrutinib Combined With Obinutuzumab as First-line Treatment for Marginal Zone Lymphoma：a Prospective Single Arm Trial
Overview
- Phase
- Phase 2
- Intervention
- Orelabrutinib and obinutuzumab
- Conditions
- Marginal Zone Lymphoma
- Sponsor
- Institute of Hematology & Blood Diseases Hospital, China
- Enrollment
- 45
- Locations
- 1
- Primary Endpoint
- the complete response rate
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
This is a prospective single arm phase II study, and the purpose of this study is to evaluate the safety and efficacy of orelabrutinib combined with obinutuzumab a in untreated marginal zone lymphoma. It is planned to recruit 45 patients. The primary endpoint is the complete remission rate at 12 months.
Detailed Description
Marginal zone lymphomas (MZL) are a type of lymphoma that originates from the marginal zone tissue of the lymphoid follicles (Mucosa-associated lymphoid tissue, MALT), and include three subtypes: MALT lymphoma, nodal MZL, and splenic MZL. For patients with marginal zone lymphoma who have indications for systemic anti-tumor treatment, therapeutic options include rituximab monotherapy or more intensive immunochemotherapy regimens in combination with bendamustine, chlorambucil, CHOP regimen (cyclophosphamide, vincristine, doxorubicin, prednisone), etc. This is a prospective, phase II, single-arm clinical study to initially explore the efficacy and safety of Orelabrutinib combined with obinutuzumab in patients with previously untreated marginal zone lymphoma. The patients will be treated with 6 cycles of OG regimen. Patients with CR/PR after 6 cycles of OG treatment will be treated with 18 cycles of single-agent orelabrutinib regimen.
Investigators
Eligibility Criteria
Inclusion Criteria
- •• Age ≥18 years, gender unrestricted;
- •Histopathologically confirmed CD20-positive marginal zone lymphoma including MALT, SMZL, NMZL;
- •MZL that has progressed, recurred, or is unsuitable for local treatment after previous local therapy (local treatments include surgery, radiotherapy, Helicobacter pylori treatment, hepatitis C treatment);
- •ECOG performance status score of 0-
- •Major organ functions meet the following criteria: a) Complete blood count: Absolute neutrophil count ≥1.5×10\^9/L, platelets ≥75×10\^9/L, hemoglobin ≥75g/L; if accompanied by bone marrow involvement, absolute neutrophil count ≥1.0×10\^9/L, platelets ≥50×10\^9/L, hemoglobin ≥50g/L; b) Blood biochemistry: Total bilirubin ≤1.5 times the upper limit of normal (ULN), AST or ALT ≤2 times ULN; serum creatinine ≤1.5 times ULN; serum amylase ≤ULN; c) Coagulation function: International normalized ratio (INR) ≤1.5 times ULN.
- •Life expectancy ≥3 months;
- •Voluntarily sign a written informed consent form before the trial screening.
Exclusion Criteria
- •Currently or previously having other malignant tumors, unless radical treatment has been performed and there is evidence of no recurrence or metastasis within the last 5 years;
- •Lymphoma involving the central nervous system or transforming into a higher grade;
- •Having uncontrollable or significant cardiovascular diseases, including: a) New York Heart Association (NYHA) class II or above congestive heart failure, unstable angina, myocardial infarction within 6 months before the first administration of the study drug, or arrhythmias requiring treatment at the time of screening, with a left ventricular ejection fraction (LVEF) \<50%; b) Primary cardiomyopathy (such as dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, restrictive cardiomyopathy, unclassified cardiomyopathy); c) A history of clinically significant QTc interval prolongation, or a QTc interval \>470ms in females and \>450ms in males during the screening period; d) Subjects with symptomatic or medication-requiring coronary artery heart disease; e) Subjects with difficult-to-control hypertension (despite lifestyle improvements and the use of reasonable, tolerable, and adequate doses of one or three or more antihypertensive drugs \[including diuretics\] for more than 1 month, blood pressure is still not at the standard, or it is only effectively controlled when taking four or more antihypertensive drugs).
- •Active bleeding within 2 months before screening, or currently taking anticoagulant drugs, or the investigator believes there is a definite bleeding tendency;
- •Active infection or uncontrolled HBV (positive for HBsAg and/or HBcAb with positive HBV DNA titer), positive for HCV Ab, HIV/AIDS, or other serious infectious diseases.
- •Any other conditions deemed unsuitable for participation in this trial by the investigator.
Arms & Interventions
OG
6 cycles of OG regimen. Patients with CR/PR after 6 cycles of OG treatment will be treated with 18 cycles of single-agent orelabrutinib regimen. Orelabrutinib 150mg QD
Intervention: Orelabrutinib and obinutuzumab
Outcomes
Primary Outcomes
the complete response rate
Time Frame: At 12 months.
CRR is defined as the proportion of patients with a response of CR
Secondary Outcomes
- ORR(At 12 months.)
- 2 years progression-free survival(From date of signing the informed consent until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 2 years)
- 2 years overall survival(From date of signing the informed consent until the date of death from any cause, whichever came first, assessed up to 2 years])
- CRR(At the end of induction therapy(6cycles). 28days/cycle)
- BOR(At 12 months.)
- Duration of Response (DOR)(Up to 2 years)
- The occurrence of adverse events and serious adverse events(One month after discontinuation of treatment)
- TTR(Up to 2 years)