MedPath

Study of Bcl-2 Inhibitor Sonrotoclax (BGB-11417) in Participants With Mature B-Cell Malignancies

Phase 1
Active, not recruiting
Conditions
Mature B-Cell Malignancies
Interventions
Registration Number
NCT04277637
Lead Sponsor
BeiGene
Brief Summary

The purpose of this study is to determine the safety, tolerability; and to define the maximum tolerated dose (MTD) and Recommended Phase 2 Dose (RP2D); and to evaluate the safety and tolerability of the ramp-up dosing schedule and at the RP2D of BGB-11417 monotherapy, and when given in combination with zanubrutinib and obinutuzumab.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
437
Inclusion Criteria
  • Confirmed diagnosis of one of the following:

NHL Cohorts:

  1. MZL i. R/R extranodal, splenic, or nodal MZL defined as disease that relapsed after, or was refractory to, at least one prior therapy ii. Active disease requiring treatment

  2. FL i. R/R FL (Grade 1, 2 or 3a based on the WHO 2008 classification of tumors of hematopoietic and lymphoid tissue) and defined as disease that relapsed after, or was refractory to, at least 1 prior systemic therapy

  3. DLBCL i. R/R DLBCL (including all subtypes of DLBCL) defined as disease that relapsed after, or was refractory to, at least two prior systemic therapies and has either progressed following or is not a candidate for autologous stem cell transplant (due to comorbidities or non-responsiveness to salvage chemotherapy)

  4. Transformed indolent B-cell NHL i. Any lymphoma otherwise eligible for Part 1 that has transformed into a more aggressive lymphoma. Patients with transformation from CLL or SLL (Richter's transformation) are not eligible for Part 1

    CLL/SLL Cohorts:

  5. CLL/SLL diagnosis that meets the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) criteria i. Disease characterized as Treatment Naive (TN) or R/R disease defined as disease that relapsed after, or was refractory to, at least 1 prior therapy ii. Requiring treatment as defined by history

    MCL cohorts:

  6. WHO-defined MCL i. R/R MCL defined as disease that relapsed after, or was refractory to, at least 1 prior systemic therapy; ii. Requiring treatment in the opinion of the investigator

WM cohorts:

g. WHO-defined WM (clinical and definitive histologic diagnosis) i. R/R disease defined as disease that relapsed after, or was refractory to, at least 1 prior therapy; ii. Meeting at least 1 criterion for treatment according to consensus panel criteria from the Seventh International Workshop on Waldenström's Macroglobulinemia (Dimopoulos et al 2014)

  • Measurable disease by computed tomography (CT)/magnetic resonance imaging (MRI), defined as:

    1. CLL: at least 1 lymph node > 1.5 cm in longest diameter and measurable in 2 perpendicular dimensions or clonal lymphocytes measured by flow cytometry
    2. DLBCL, FL, MZL, MCL, or SLL: at least 1 lymph node > 1.5 cm in longest diameter OR 1 extranodal lesion > 1.0 cm in the longest diameter, measurable in at least 2 perpendicular dimensions. For MZL, isolated splenomegaly is considered measurable for this study
    3. WM: serum immunoglobulin (Ig) M level > 0.5 g/dL
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2

  • Adequate organ function

  • Adequate pancreatic function indicated by:

    1. Serum amylase ≤ 1.5 x upper limit of normal (ULN)
    2. Serum lipase ≤ 1.5 x ULN

Key

Exclusion Criteria
  • Known current central nervous system involvement by lymphoma/leukemia
  • Known plasma cell neoplasm, prolymphocytic leukemia, history of or currently suspected Richter's syndrome
  • Prior therapy ≥ 2 months with or progression on a B-cell lymphoma-2 (Bcl-2) inhibitor

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sonrotoclax Monotherapy Dose Finding: Part 1SonrotoclaxParticipants with relapsed/refractory (R/R) non-Hodgkin lymphoma (NHL) including follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), marginal zone lymphoma (MZL) or transformed NHL, mantle cell lymphoma (MCL); Waldenströms macroglobulinemia (WM); and chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) will receive oral sonrotoclax evaluated as monotherapy.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Finding: Part 3ZanubrutinibParticipants with R/R MCL, R/R or treatment-naïve (TN) CLL/SLL will receive oral sonrotoclax in combination with zanubrutinib.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Expansion: Part 4ZanubrutinibParticipants with R/R indolent NHL including FL, MZL; aggressive NHL including DLBCL, transformed NHL; R/R MCL; R/R or treatment-naïve (TN) CLL/SLL will receive oral sonrotoclax in combination with zanubrutinib at an RP2D dose to further define the safety profile.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Escalation: Part 5SonrotoclaxParticipants with treatment naïve CLL/SLL will receive oral sonrotoclax in combination with obinutuzumab without and with zanubrutinib.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Escalation: Part 5ZanubrutinibParticipants with treatment naïve CLL/SLL will receive oral sonrotoclax in combination with obinutuzumab without and with zanubrutinib.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Escalation: Part 5ObinutuzumabParticipants with treatment naïve CLL/SLL will receive oral sonrotoclax in combination with obinutuzumab without and with zanubrutinib.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Expansion: Part 6ZanubrutinibParticipants with treatment naïve CLL/SLL will receive oral sonrotoclax in combination with obinutuzumab without and with zanubrutinib at an RP2D dose to further define the safety profile.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Expansion: Part 6ObinutuzumabParticipants with treatment naïve CLL/SLL will receive oral sonrotoclax in combination with obinutuzumab without and with zanubrutinib at an RP2D dose to further define the safety profile.
Sonrotoclax Monotherapy Expansion Cohorts: Part 2SonrotoclaxParticipants with R/R indolent NHL including FL, MZL; aggressive NHL including DLBCL, transformed NHL; CLL/SLL with low tumor burden or low creatine clearance; CLL/SLL with without high tumor burden or low creatine clearance will receive oral sonrotoclax at the RP2D dose to further define the safety profile.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Finding: Part 3SonrotoclaxParticipants with R/R MCL, R/R or treatment-naïve (TN) CLL/SLL will receive oral sonrotoclax in combination with zanubrutinib.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Expansion: Part 4SonrotoclaxParticipants with R/R indolent NHL including FL, MZL; aggressive NHL including DLBCL, transformed NHL; R/R MCL; R/R or treatment-naïve (TN) CLL/SLL will receive oral sonrotoclax in combination with zanubrutinib at an RP2D dose to further define the safety profile.
Sonrotoclax + Zanubrutinib Combination Therapy Dose Expansion: Part 6SonrotoclaxParticipants with treatment naïve CLL/SLL will receive oral sonrotoclax in combination with obinutuzumab without and with zanubrutinib at an RP2D dose to further define the safety profile.
Primary Outcome Measures
NameTimeMethod
Number of Participants Experiencing Treatment Emergent Adverse Events (TEAEs)Up to 30 days after the last dose of study drug, an average of 18 months
Number of Participants Experiencing Serious Adverse Events (SAEs)Up to 30 days after the last dose of study drug, an average of 18 months
Number of Participants Experiencing Adverse Events (AEs) leading to discontinuation of SonrotoclaxUp to 30 days after the last dose of study drug, an average of 18 months
Part 1, Part 3: Maximum Tolerated Dose (MTD) of SonrotoclaxUp to approximately 2 months
Part 1, Part 3, Part 5: RP2D of SonrotoclaxDay 1 to last dose of study drug, an average of 18 months
Part 1, Part 3, Part 5: Number of participants experiencing tumor lysis syndrome (TLS) relevant eventsUp to 30 days after the last dose of study drug, an average of 18 months
Part 1, Part 3, Part 5: Number of Participants Experiencing Dose-Limiting Toxicities (DLTsUp to approximately 2 months
Secondary Outcome Measures
NameTimeMethod
Maximum Observed Plasma Concentration (Cmax) After a Single Dose of SonrotoclaxPredose up to 12 hours postdose
Area Under the Concentration-Time Curve from Time 0 to the Last Quantifiable Concentration (AUC0-last) After a Single Dose of SonrotoclaxPredose up to 12 hours postdose
Area Under the Concentration-Time Curve from Time 0 to Infinity (AUC0-∞) After a Single Dose of SonrotoclaxPredose up to 12 hours postdose
Time Taken for Half the Initial Dose Administered to Be Eliminated from The Body (T1/2) of SonrotoclaxPredose up to 12 hours postdose
Time to Maximum Plasma Concentration (Tmax) After a Single Dose of SonrotoclaxPredose up to 12 hours postdose
Apparent Clearance (CL/F) After a Single Dose of SonrotoclaxPredose up to 12 hours postdose
Apparent volume of distribution (Vz/F) After a Single Dose of SonrotoclaxPredose up to 12 hours postdose
Steady State Area Under the Concentration-Time Curve of 0 - Last Day (AUCLast, ss) of SonrotoclaxPredose up to 12 hours postdose
Part 3, Part 4: Steady State Area Under the Concentration-Time Curve of 0 - Last Day (AUCLast, ss) of zanubrutinibPredose up to 12 hours postdose
Steady State Maximum Observed Plasma Concentration (Cmax, ss) of SonrotoclaxPredose up to 12 hours postdose
Part 3, Part 4: Steady State Maximum Observed Plasma Concentration (Cmax, ss) of zanubrutinibPredose up to 12 hours postdose
Steady State Trough Observed Plasma Concentration (Ctrough, ss) of SonrotoclaxPredose up to 12 hours postdose
Part 3, Part 4: Steady State Trough Observed Plasma Concentration (Ctrough, ss) of zanubrutinibPredose up to 12 hours postdose
Steady State Time to Maximum Plasma Concentration (Tmax, ss) of SonrotoclaxPredose up to 12 hours postdose
Part 3, Part 4: Steady State Time to Maximum Plasma Concentration (Tmax, ss) of zanubrutinibPredose up to 12 hours postdose
Part 2: AUC of Sonrotoclax administered after a high fat/calorie meal (HF-Fed)Predose up to 12 hours postdose
Part 2: Cmax of Sonrotoclax administered after a high fat/calorie meal (HF-Fed)Predose up to 12 hours postdose
Part 2, Part 4, Part 6: Overall Response Rate (ORR) as Assessed by the InvestigatorUp to 18 months

ORR is defined as the proportion of participants who had confirmed complete response Complete Response (CR) or Partial Response (PR)

Part 2: Major Response Rate (MRR) for WM as Assessed by the InvestigatorUp to 18 months
Part 6: Minimum residual disease (MRD) negativity as measured by next generation sequencingUp to 18 months

Trial Locations

Locations (44)

UCLA Hematologyoncology

🇺🇸

Los Angeles, California, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

University of Kansas Medical Center Research Institute

🇺🇸

Kansas City, Kansas, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Mayo Clinic Rochester

🇺🇸

Rochester, Minnesota, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

John Theurer Cancer Center Hackensack University Medical Center

🇺🇸

Hackensack, New Jersey, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Memorial Sloan Kettering Cancer Center Mskcc

🇺🇸

New York, New York, United States

The James Cancer Hospital and Solove Research Institute At Ohio State University

🇺🇸

Columbus, Ohio, United States

Upmc Hillman Cancer Center(Univ of Pittsburgh)

🇺🇸

Pittsburgh, Pennsylvania, United States

Md Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Fred Hutchinson Cancer Research Center

🇺🇸

Seattle, Washington, United States

Concord Repatriation General Hospital

🇦🇺

Concord, New South Wales, Australia

Orange Health Service (Central West Cancer Care Centre)

🇦🇺

Orange, New South Wales, Australia

Pindara Private Hospital

🇦🇺

Benowa, Queensland, Australia

John Flynn Private Hospital

🇦🇺

Tugun, Queensland, Australia

Royal Adelaide Hospital

🇦🇺

Adelaide, South Australia, Australia

Flinders Medical Centre

🇦🇺

Bedford PK, South Australia, Australia

Box Hill Hospital

🇦🇺

Box Hill, Victoria, Australia

Monash Health

🇦🇺

Clayton, Victoria, Australia

St Vincents Hospital Melbourne

🇦🇺

Fitzroy, Victoria, Australia

Peter Maccallum Cancer Centre

🇦🇺

Melbourne, Victoria, Australia

The Alfred Hospital

🇦🇺

Melbourne, Victoria, Australia

Linear Clinical Research

🇦🇺

Nedlands, Western Australia, Australia

Universitatsklinikum Carl Gustav Carus An Der Technischen Universitat Dresden

🇩🇪

Dresden, Germany

Ospedale San Raffaele

🇮🇹

Milano, Italy

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda

🇮🇹

Milano, Italy

Ospedale Santa Maria Della Misericordia

🇮🇹

Perugia, Italy

Azienda Unita Sanitaria Locale Di Ravenna

🇮🇹

Ravenna, Italy

Fondazione Policlinico Universitario Agostino Gemelli

🇮🇹

Roma, Italy

Centroricerche Cliniche Di Verona Srl

🇮🇹

Verona, Italy

Auckland City Hospital

🇳🇿

Auckland, New Zealand

North Shore Hospital

🇳🇿

Takapuna, New Zealand

Wellington Regional Hospital (Ccdhb)

🇳🇿

Wellington, New Zealand

Hospital de La Santa Creu I Sant Pau

🇪🇸

Barcelona, Spain

Vall D Hebron Institute of Oncology Vhio

🇪🇸

Barcelona, Spain

Ico H Duran I Reynals

🇪🇸

Barcelona, Spain

Hospital Clinic de Barcelona

🇪🇸

Barcelona, Spain

Start Madrid Fundacion Jimenez Diaz

🇪🇸

Madrid, Spain

Clinica Universidad de Navarra Pamplona

🇪🇸

Pamplona, Spain

Hospital Universitario de Salamanca

🇪🇸

Salamanca, Spain

Hospital Universitario Marques de Valdecilla

🇪🇸

Santander, Spain

The Leeds Teaching Hospitals Nhs Trust

🇬🇧

Leeds, United Kingdom

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