Zanubrutinib (BGB-3111) in Participants With Previously Treated B-Cell Lymphoma Intolerant of Prior Bruton Tyrosine Kinase Inhibitor (BTKi) Treatment

Phase 2

Active, not recruiting

• Conditions: Marginal Zone Lymphoma; Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma; Mantle Cell Lymphoma; Waldenstrom Macroglobulinemia
• Interventions: Drug: Zanubrutinib

• Registration Number: NCT04116437
• Lead Sponsor: BeiGene

Brief Summary

The primary objective of this study is to evaluate the safety of zanubrutinib (also known as BGB-3111) in chronic lymphocytic leukemia/small lymphocytic lymphoma, Waldenström macroglobulinemia, mantle cell lymphoma, or marginal zone lymphoma patients who have become intolerant of prior ibrutinib and/or acalabrutinib treatment, by comparing intolerance to adverse event profile as assessed by the recurrence and the change in severity of adverse events.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2019-10-01
• Study First Submitted QC: 2019-10-02
• Study First Posted: 2019-10-04
• Study Start: 2019-10-15
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-29
• Last Update Posted: 2025-05-01
• Primary Completion: 2025-10
• Study Completion: 2025-10

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

1. Participants must meet protocol defined disease criteria requiring treatment for their respective disease prior to initiation of ibrutinib or acalabrutinib

2. Ibrutinib and acalabrutinib intolerance is defined as an unacceptable toxicity where, in the opinion of the investigator, treatment should be discontinued in spite of optimal supportive care as a result of one of the following:

   1. For ibrutinib and acalabrutinib intolerance events:

      • 1 or more ≥ Grade 2 nonhematologic toxicities for >7 days (with or without treatment)
      • 1 or more ≥ Grade 3 nonhematologic toxicity of any duration
      • 1 or more Grade 3 neutropenia with infection or fever of any duration; or
      • Grade 4 heme toxicity which persists to the point that the investigator chose to stop therapy due to toxicity NOT progression.

   2. For acalabrutinib intolerance events only;

      • 1 or more ≥ Grade 1 nonhematologic toxicities of any duration with > 3 recurrent episodes; or
      • 1 or more ≥ Grade 1 nonhematologic toxicities for > 7 days (with or without treatment); or
      • Inability to use acid-reducing agents or anticoagulants (eg, proton pump inhibitors, warfarin) due to concurrent acalabrutinib use

3. Ibrutinib and/or acalabrutinib-related ≥ Grade 2 toxicities must have resolved to ≤ Grade 1 or baseline prior to initiating treatment with zanubrutinib. Grade 1 acalabrutinib-related toxicities must have resolved to Grade 0 or baseline prior to initiating treatment with zanubrutinib.

4. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2

5. Absolute neutrophil count (ANC) ≥ 1000/mm^3 with or without growth factor support and platelet count ≥ 50,000/mm^3 (may be post-transfusion), on or prior to C1D1 of zanubrutinib

Key

Exclusion Criteria

1. Clinically significant cardiovascular disease including the following:

   1. Myocardial infarction within 6 months before the Screening
   2. Unstable angina within 3 months before the Screening
   3. New York Heart Association class III or IV congestive heart failure
   4. History of sustained ventricular tachycardia, ventricular fibrillation, and/or Torsades de Pointes
   5. QT interval corrected by Fridericia's formula > 480 milliseconds
   6. History of Mobitz II second-degree or third-degree heart block without a permanent pacemaker in place

2. History of central nervous system (CNS) hemorrhage

3. Documented progressive disease (PD) during ibrutinib and/or acalabrutinib treatment.

4. Have received any anticancer therapy (other than immunotherapy) for CLL/SLL, WM, MCL, and MZL < 7 days before any Screening assessments are performed or any immunotherapy treatment, taken alone or as part of a chemoimmunotherapy regimen, < 4 weeks before any Screening assessments are performed

5. Requires ongoing need for corticosteroid treatment > 10 mg daily of prednisone or equivalent corticosteroid. Note: Systemic corticosteroids must be fully tapered off/discontinued ≥ 5 days before the first dose of study drug is administered.

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Zanubrutinib	Zanubrutinib	Cohort 1: Chronic lymphocytic leukemia (CLL)/ small lymphocytic lymphoma (SLL), Waldenström macroglobulinemia (WM), mantle cell lymphoma (MCL), or marginal zone lymphoma (MZL) previously treated with ibrutinib Cohort 2: Chronic lymphocytic leukemia (CLL)/ small lymphocytic lymphoma (SLL), Waldenström macroglobulinemia (WM), mantle cell lymphoma (MCL), or marginal zone lymphoma (MZL) previously treated with acalabrutinib alone/with ibrutinib

Primary Outcome Measures

Name	Time	Method
Recurrence and change in severity of treatment-emergent Adverse Events (AEs) of interest.	24 months

Secondary Outcome Measures

Name	Time	Method
Overall response as determined by investigator	24 months
Progression free survival (PFS) as determined by investigator	24 months
Patient reported outcomes as measured by EuroQol five dimension scale (EQ-5D)	24 months
Patient reported outcomes as measured by European Organisation for Research and Treatment of Cancer (EORTC)	24 months
Disease control rate as determined by investigator	24 months

Trial Locations

Locations (24)

Rocky Mountain Cancer Centers (Williams) Usor; 🇺🇸 Aurora, Colorado, United States

Christiana Care; 🇺🇸 Newark, Delaware, United States

Scri Florida Cancer Specialists South; 🇺🇸 Fort Myers, Florida, United States

St Century Oncology; 🇺🇸 Jacksonville, Florida, United States

Scri Florida Cancer Specialists North; 🇺🇸 Saint Petersburg, Florida, United States

Healthcare Research Network Iii, Llc; 🇺🇸 Flossmoor, Illinois, United States

Minnesota Oncology Burnsville Clinic; 🇺🇸 Burnsville, Minnesota, United States

Comprehensive Cancer Centers of Nevada; 🇺🇸 Las Vegas, Nevada, United States

Summit Medical Group; 🇺🇸 Florham Park, New Jersey, United States

Morristown Medical Center; 🇺🇸 Morristown, New Jersey, United States

Clinical Research Alliance, Inc; 🇺🇸 Westbury, New York, United States

Oncology Associates of Oregon Willamette Valley Cancer Center; 🇺🇸 Eugene, Oregon, United States

St Lukes University Health Network; 🇺🇸 Fountain Hill, Pennsylvania, United States

Abington Hematology Oncology Associates; 🇺🇸 Horsham, Pennsylvania, United States

Tennessee Oncology, Pllc Nashville; 🇺🇸 Nashville, Tennessee, United States

Texas Oncology Amarillo; 🇺🇸 Amarillo, Texas, United States

Texas Oncology Tyler Longview; 🇺🇸 Austin, Texas, United States

Baylor Research Institute; 🇺🇸 Dallas, Texas, United States

Texas Oncology McAllen South Second Street; 🇺🇸 McAllen, Texas, United States

Us Oncology Virginia Cancer Specialists, Pc; 🇺🇸 Fairfax, Virginia, United States

Virginia Oncology Associates Hampton; 🇺🇸 Virginia Beach, Virginia, United States

Fred Hutchinson Cancer Research Center; 🇺🇸 Seattle, Washington, United States

Medical Oncology Associates; 🇺🇸 Spokane, Washington, United States

Ssm Health Cancer Care Dean Medical Center; 🇺🇸 Madison, Wisconsin, United States