A phase II trial of belimumab in combination with rituximab/venetoclax in patients with refractory or relapsed chronic lymphocytic leukemia
- Conditions
- refractory or relapsed chronic lymphocytic leukemiaMedDRA version: 21.0Level: LLTClassification code: 10008976Term: Chronic lymphocytic leukemia Class: 10029104Therapeutic area: Diseases [C] - Hemic and Lymphatic Diseases [C15]
- Registration Number
- CTIS2024-511474-68-00
- Lead Sponsor
- niversitaetsklinikum Tuebingen AöR
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- All
- Target Recruitment
- 120
Male or female =18 years of age., Eastern Cooperative Oncology Group [ECOG] < 3., Diagnosis of CLL/SLL established according to iwCLL criteria, Refractory or relapsed CLL that warrants treatment (according to modified criteria for initiation of therapy (Hallek et al., 2018)), CLL relapsing after any line of treatment that included radiotherapy, chemotherapy, immunotherapy, or small molecules. Patients who relapse after a previous therapy with venetoclax can be included in the study in case of a late relapse (i.e. >18 months after venetoclax was discontinued., Discontinuation of all therapy (including radiotherapy, chemotherapy, immunotherapy, or small molecules) for the treatment of CLL =2 weeks before study treatment excluding systemic corticosteroids for symptomatic control., All acute toxic effects of any prior antitumor therapy resolved to Grade =1 before treatment (with the exception of alopecia [Grade 1 or 2 permitted], neurotoxicity [Grade 1 or 2 permitted], or bone marrow parameters [any of Grade 1, 2, 3, or 4 permitted])., Required baseline laboratory data (within 4 weeks prior to treatment), Negative serological Hepatitis B and C test or negative PCR in case of positive serological test without evidence of an active infection, negative HIV test within 6 weeks prior to treatment., Written informed consent of the subject
(Suspicion of) transformation of CLL (i.e. Richter’s transformation, pro-lymphocytic leukemia) or central nervous system (CNS) involvement, History of prior allogeneic bone marrow or organ transplantation., Ongoing immunosuppressive therapy. Subjects may use topical, enteric, or inhaled corticosteroids as therapy for comorbidities and systemic steroids for autoimmune anemia and/or thrombocytopenia. Ongoing use of low-dose systemic corticosteroids (=5 mg/day of methylprednisolone or equivalent) for rheumatologic conditions is permitted., History of primary immunodeficiency, Concurrent participation in another therapeutic clinical trial., History of serious suicide risk including any suicidal behaviour in the last 6 months, Live vaccination 30 days prior to treatment., Hypersensitivity known from medical history to one of the drugs used or their ingredients or to drugs with a similar chemical structure, Simultaneous participation in another interventional clinical trial (including within the last 4 weeks before inclusion), Addictions or other illnesses that do not allow the person concerned to assess the nature and extent of the clinical trial and its possible consequences, Pregnant or breastfeeding women, Early relapse (i.e <18 months) after any line of treatment that included venetoclax., Women of childbearing potential, except women who meet the following criteria: A.) post-menopausal (12 months natural amenorrhoea or 6 months amenorrhoea with serum FSH > 40 U/ml) B.) postoperative (6 weeks after bilateral ovarectomy with or without hysterectomy) C.) regular and correct use of a contraceptive method with a Pearl Index < 1% per year, which will have to be continued for up to four months after the discontinuation of the study drug D.) sexual abstinence E.) Vasectomy of the partner, Male subjects who are able to father a child, except men who meet the following criteria: a. willingness to abstain from heterosexual intercourse or use a protocol-recommended method contraception from the screening visit throughout the study treatment period and for four months following the last dose of study drug b. refrain from sperm donation from screening visit throughout the study treatment period and for 90 days following the last dose of study drug., Indications that the subject is unlikely to adhere to the protocol (e.g., lack of compliance), IgG < 4 g/L under substitution of immunoglobulins, Malignancies other than CLL currently requiring systemic therapies, Evidence of active systemic bacterial (e.g. tuberculosis), fungal, or viral infection (e.g., CMV) at the time of initiation of therapy., Confirmed progressive multifocal leukencephalopathy (PML), Known history of drug-induced liver injury (DILI), chronic/active hepatitis C (HCV), chronic/active hepatitis B (HBV)., Requirement of therapy with strong CYP3A4 inhibitors/ inducers or anticoagulant with phenprocoumon (marcumar) or other vitamin Kantagonists, Active inflammatory bowel disease.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: To assess efficacy (MRD response) of belimumab in combination with rituximab/venetoclax in CLL compared to treatment with rituximab/venetoclax alone.;Secondary Objective: To assess safety of belimumab and rituximab/venetoclax in patients with relapsed or refractory CLL, To evaluate overall response rate (ORR), To evaluate progression free survival (PFS), To evaluate overall survival (OS), To assess further efficacy markers of belimumab in combination with rituximab/venetoclax in CLL compared to control, To evaluate duration of response (DOR), Pharmacokinetics of belimumab in CLL patients;Primary end point(s): Negativity rate of minimal residual disease (MRD) in peripheral blood (PB) measured by flow cytometry at EOI
- Secondary Outcome Measures
Name Time Method