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A Study to Investigate Progression-Free Survival With Sonrotoclax Plus Obinutuzumab Or Sonrotoclax Plus Rituximab Compared With Venetoclax Plus Rituximab Treatment In Patients With Relapsed and/or Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CELESTIAL-RRCLL)

Phase 3
Not yet recruiting
Conditions
Chronic Lymphocytic Leukemia
Small Lymphocytic Lymphoma
Interventions
Registration Number
NCT06943872
Lead Sponsor
BeiGene
Brief Summary

The goal of this study is to compare how well sonrotoclax plus obinutuzumab works versus venetoclax plus rituximab in treating adults with relapsed and/or refractory (R/R) chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The study will also compare how well sonrotoclax plus rituximab works versus venetoclax plus rituxumab in treating adults with R/R CLL/SLL. The safety of these treatments will also be assessed.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
630
Inclusion Criteria
  • Confirmed diagnosis of CLL/SLL that meets the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria
  • Received one or more prior therapies for CLL/SLL. For each line of therapy, participants must have received at least 2 cycles of the therapy
  • Participants with prior BCL2i exposure are eligible if remission duration was ≥3 years with ≥2 years from last BCL2i intake
  • Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0, 1, or 2
  • Adequate organ function
Exclusion Criteria
  • Known active prolymphocytic leukemia or currently suspected Richter's transformation
  • Prior autologous stem cell transplantation or chimeric antigen receptor T-cell therapy within 3 months before first dose of study drug
  • Prior allogeneic stem cell transplant with active graft-versus-host disease (GVHD), requiring immunosuppressive drugs for treatment of GVHD, or have taken calcineurin inhibitors within 4 weeks prior to consent
  • Known central nervous system involvement by CLL/SLL
  • Severe or debilitating pulmonary disease
  • Clinically significant cardiovascular disease

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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm A: Sonrotoclax plus ObinutuzumabSonrotoclaxSonrotoclax and obinutuzumab will be administered in combination.
Arm A: Sonrotoclax plus ObinutuzumabObinutuzumabSonrotoclax and obinutuzumab will be administered in combination.
Arm B: Sonrotoclax plus RituximabSonrotoclaxSonrotoclax and rituximab will be administered in combination.
Arm B: Sonrotoclax plus RituximabRituximabSonrotoclax and rituximab will be administered in combination.
Arm C: Sonrotoclax plus Obinutuzumab (MRD)SonrotoclaxSonrotoclax and obinutuzumab will be administered in combination with treatment guided by evaluation of minimal residual disease (MRD).
Arm C: Sonrotoclax plus Obinutuzumab (MRD)ObinutuzumabSonrotoclax and obinutuzumab will be administered in combination with treatment guided by evaluation of minimal residual disease (MRD).
Arm D: Venetoclax plus RituximabVenetoclaxVenetoclax and rituximab will be administered in combination.
Arm D: Venetoclax plus RituximabRituximabVenetoclax and rituximab will be administered in combination.
Primary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) as assessed by Blinded Independent Review Committee (BIRC) for Arm A versus Arm DUp to approximately 51 months

PFS is defined as the time from randomization to the date of progression or death, whichever occurs first.

Secondary Outcome Measures
NameTimeMethod
Progression-Free Survival (PFS) as assessed by BIRC for Arm B versus Arm DUp to approximately 69 months

PFS is defined as the time from randomization to the date of progression or death, whichever occurs first.

Rate of uMRD4 for Arm A versus Arm DUp to approximately 25 months

The rate of uMRD4 in peripheral blood based on NGS

PFS per Investigator Assessment (INV) for Arm B versus Arm DUp to approximately 69 months

PFS is defined as the time from randomization to the date of progression or death, whichever occurs first.

CRR per BIRC and by INV for Arm B versus Arm DUp to approximately 25 months

CRR is defined as the percentage of participants that achieve a best response of CR or CRi

OS for Arm B versus Arm DUp to approximately 84 months

OS is defined as the time from the date of randomization to the date of death

Rate of uMRD4 for Arm B versus Arm DUp to approximately 25 months

The rate of uMRD4 in peripheral blood based on NGS

PFS per BIRC and by INV for Arm A versus Arm BUp to approximately 69 months

PFS is defined as the time from randomization to the date of progression or death, whichever occurs first.

OS for Arm A versus Arm BUp to approximately 84 months

OS is defined as the time from the date of randomization to the date of death

CRR per BIRC and by INV for Arm A versus Arm BUp to approximately 25 months

CRR is defined as the percentage of participants that achieve a best response of CR or CRi

CRR per INV for Arm A versus Arm DUp to approximately 25 months

CRR is defined as the percentage of participants that achieve a best response of CR or CRi

PFS per INV for Arm A versus Arm DUp to approximately 51 months

PFS is defined as the time from randomization to the date of progression or death, whichever occurs first.

PFS per INV for Arm C versus Arm DUp to approximately 69 months

PFS is defined as the time from randomization to the date of progression or death, whichever occurs first.

CRR per INV for Arm C versus Arm DUp to approximately 25 months

CRR is defined as the percentage of participants that achieve a best response of CR or CRi

OS for Arm C versus Arm DUp to approximately 84 months

OS is defined as the time from the date of randomization to the date of death

Rate of uMRD4 for Arm C versus Arm DUp to approximately 25 months

The rate of uMRD4 in peripheral blood based on NGS

Overall Response Rate (ORR) per BIRC and by INVUp to approximately 25 months

ORR is defined as the percentage of participants that achieve a best response of partial response (PR) or better

Time to Response (TTR) per BIRC and by INVUp to approximately 25 months

TTR is defined as the time from the date of randomization to the date response criteria were first met

Time to Next Anti-CLL/SLL Treatment (TTNT)Up to approximately 84 months

TTNT is defined as the time from the date of randomization to the date of next anti-CLL/SLL treatment

Rate of uMRD4Up to approximately 25 months

The rate of uMRD4 in peripheral blood based on NGS

Change from Baseline in the European Organisation of Research and Treatment of Cancer-Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) Global Health Status/Quality of Life and Physical Functioning ScalesBaseline and up to approximately 69 months

The EORTC QLQ-30 contains 30 questions that incorporate 5 functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). The participant answers questions about their health during the past week. There are 28 questions answered on a 4-point scale where 1 =Not at all (best) to 4 =Very Much (worst) and 2 questions answered on a 7-point scale where 1 =Very poor (worst) to 7 =Excellent (best). Higher scores in global health status (GHS) and functional scales indicate better health-related quality of life (HRQoL).

Change from Baseline in EORTC QLQ for Chronic Lymphocytic Leukemia (EORTC QLQ-CLL17) Symptom Burden and Fatigue ScalesBaseline and up to approximately 69 months

The EORTC QLQ-CLL17 is the CLL module of QLQ-C30 consisting of 17 items and comprising 3 scales: symptom burden due to disease and/or treatment (6 items), physical condition/fatigue (4 items), and worries/fears about health and functioning (7 items) Items are rated using a 4-point response scale ("not at all," "a little," "quite a bit," and "very much") and the recall period for all items is the past 7 days. Lower scores indicate better HRQoL.

Number of Participants with Treatment-Emergent Adverse Events (TEAEs)From the first dose of study drug(s) to 30 days after the last dose of sonrotoclax or venetoclax, or 90 days after the last dose of obinutuzumab or rituximab; up to approximately 26 months

Number of participants with TEAEs, including laboratory values, vital signs, and physical examination findings, graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0.

Duration of Response (DOR) per BIRC and by INVUp to approximately 69 months

DOR is defined as the time from the date that response criteria were first met to the date of first documentation of disease progression or death, whichever occurs first

Complete Response Rate as assessed by BIRC for Arm A versus Arm DUp to approximately 25 months

Complete Response Rate (CRR) is defined as the percentage of participants that achieve a best response of complete response (CR) or complete response with incomplete hematopoietic recovery (CRi)

Overall Survival for Arm A versus Arm DUp to approximately 84 months

Overall survival (OS) is defined as the time from the date of randomization to the date of death

Rate of uMRD4 for Arm A versus Arm BUp to approximately 25 months

The rate of uMRD4 in peripheral blood based on NGS

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