A multicenter, phase 2 randomized, open label study to evaluate the efficacy and security of zanubrutinib in combination with obinutuzumab in previously untreated patients with Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL) (GELLC-10-ZANUBIO)
- Conditions
- Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL)Therapeutic area: Diseases [C] - Hemic and Lymphatic Diseases [C15]
- Registration Number
- CTIS2023-504647-14-00
- Lead Sponsor
- Pethema Fundacion
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Recruiting
- Sex
- All
- Target Recruitment
- 106
Patients with treatment-naïve chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). 1. Adult patients with previously untreated CLL defined following IWCLL criteria., Must understand and voluntarily sign an informed consent form., Age = 18 years at the time of signing the informed consent form and must be able to adhere to the study visit schedule and other protocol requirements., Must have a documented diagnosis of CLL or SLL [IWCLL guidelines for diagnosis and treatment of CLL] meeting at least one of the following criteria: • Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia and/or thrombocytopenia. • Massive (i.e. =6 cm below the left costal margin) or progressive or symptomatic splenomegaly. • Massive nodes (i.e. =10 cm in longest diameter) or progressive or symptomatic lymphadenopathy. • Progressive lymphocytosis with an increase of =50% over a 2-month period, or lymphocyte doubling time (LDT) of less than 6 months. • A minimum of any one of the following disease-related symptoms: unintentional weight loss = 10% within the previous 6 months, significant fatigue (i.e., ECOG PS 2 or worse; cannot work or unable to perform usual activities), fevers of greater than 38.0°C for 2 or more weeks without other evidence of infection, or night sweats for more than 1 month without evidence of infection. • Autoimmune complications including anemia or thrombocytopenia poorly responsive to corticosteroids. • Symptomatic or functional extranodal involvement (eg, skin, kidney, lung, spine)., Must have an Eastern Cooperative Oncology Group (ECOG) performance status score of =2., Female patients of childbearing potential must practice highly effective methods of contraception initiated prior to first dose of study drug, for the duration of the study, and for = 90 days after the last dose of zanubrutinib and 18 months after last dose of obinutuzumab. Male patients are eligible if vasectomized or if they agree to the use of barrier contraception with other applicable highly effective methods described below during the study treatment period and for = 90 days after the last dose of zanubrutinib and 18 months after last dose of obinutuzumab. A woman is considered of childbearing potential, ie, fertile, following menarche and until becoming postmenopausal unless permanently sterile. Permanent sterilization methods include hysterectomy, bilateral salpingectomy, and bilateral oophorectomy. Contraception methods include the following: Combined (estrogen- and progestogen- containing) hormonal contraception associated with the inhibition of ovulation - Oral, intravaginal, or transdermal. • Progestogen-only hormonal contraception associated with the inhibition of ovulation - Oral, injectable, implantable. • An intrauterine device • Intrauterine hormone-releasing system • Bilateral tubal occlusion • Vasectomized partner (provided that the vasectomized partner is the sole sexual partner of the woman of childbearing potential study participant and that the vasectomized partner has received medical assessment of surgical success). • Sexual abstinence (defined as refraining from heterosexual intercourse during the entire period of risk associated with the study treatment, starting the day prior to first dose of study drug, for the duration of the study, and for = 90 days after the last dose of zanubrutinib or ibrutinib. Total sexual abstinence should only be used as a contraceptive method if it is
Prior treatment for CLL., Unable to swallow capsules, or has disease significantly affecting gastrointestinal function that would limit absorption of oral medication., Currently active, clinically significant cardiovascular disease or a history of myocardial infarction within 3 months prior to enrollment. Exception: Subjects with controlled, asymptomatic atrial fibrillation during screening can enrol on study., Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists (eg, phenprocoumon) within 7 days of first dose of study drug., Systemic infection that has not resolved prior to initiating study treatment in spite of adequate anti-infective therapy., Pregnant or lactating females., Participation in any clinical study or having taken any investigational therapy within 28 days prior to initiating study therapy., Central nervous system (CNS) involvement as documented by spinal fluid cytology or imaging., Prior history of malignancies, other than CLL, unless the patient has been free of the disease for = 3 years. Exceptions include the following: - Basal cell carcinoma of the skin - Squamous cell carcinoma of the skin - Carcinoma in situ of the cervix - Carcinoma in situ of the breast - Incidental histologic finding of prostate cancer (TNM stage of T1a or T1b), Presence of autoimmune haemolytic anaemia or autoimmune thrombocytopenia., Major surgery within the last 28 days prior to registration., Known Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and/or Hepatitis C Virus (HCV) infection. Subjects who are hepatitis B core antibody (anti-HBc) positive and who are surface antigen negative could be eligible if they have an undetectable HBV DNA (negative polymerase chain reaction (PCR) <20 IU). Those who are hepatitis B surface antigen (HbsAg) positive or hepatitis B PCR positive will be excluded. Subjects who are hepatitis C antibody positive will need to have a negative PCR result. Those who are hepatitis C PCR positive will be excluded. Per published guidelines (NCCN 2012) or institutional guidelines, patients should be closely monitored for hepatitis B reactivation. Obtaining repeated hepatitis B PCR every 3 months during treatment and for the 12 months after last dose of study drug according to usual clinical practice in order to monitor for reactivation of hepatitis B is recommended., History of stroke or intracranial haemorrhage within 6 months prior to enrollment., Requires treatment with strong CYP3A4/5 Inhibitors., Known history of drug-specific hypersensitivity or anaphylaxis to study drug (including active product or excipient components)., Any life-threatening illness, medical condition, or organ system dysfunction which, in the Investigator's opinion, could compromise the subject's safety, interfere with the absorption or metabolism of zanubrutinib, or put the study outcomes at undue risk., Estimated Glomerular Filtration Rate (Cockcroft-Gault Appendix C) =30 mL/min/1.73m2, Absolute neutrophil count (ANC) < 1.0 X 109/L., Platelet count < 75 X 109/L, except for patients with bone marrow involvement by CLL in which case the platelet count must be = 30 X 109/L., Serum aspartate aminotransferase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) or alanine transaminase (ALT)/serum glutamate pyruvate transaminase (SGPT) >2.5 x upper limit of normal (ULN)., Serum total bilirubin > 1.5 x ULN, except in cases of Gilbert’s syndrome., Prothrombin time/INR or aPTT (in the absence of Lupus anticoa
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method