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A Study of BGB-21447, a Bcl-2 Inhibitor, in Mature B-Cell Malignancies

Phase 1
Recruiting
Conditions
Refractory Chronic Lymphocytic Leukemia
Relapsed Non-Hodgkin Lymphoma
Refractory Non-Hodgkin Lymphoma
Relapsed Chronic Lymphocytic Leukemia
Relapsed Follicular Lymphoma
Relapsed Marginal Zone Lymphoma
Relapse Diffuse Large B Cell Lymphoma
Relapsed Small Lymphocytic Lymphoma
Refractory Follicular Lymphoma
Refractory Marginal Zone Lymphoma
Interventions
Registration Number
NCT05828589
Lead Sponsor
BeiGene
Brief Summary

This study is testing the safety and tolerability of BGB-21447 monotherapy in participants with relapsed or refractory (R/R) non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The study aims to determine the maximum tolerated dose (MTD), maximum administered dose (MAD), recommended Phase 2 dose (RP2D), and pharmacokinetic profile of the drug. Additionally, preliminary antitumor activity will be characterized. The study is divided into 2 main parts: Part 1 "Monotherapy Dose Finding" and Part 2 "Monotherapy Dose Optimization."

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
112
Inclusion Criteria

Not provided

Exclusion Criteria
  1. Prior malignancy (other than the disease under study) within the past 2 years, except for curatively treated basal or squamous skin cancer, superficial bladder cancer, carcinoma in situ of the cervix or breast, or localized Gleason score ≤ 6 prostate cancer or lentigo maligna melanoma that has been curatively resected
  2. Known central nervous system involvement by lymphoma/leukemia
  3. Prior autologous stem cell transplant < 3 months before the first dose of study drug. Or prior chimeric antigen receptor T-cell (CAR-T) therapy < 3 months before the first dose of study drug
  4. Prior allogeneic stem cell transplant.
  5. Major surgery < 4 weeks before the first dose of study treatment

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

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Part 1 (Cohort A1): Dose escalation in patients with B-cell non-Hodgkin lymphoma (NHL)BGB-21447Participants with R/R B-cell NHL (including diffuse large B-cell lymphoma \[DLBCL\], follicular lymphoma \[FL\], marginal zone lymphoma \[MZL\], transformed B-cell NHL (B-NHL), and Richter's transformation to DLBCL) will receive BGB-21447 once a day.
Part 1 (Cohort B): Dose escalation in R/R CLL/SLL participants with low tumor burdenBGB-21447Participants with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) will receive BGB-21447 once a day.
Part 2 (Cohort A2.1): BGB-21447 Monotherapy Dose Optimization in R/R DLBCLBGB-21447Participants will receive BGB-21447 with two dose levels from Cohort A1 for further evaluation of safety and efficacy.
Part 2 (Cohort A2.2): BGB-21447 Monotherapy Dose Optimization in R/R FL or R/R MZLBGB-21447Participants will receive BGB-21447 with two dose levels from Cohort A1 for further evaluation of safety and efficacy.
Primary Outcome Measures
NameTimeMethod
Part 1: Number of participants with dose limiting toxicities (DLTs)Up to approximately 1 month

Number of participants with dose limiting toxicities, as defined in the study protocol.

Number of participants with adverse events (AEs)From the first dose of study drug to 30 days after the last dose or initiation of new anticancer therapy, whichever occurs first; up to approximately 12 months

Number of participants with treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs) assessed and graded based upon the National Cancer Institute Common Terminology Criteria for Adverse Events Version 5.0 (NCI-CTCAE v5.0).

Number of participants with Tumor Lysis Syndrome (TLS)From the first dose of study drug to 30 days after the last dose or initiation of new anticancer therapy, whichever occurs first; up to approximately 12 months

TLS will be determined via laboratory values and assessed by the investigator.

In laboratory tumor lysis syndrome, 2 or more metabolic abnormalities must be present during the 24-hour period within 3 days before the start of study drug treatment or up to 7 days afterward. Clinical tumor lysis syndrome requires the presence of laboratory tumor lysis syndrome plus an increased creatinine level, seizures, cardiac dysrhythmia, or death.

Secondary Outcome Measures
NameTimeMethod
Maximum observed plasma concentration (Cmax) After a Single Dose of BGB-21447Up to approximately 8 weeks
Area under the curve from time 0 to the last sampling time point within the dose interval (AUC0-t) After a Single Dose of BGB-21447Up to approximately 8 weeks
Area under the curve from time 0 extrapolated to infinity time (AUCinf) After a Single Dose of BGB-21447Up to approximately 8 weeks
Time to reach maximum observed plasma concentration (Tmax) After a Single Dose of BGB-21447Up to approximately 8 weeks
Apparent terminal elimination half-life (t1/2) After a Single Dose of BGB-21447Up to approximately 8 weeks
Apparent oral clearance (CL/F) After a Single Dose of BGB-21447Up to approximately 8 weeks
Apparent volume of distribution (Vz/F) After a Single Dose of BGB-21447Up to approximately 8 weeks
Steady state maximum observed plasma concentration (Cmax,ss) of BGB-21447Up to approximately 8 weeks
Steady state pre-dose trough concentration (Ctrough,ss) of BGB-21447Up to approximately 8 weeks
Steady state area under the curve from time 0 to the quantifiable concentration (AUClast,ss) of BGB-21447Up to approximately 8 weeks
Steady state time to reach maximum observed plasma concentration (Tmax,ss) of BGB-21447Up to approximately 8 weeks
Overall response rate (ORR)Up to approximately 24 months

Defined as the percentage of patients who achieve partial response or better for diffuse large B-cell lymphoma, marginal zone lymphoma, follicular lymphoma, transformed B-NHL, and Richter's transformation to DLBCL as per the Lugano Classification for non-Hodgkin lymphoma.

Duration of Response (DOR)Up to approximately 24 months

Defined as the time from the first response documentation to the date that progression is documented after treatment initiation or death due to any cause, whichever occurs first.

Time to response (TTR)Up to approximately 24 months

Defined as the time from treatment initiation to the first documentation of response.

Progression-free survival (PFS)Up to approximately 24 months

Defined as the time from treatment initiation to the first documented disease progression or death due to any cause, whichever occurs first.

Trial Locations

Locations (22)

Pindara Private Hospital

🇦🇺

Benowa, Queensland, Australia

Mission Cancer and Blood

🇺🇸

Waukee, Iowa, United States

Sidney Kimmel Comprehensive Cancer At Johns Hopkins

🇺🇸

Baltimore, Maryland, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

Avera Cancer Institue

🇺🇸

Sioux Falls, South Dakota, United States

Blacktown Cancer and Haematology Centre

🇦🇺

Blacktown, New South Wales, Australia

Monash Health

🇦🇺

Clayton, Victoria, Australia

Peking University Third Hospital

🇨🇳

Beijing, Beijing, China

Tongji Hospital of Tongji Medical College Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

Jiangsu Province Hospital

🇨🇳

Nanjing, Jiangsu, China

The First Affiliated Hospital of Nanchang University Branch Donghu

🇨🇳

Nanchang, Jiangxi, China

The First Affiliated Hospital of Nanchang University Branch Xianghu

🇨🇳

Nanchang, Jiangxi, China

Shengjing Hospital of China Medical University

🇨🇳

Shenyang, Liaoning, China

Linear Clinical Research

🇦🇺

Nedlands, Western Australia, Australia

Henan Cancer Hospital

🇨🇳

Zhengzhou, Henan, China

Fujian Cancer Hospital

🇨🇳

Fuzhou, Fujian, China

The First Affiliated Hospital of Soochow University

🇨🇳

Suzhou, Jiangsu, China

Shandong Provincial Hospital

🇨🇳

Jinan, Shandong, China

Linyi Peoples Hospital

🇨🇳

Linyi, Shandong, China

Affiliated Zhongshan Hospital of Fudan University

🇨🇳

Shanghai, Shanghai, China

Institute of Hematology and Hospital of Blood Disease

🇨🇳

Tianjin, Tianjin, China

Auckland City Hospital

🇳🇿

Auckland, New Zealand

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