A pilot study to assess whether mutations detected in baseline marginal zone lymphoma are predictive of resistance to bruton tyrosine kinase (BTK) inhibition.
- Conditions
- ymphomaLymphomaCancer - Lymphoma (non Hodgkin's lymphoma) - Low grade lymphoma
- Registration Number
- ACTRN12619000024145
- Lead Sponsor
- Australasian Leukaemia and Lymphoma Group
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Active, not recruiting
- Sex
- All
- Target Recruitment
- 21
1.Age 18 years or older.
2.Histologically confirmed diagnosis of MZL including splenic, nodal, and extranodal subtypes. Gastric MZL must be H. pylori-negative disease or H. pylori-positive disease that has remained stable, progressed, or relapsed following antibiotic therapy.
3.Previously received one or more lines of therapy including at least one CD20-directed regimen (either as monotherapy or as chemoimmunotherapy) with documented failure to achieve at least PR or documented PD after, the most recent systemic treatment.
4.Current need for systemic therapy for MZL in the opinion of the investigator.
5.Availability of archival tissue or consent to obtain fresh tumor tissue sample from an evaluable core or excisional biopsy (approximately 10 to 15 unstained formalin fixed paraffin embedded slides or tissue box). Patients who do not have archival tissue available and are not candidates to undergo a tumor biopsy can only be enrolled after discussion with and approval of the medical monitor.
6.Measurable disease by CT or MRI. Measurable disease is defined as greater or equal to 1 lesion greater than 1.5 cm in longest diameter, and measurable in 2 perpendicular diameters. Patients with spleen-only disease are not considered to have measurable disease.
7.Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.
8.Life expectancy equal to or greater than 6 months.
9.Adequate bone marrow function:
a. Absolute neutrophil count (ANC) equal to or greater than 1,000/mm^3
(growth factor use is allowed), except for patients with bone marrow
involvement by MZL in which case ANC must be equal to or greater than
750/mm^3.
b. Platelet equal to or greater than 75,000/mm^3 (may not be post-
transfusion), except for patients with bone marrow involvement by MZL in
which case the platelet count must be equal to or greater than
50,000/mm^3.
10.Adequate organ function:
a. Creatinine clearance equal to or greater than 30 mL/min (as estimated by
the Cockcroft-Gault equation or as measured by nuclear medicine scan or
24-hour urine collection).
b. Aspartate aminotransferase/serum glutamic-oxaloacetic transaminase
and alanine aminotransferase/serum glutamic pyruvic transaminase equal
to or less than 2.5 × upper limit of normal (ULN) unless due to MZL.
c. Serum total bilirubin less than 2.0 × ULN (unless documented Gilbert’s
syndrome).
11. Female patients of childbearing potential must have a negative pregnancy test at screening and must practice highly effective methods of contraception initiated prior to first dose of study drug, for the duration of the study, and for at least 90 days after the last dose of zanubrutinib.
12.Male patients are eligible if vasectomized or if they agree to the use of barrier contraception with other methods described above during the study treatment period and for at least 90 days after the last dose of zanubrutinib.
13.Ability to provide written informed consent and can understand and comply with the requirements of the study.
14. Consent to the ALLG National Blood Cancer Registry (NBCR).
1.Known transformation to aggressive lymphoma, eg, large cell lymphoma. Clinically suspected transformation will require a biopsy of the suspected area prior to enrollment to confirm absence of transformation.
2.Clinically significant cardiovascular disease.
3.Prior malignancy within the past 2 years, except for curatively treated basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of the cervix or breast, or localized Gleason score 6 prostate cancer.
4.History of severe bleeding disorder such as hemophilia A, hemophilia B, von Willebrand disease, or history of spontaneous bleeding requiring blood transfusion or other medical intervention.
5.History of stroke or intracranial hemorrhage within 180 days before first dose of study drug.
6.Severe or debilitating pulmonary disease.
7.Unable to swallow capsules or disease significantly affecting gastrointestinal function such as malabsorption syndrome, resection of the stomach or small bowel, bariatric surgery procedures, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction.
8.Active fungal, bacterial and/or viral infection requiring systemic therapy.
9.Known central nervous system involvement by lymphoma.
10.Underlying medical conditions that, in the investigator’s opinion, will render the administration of study drug hazardous or obscure the interpretation of toxicity or AEs.
11.Known infection with HIV, or serologic status reflecting active viral hepatitis B (HBV) or viral hepatitis C (HCV) infection.
12.Major surgery within 4 weeks of the first dose of study drug.
13.Prior treatment with a Bruton tyrosine kinase (BTK) inhibitor.
14.Last dose of prior therapy for MZL less than or equal to 21 days prior to first dose of study drug, with the following additional exclusion requirements:
a. Treatment with monoclonal antibody-based therapy within 28 days
of first dose of study drug.
b. Treatment with chimeric antigen receptor T-cell therapy within 180
days of first dose of study drug.
c. Treatment with any herbal medicine with anti-neoplastic intent
within 28 days of first dose of study drug.
d. Allogeneic hematopoietic stem cell transplantation within 12
months of first dose of study drug.
15.Any chemotherapy or radiation treatment for non-MZL indications within 21 days of first dose of study drug.
16.Toxicity from prior anti-cancer therapy that has not recovered to less tha or equal to Grade 1 (except for alopecia, ANC, and platelet count; for ANC and platelet count, see Inclusion criterion 9).
17.Pregnant or lactating women.
18.Vaccination with a live vaccine within 35 days prior to the first dose of study drug.
19.Ongoing alcohol or drug addiction.
20.Hypersensitivity to zanubrutinib or any of the other ingredients in zanubrutinib.
21.Requires ongoing treatment with a strong CYP3A inhibitor or inducer.
22.Concurrent participation in another therapeutic clinical trial.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method