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临床试验/NCT03836261
NCT03836261进行中(未招募)3 期

A Randomized, Multicenter, Open-Label, Phase 3 Study to Compare the Efficacy and Safety of Acalabrutinib (ACP-196) in Combination With Venetoclax With and Without Obinutuzumab Compared to Investigator's Choice of Chemoimmunotherapy in Subjects With Previously Untreated Chronic Lymphocytic Leukemia Without Del(17p) or TP53 Mutation (AMPLIFY)

Acerta Pharma BV1 个研究点 分布在 1 个国家目标入组 984 人开始时间: 2019年2月25日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
3 期
状态
进行中(未招募)
入组人数
984
试验地点
1
主要终点
To evaluate the efficacy of acalabrutinib with venetoclax (Arm A) compared to chemoimmunotherapy fludarabine/cyclophosphamide/rituximab [FCR] or bendamustine/rituximab [BR] (Arm C): PFS

研究概览

简要总结

The purpose of this study is to evaluate the efficacy and safety of acalabrutinib in combination with venetoclax and acalabrutinib in combination with venetoclax with and without obinutuzumab compared to chemoimmunotherapy in subjects with previously untreated CLL

详细描述

This randomized, global, multicenter, open-label, Phase 3 study will evaluate the efficacy and safety of AV and AVG versus chemoimmunotherapy (FCR or BR) in subjects with previously untreated CLL without del(17p) or TP53. Subjects will be randomized in a 1:1:1 ratio into 3 arms through a block stratified randomization procedure.

The study includes screening (35 days), treatment (from randomization until study drug discontinuation) and follow-up phase.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 130 Years(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Men and women ≥18 years of age.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-
  • Diagnosis of CLL that meets published diagnostic criteria (Hallek et al. 2018)
  • Active disease per IWCLL 2018 criteria that requires treatment.
  • Participants must use highly effective birth control throughout the study.

排除标准

  • Any prior CLL-specific therapies.
  • Detected del(17p) or TP53 mutation.
  • Transformation of CLL to aggressive non-Hodgkin lymphoma (NHL) (e.g., Richter's transformation, prolymphocytic leukemia [PLL], or diffuse large B cell lymphoma [DLBCL]), or central nervous system (CNS) involvement by leukemia.
  • History of confirmed progressive multifocal leukoencephalopathy (PML).
  • Received any investigational drug within 30 days before first dose of study drug.
  • Major surgical procedure within 30 days before the first dose of study drug.
  • Significant cardiovascular disease such as symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of Screening, or any Class 3 or 4 cardiac disease. Note: Subjects with controlled, asymptomatic atrial fibrillation are allowed to enroll on study.
  • Malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach, or extensive small bowel resection that is likely to affect absorption, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction, or gastric restrictions and bariatric surgery, such as gastric bypass.
  • Received a live virus vaccination within 28 days of first dose of study drug.
  • Known history of infection with human immunodeficiency virus (HIV).
  • Serologic status reflecting active hepatitis B or C infection.
  • History of known hypersensitivity or anaphylactic reactions to study drugs or excipients.
  • History of stroke or intracranial hemorrhage within 6 months before first dose of study drug.
  • Known bleeding disorders.
  • Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists.
  • Female participants must not be breastfeeding or pregnant.
  • Concurrent participation in another therapeutic clinical trial.

研究组 & 干预措施

Acalabrutinib, Venetoclax

Experimental

Acalabrutinib in combination with Venetoclax

干预措施: Acalabrutinib (Drug)

Acalabrutinib, Venetoclax

Experimental

Acalabrutinib in combination with Venetoclax

干预措施: Venetoclax (Drug)

Acalabrutinib, Venetoclax, Obinutuzumab

Experimental

Acalabrutinib in combination with Venetoclax with Obinutuzumab

干预措施: Acalabrutinib (Drug)

Acalabrutinib, Venetoclax, Obinutuzumab

Experimental

Acalabrutinib in combination with Venetoclax with Obinutuzumab

干预措施: Venetoclax (Drug)

Acalabrutinib, Venetoclax, Obinutuzumab

Experimental

Acalabrutinib in combination with Venetoclax with Obinutuzumab

干预措施: Obinutuzumab (Drug)

Chemoimmunotherapy

Active Comparator

Chemoimmunotherapy

FCR: Fludarabine, Cyclophosphamide and Rituximab

BR: Bendamustine and Rituximab

干预措施: Chemoimmunotherapy (Drug)

结局指标

主要结局

To evaluate the efficacy of acalabrutinib with venetoclax (Arm A) compared to chemoimmunotherapy fludarabine/cyclophosphamide/rituximab [FCR] or bendamustine/rituximab [BR] (Arm C): PFS

时间窗: 6 years

Progression-free survival (PFS) after randomization, defined as the time from randomization to the first occurrence of disease progression or death from any cause (whichever occurs first), as determined by the Independent Review Committee (IRC) according to the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2018 criteria

次要结局

  • To evaluate the efficacy of acalabrutinib with venetoclax (Arm A) compared with FCR or BR (Arm C): PFS defined the same as above per investigator assessment.(6 years)
  • To evaluate the efficacy of acalabrutinib with venetoclax in combination with obinutuzumab (Arm B) compared with FCR or BR (Arm C): PFS(6 years)

研究者

申办方类型
Industry
责任方
Sponsor

研究点 (1)

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相似试验

相关资讯

AMPLIFY Trial: Acalabrutinib and Venetoclax Show Promise in Treatment-Naive CLL- The AMPLIFY trial investigated acalabrutinib plus venetoclax (AV) with or without obinutuzumab (AVO) versus chemoimmunotherapy in treatment-naive chronic lymphocytic leukemia (CLL) patients. - Results showed significantly improved progression-free survival (PFS) with both AV and AVO compared to chemoimmunotherapy at the interim analysis. - The AVO arm achieved the highest rates of undetectable minimal residual disease (uMRD), suggesting a potential for deeper remission. - Overall survival was prolonged with AV compared to chemoimmunotherapy, indicating a potential new treatment paradigm for CLL.last yearKey BTK Inhibitor Advances in CLL Treatment Highlighted at ASH 2024Leading experts Dr. Alexey Danilov and Dr. Susan O'Brien discussed significant updates on BTK inhibitors for chronic lymphocytic leukemia (CLL) treatment at ASH 2024. The discussion covered promising data from the phase 3 AMPLIFY trial with acalabrutinib, zanubrutinib's performance both as monotherapy and in combination with sonrotoclax, and practice-confirming results from the BRUIN CLL-321 trial with pirtobrutinib.last yearAcalabrutinib, Venetoclax, and Obinutuzumab Triplet Shows High Efficacy in CLL- Acalabrutinib, venetoclax, and obinutuzumab (AVO) triplet therapy demonstrates high activity in previously untreated CLL patients, including those with high-risk TP53 aberrations. - The AVO regimen achieved a bone marrow undetectable MRD (BM-uMRD) rate of 78% after 15 months, indicating deep remission in a significant proportion of patients. - The triplet therapy exhibited a favorable safety profile, with low rates of severe infections and atrial fibrillation, and no tumor lysis syndrome (TLS) related to venetoclax ramp-up. - The ongoing phase 3 trial (CL-311, NCT03836261) is further evaluating AVO, potentially establishing a new standard frontline treatment for CLL.5 years ago