To compare efficacy between zanubrutinib versus bendamustine and rituximab in patients with previously untreated CLL/SLL, as measured by progression free survival assess by Independent Central Review.
This is a global phase 3, open label, randomized study of zanubrutinib versus bendamustine plus rituximab (B+R) in participants with previously untreated chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL), including participants without del(17p) \[Cohort 1\] and participants with del(17p) \[Cohort 2 and Cohort 3\]. Participants in Cohort 1 are randomized 1:1 to zanubrutinib (Arm A) or bendamustine plus rituximab (Arm B). Randomization will be stratified by age, Binet stage, immunoglobulin variable region heavy chain (IGHV) mutational status, and geographic region. Participants in Cohort 2 will receive treatment with zanubrutinib. Participants in Cohort 3 will receive treatment with zanubrutinib and venetoclax.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
590
Administered as two 80-milligram (mg) capsules by mouth twice a day (160 mg twice a day)
Administered intravenously (IV) at a dose of 90 mg/m\^2/day on the first 2 days of each cycle for 6 cycles.
Administered intravenously (IV) at a dose of 375 mg/m\^2 on day 0 of cycle 1, and at a dose of 500 mg/m\^2 on day 1 of cycles 2 to 6
Cohort 1: Progression-free Survival (PFS) as Determined by Independent Central Review (ICR)
PFS is defined as the time from randomization until first documentation of progression or death from any cause, whichever occurs first, as assessed by the ICR per 2008 International Workshop on Chronic Lymphocytic Leukemia (iwCLL) guidelines with modifications for treatment-related lymphocytosis in participants with CLL and the Revised Criteria for Response for Malignant Lymphoma in participants with small lymphocytic lymphoma (SLL).
Time frame: Up to approximately 3 years and 7 months (as of cut-off date of 07MAY2021)
Cohort 1: Overall Response Rate (ORR) Between Treatment Groups as Determined by ICR
ORR in Cohort 1 is defined as the percentage of participants who achieve a complete response, complete response with incomplete bone marrow recovery, partial response, or partial response with lymphocytosis, determined by the ICR.
Time frame: Up to 5 years
Pooled Cohort 1/1a: Overall Response Rate (ORR) Between Treatment Groups
Time frame: Up to 5 years
Cohort 1: Overall Survival (OS) Between Treatment Groups as Determined by the ICR
OS in Cohort 1 is defined as the time from randomization to the date of death due to any reason.
Time frame: Up to 5 years
Cohort 1: Duration of Response (DOR) Between Treatment Groups as Determined by the ICR
Duration of response in Cohort 1 determined using the iwCLL criteria with modification for treatment related lymphocytosis (in participants with CLL) and the Lugano Classification for non-Hodgkin lymphoma (NHL; in participants with SLL), is defined as the time from the date that criteria for response (ie, partial response with lymphocytosis \[PR-L\] or better) are first met to the date that disease progression is objectively documented or death, whichever occurs first.
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400 mg tablets administered orally once daily.
Augusta University
Augusta, Georgia, United States
Northwestern University
Chicago, Illinois, United States
Dana Farber Cancer Institute
Boston, Massachusetts, United States
Research Medical Center
Kansas City, Missouri, United States
Washington University
St Louis, Missouri, United States
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, United States
Summit Medical Group
Florham Park, New Jersey, United States
Icahn School of Medicine At Mount Sinai
New York, New York, United States
Columbia University Medical Center
New York, New York, United States
University of Rochester
Rochester, New York, United States
...and 148 more locations
Time frame: Up to 5 years
Pooled Cohort 1/1a: Duration of Response (DOR) Between Treatment Groups
Time frame: Up to 5 years
Cohort 1: Progression-free Survival (PFS) Between Treatment Groups Determined by Investigator Assessment (IA)
PFS is defined as the time from randomization until first documentation of progression or death from any cause, whichever occurs first, as assessed by the investigator per iwCLL guidelines with modifications for treatment-related lymphocytosis in participants with CLL and the Revised Criteria for Response for Malignant Lymphoma in participants with SLL.
Time frame: Up to 5 years
Pooled Cohort 1/1a: Progression-free Survival (PFS) Between Treatment Groups Determined by Investigator Assessment (IA)
Time frame: Up to 5 years
Cohort 1: Patient-reported Outcomes as Assessed by the (European Quality Of Life 5D 5L) EQ-5D-5L Questionnaire
Time frame: Up to 5 years
Cohort 1: Patient-reported Outcomes as Assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Questionnaire.
Time frame: Up to 5 years
Cohort 2: Overall Response Rate (ORR)
Time frame: Up to 5 years
Cohort 2: Progression-free Survival (PFS)
Time frame: Up to 5 years
Cohort 2: Duration of Response (DOR)
Time frame: Up to 5 years
Cohort 3: Overall Response Rate (ORR)
Time frame: Up to 5 years
Cohort 3: Progression-free Survival (PFS)
Time frame: Up to 5 years
Cohort 3: Duration of Response (DOR)
Time frame: Up to 5 years
Cohort 3: Rate of Undetectable Minimal Residual Disease (MRD4)
Time frame: Up to 5 years
Number of Participants Experiencing Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time frame: Up to 5 years
Apparent Rate of Clearance of Zanubrutinib From Plasma (CL/F)CL/F
Time frame: Predose up to 12 hours postdose
Cohort 1 Zanubrutinib Only Arms: Area-Under-Curve From Time 0 to 12 Hours Postdose (AUC0-12)
Time frame: Predose up to 12 hours postdose
Cohort 3: Area-Under-Curve From Time 0 to 12 Hours Postdose (AUC0-12) of Zanubrutinib
Time frame: Predose up to 12 hours postdose