The aim of this study is to compare the efficacy of continuous ibrutinib monotherapy with fixed-duration venetoclax plus obinutuzumab and fixed-duration ibrutinib plus venetoclax by measuring progression-free survival (PFS) in patients with previously untreated CLL.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
897
Cycles 1 - X: 420 mg daily, d1-28 p.o.
Arm VG Cycle 1: 20 mg (2 tabl. at 10 mg), d22-28 p.o. Cycle 2: 50 mg (1 tabl. at 50 mg), d1-7; 100 mg (1 tabl. at 100 mg), d8-14; 200 mg (2 tabl. at 100 mg), d15-21; 400 mg (4 tabl. at 100 mg), d22-28 p.o. Cycles 3-12: 400 mg (4 tabl. at 100 mg), d1-28 p.o. Arm VI Cycle 4: 20 mg (2 tabl. at 10 mg), d1-7; 50 mg (1 tabl. at 50 mg), d8-14; 100 mg (1 tabl. at 100 mg), d15-21; 200 mg (2 tabl. at 100 mg), d22-28 p.o. Cycles 5-15: 400 mg (4 tabl. at 100 mg), d1-28 p.o.
Cycle 1: (100 mg, d1 + 900 mg, d2) or 1000 mg, d1; 1000 mg, d8 + d15 i.v. Cycle 2 - 6: 1000 mg, d1 i.v.
Investigator-assessed progression-free survival (PFS)
Time from randomization to the first occurrence of progression or relapse (determined using standard iwCLL guidelines), or death from any cause, whichever occurs first
Time frame: Up to 80 month
Rates of undetectable minimal residual disease (uMRD) in peripheral blood (PB) and bone marrow (BM)
Undetectable MRD (uMRD) is defined as \<10-4 (=1 CLL-cell per 10,000 leukocytes analyzed).The uMRD rate is defined as the proportion of patients having achieved uMRD.
Time frame: At final restaging (RE): 18 months after start of treatment and additional BM assessment approx. 12 months after RE
MRD levels in PB at different time points
MRD is defined as the number of CLL-cells that can be detected in peripheral blood (PB) or bone marrow (BM). MRD values will be categorized into negative (\<10-4) and positive (≥10-4)
Time frame: Up to 80 month
Overall response rate (ORR)
Proportion of patients having achieved a complete response (CR), a CR with incomplete recovery of the bone marrow (CRi), or a partial response (PR) as best response.
Time frame: At final restaging (RE): 18 months after start of treatment
CR/CRi rate
Proportion of patients having achieved a CR or CRi as best response (= number of patients with best response CR or CRi divided by the number of the intention-to-treat population (ITT) population)
Time frame: At final restaging (RE): 18 months after start of treatment
Event-free survival
Event-free survival (EFS) (I vs VG and I vs VI)
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LKH-Universtitätsklinikum Graz
Graz, Austria
Landeskrankenhaus - Universitätskliniken Innsbruck
Innsbruck, Austria
Medizinische Universität Wien
Vienna, Austria
Hanusch Krankenhaus
Vienna, Austria
Wiener Gesundheitsverbund Klinik Ottakring
Vienna, Austria
Algemeen Ziekenhuis St. Jan
Bruges, Belgium
Universitair Ziekenhuis Leuven
Leuven, Belgium
Algemeen Ziekenhuis Delta
Roeselare, Belgium
Aalborg Universitetshospital
Aalborg, Denmark
Aarhus Universitetshospital
Aarhus, Denmark
...and 171 more locations
Time frame: Up to 80 month
Time to next treatment
Time to next treatment (TTNT)
Time frame: Up to 80 month
PFS2
Progression free survival 2 (i.e. PFS after second-line treatment)
Time frame: Up to 80 month
Incidence of safety parameters such as adverse events (AE) and adverse events of particular/special interest (AEPI/AESI)
Type, frequency, severity and relationship to study treatment.of AEs and AEPIs/AESIs
Time frame: Up to 80 month
Safety parameter TLS
Tumour lysis syndrome (TLS) risk category after G or I lead-in (before venetoclax ramp up)
Time frame: Up to 80 month