BTK inhibitors and BCL-2 inhibitors have demonstrated significant clinical activity in mature B-cell malignancies, and combination therapy may provide improved clinical benefit. This is a multi-center, open-label, single-arm Phase Ib/II clinical study. The purpose of this clinical trial is to investigate the safety, tolerability, pharmacokinetics, and preliminary efficacy of Rocbrutinib, a fourth-generation Bruton tyrosine kinase inhibitor (BTKi), in combination with the BCL-2 inhibitor Lacutoclax in patients with mature B-cell malignancies. The Phase Ib will use a classic 3+3 dose-escalation design to evaluate dose-limiting toxicities (DLTs), determine the maximum tolerated dose (MTD), and identify the recommended dosing regimen. The Phase II portion is intended to further evaluate the efficacy and safety of the combination therapy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
92
Phase Ib dose-escalation study of Rocbrutinib in combination with Lacutoclax. Rocbrutinib will be administered at a fixed dose of 150 mg once daily (QD), while Lacutoclax will be dose-escalated. Initial dose levels include Lacutoclax 200 mg QD and 400 mg QD in 28-day treatment cycles.Treatment will continue until disease progression, unacceptable toxicity/intolerance, or completion of the protocol-defined treatment duration, whichever occurs first. In phase II, participants will receive Rocbrutinib monotherapy for 8-12 weeks prior to combination treatment. Upon initiation of combination therapy, Lacutoclax will undergo dose ramp-up to the target dose and will then be administered continuously at the target dose. Treatment will continue until disease progression, unacceptable toxicity/intolerance, or completion of the protocol-defined treatment duration, whichever occurs first.
Phase Ib: Dose-limiting toxicity (DLT)
Time frame: At the end of Cycle 1 (the length of cycle 1 is 28 days)
Phase Ib: Maximum Tolerated Dose (MTD)
Time frame: At the end of Cycle 1 (the length of cycle 1 is 28 days)
Phase Ib: Adverse events as assessed by CTCAE v5.0
Time frame: From the first administration to 28 days after the last administration
Phase Ib: Time to Maximum Plasma Concentration (Tmax)
Time frame: From 1 hour prior to administration to 24 hours post-dose
Phase Ib: Maximum Plasma Concentration (Cmax)
Time frame: From 1 hour prior to administration to 24 hours post-dose
Phase Ib: Area Under the Plasma Concentration-Time Curve from Time Zero to Time t (AUC0-t)
Time frame: From 1 hour prior to administration to 24 hours post-dose
Phase Ib: Half-life (t1/2)
Time frame: From 1 hour prior to administration to 24 hours post-dose
Phase II: Undetectable minimal residual disease (uMRD) rate assessed by flow cytometry
Time frame: Up to approximately three years
Phase II: Maximum Plasma Concentration (Cmax)
Time frame: From 1 hour prior to administration to 24 hours post-dose
Phase II: Time to Maximum Plasma Concentration (Tmax)
Time frame: From 1 hour prior to administration to 24 hours post-dose
Phase II: Area Under the Plasma Concentration-Time Curve from Time Zero to Time t (AUC0-t)
Time frame: From 1 hour prior to administration to 24 hours post-dose
Phase II: Half-life (t1/2)
Time frame: From 1 hour prior to administration to 24 hours post-dose
Overall Response Rate(ORR)
Time frame: Up to approximately three years
Progression-free Survival(PFS)
Time frame: Up to approximately three years
Overall Survival(OS)
Time frame: Up to approximately three years
Phase II: Adverse events as assessed by CTCAE v5.0
Time frame: From the first administration to 28 days after the last administration
Complete Response Rate (CRR)
Time frame: Up to approximately three years
Duration of Response (DOR)
Time frame: Up to approximately three years
Phase Ib: Undetectable Minimal Residual Disease (uMRD) Rate assessed by flow cytometry
Time frame: Up to approximately three years
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