This is a phase 2, open-label, multicenter study evaluating the efficacy and safety of a fixed-duration combination of epcoritamab, venetoclax, and ibrutinib (EVI) in previously untreated patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who have TP53 alterations. Patients with TP53 abnormalities, including TP53 mutation and/or 17p deletion, have a poorer prognosis and are less likely to benefit from conventional chemoimmunotherapy. Targeted therapies such as ibrutinib and venetoclax have improved outcomes in this population, but many patients eventually experience disease progression. This study investigates whether adding epcoritamab, a CD3×CD20 bispecific antibody, to the combination of ibrutinib and venetoclax can improve the depth and durability of treatment responses while using a fixed-duration treatment approach. Participants will receive sequential treatment with ibrutinib alone, followed by ibrutinib plus venetoclax, and then the triple combination of epcoritamab, venetoclax, and ibrutinib. The study will evaluate the effectiveness of this regimen, including the achievement of deep remission, as well as its safety and tolerability in this high-risk patient population.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
44
Orally once daily, administered alone during the initial treatment phase and continued in combination with venetoclax and epcoritamab according to the study treatment schedule.
Oral administration as part of the study treatment regimen, in combination with ibrutinib and subsequently with epcoritamab according to the study treatment schedule.
Subcutaneous administration as part of the study treatment regimen in combination with ibrutinib and venetoclax according to the study treatment schedule
Institut Jules Bordet
Brussels, Belgium
Universitair Ziekenhuis Gent
Ghent, Belgium
HELORA - Hôpital de La Louvière Site Jolimont
La Louvière, Belgium
U.Z. LEUVEN - Campus GASTHUISBERG
Leuven, Belgium
Chu Ucl Namur - Site Godinne
Namur, Belgium
CHU d'ANGERS
Angers, France
Institut D'Hematologie de Basse Normandie
Caen, France
Ch Metropole Savoie
Chambéry, France
Chu Estaing
Clermont-Ferrand, France
Chd de Vendee
La Roche-sur-Yon, France
...and 19 more locations
Rate of Participants Achieving Complete Remission (CR) with Undetectable Minimal Residual Disease (uMRD) in Bone Marrow
Rate of participants achieving complete remission (CR) with undetectable minimal residual disease (uMRD) in bone marrow, assessed according to 2018 iwCLL response criteria.
Time frame: 18 months
Bone Marrow uMRD Rate
Proportion of participants with undetectable minimal residual disease in bone marrow.
Time frame: 18 months
Complete Response Rate (CRR)
Proportion of participants achieving complete response according to iwCLL 2018 criteria.
Time frame: 18 months
Overall Response Rate (ORR)
Proportion of participants achieving complete or partial response according to iwCLL 2018 criteria.
Time frame: 18 months
Duration of Response
Time from first response to disease progression or death
Time frame: 4 years
Duration of Complete Response
Time from complete response to relapse or progression
Time frame: 4 years
Time to Next Treatment
Time from treatment initiation to start of next anti-CLL therapy.
Time frame: 4 years
Peripheral Blood MRD Kinetics
Assessment of MRD dynamics in peripheral blood during and after treatment
Time frame: Day 1 of Cycle7 (each cycle is 28 days); 18 months; Follow-up Months12; Follow-up Months 24
Progression-Free Survival (PFS)
Time from treatment initiation to disease progression or death
Time frame: 3 years
Overall Survival (OS)
Time from treatment initiation to death from any cause
Time frame: 3 years
Safety and tolerability (Adverse Events)
Incidence and severity of adverse events including serious adverse events and immune-related toxicities
Time frame: 38 months
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