Study of Zanubrutinib, Rituximab and Combination Chemotherapy in Newly-diagnosed Aggressive B-cell Non-Hodgkin Lymphoma

Last updated: December 7, 2021
Sponsor: Shandong Provincial Hospital
Overall Status: Active - Recruiting

Phase

3

Condition

Lymphoma

Lymphoma, B-cell

Lymphoproliferative Disorders

Treatment

N/A

Clinical Study ID

NCT05164770
B-NHL002
  • Ages > 18
  • All Genders

Study Summary

Non-Hodgkin lymphoma (NHL), with high aggressiveness and mortality, is one of the top ten high-incidence tumors in the world and is among the ten most prevalent cancers worldwide with the fastest growing incidence. Although novel immunotherapies represented by anti-CD20 monoclonal antibodies and CAR-T cell therapies have significantly improved the prognosis of B-NHL patients, there are still nearly one-third of patients who are resistant to initial treatment or relapse after remission. Zanubrutinib is an oral small molecule BTK inhibitor, and has shown good efficacy and safety in multiple subtypes of B-cell lymphoma. However, the efficacy of zanubrutinib in highly aggressive B-cell lymphoma remains to be further studied

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Age ≥18 years, gender not limited
  2. Newly and histologically diagnosed aggressive B-NHL
  3. Patients who have not received systematic chemotherapy or immunotherapy;
  4. Patients with at least ≥1 tumor foci with a measurable maximum axis exceeding 1.5 cm;
  5. Eastern cancer collaboration group(ECOG) physical status score: 0-2
  6. a)Blood routine: (independent of growth factor support or transfusion within 7 days ofstudy entry) neutrophils absolute value ≥1.5×109/L, platelets ≥75×109/L, b)Coagulation function: INR ≤2.5 times ULN, c) Blood biochemistry: total bilirubin ≤2times ULN, AST or ALT≤2.5 times ULN d) Ccr ≥ 30 mL/min;
  7. expected survival time ≥3 months;
  8. Willing to take contraceptive measures during the trial period and within 1 week afterthe trial ends;
  9. Voluntarily sign written informed consent before screening.

Exclusion

Exclusion Criteria:

  1. Current or previous malignancy, unless radical therapy has been performed and there isno evidence of recurrence or metastasis in the past 5 years;
  2. Patients scheduled for major surgery(except for examination for diagnostic purposes)within 4 weeks or participating in drug/device clinical trials;
  3. Prior or concurrent indolent B-cell lymphoma transformation;
  4. Uncontrolled or significant cardiovascular disease;
  5. Had active bleeding within 2 months prior to screening, or was taking anticoagulantdrugs, or was considered by the investigator to have a clear tendency to bleeding;
  6. Stroke or intracranial hemorrhage within 6 months;
  7. Subjects with clinically significant gastrointestinal abnormalities that may affectdrug intake, transport or absorption (such as inability to swallow, chronic diarrhea,intestinal obstruction, etc.)
  8. Active or uncontrolled HBV (HBsAg positive and HBV DNA titer positive), HCV Abpositive or HIV positive;
  9. Uncontrolled, active systemic fungal, bacterial, viral, or other infections (definedas showing persistent signs/symptoms related to infection, despite the use ofappropriate antibiotics or other treatments without improvement)
  10. Allergies or hypersensitivity reactions to zanubrutinib, rituximab or any othercomponent of the applicable study drug;

Study Design

Total Participants: 160
Study Start date:
March 01, 2021
Estimated Completion Date:
December 31, 2024

Study Description

Non-Hodgkin lymphoma (NHL), with high aggressiveness and mortality, is one of the top ten high-incidence tumors in the world and is among the ten most prevalent cancers worldwide with the fastest growing incidence. B-cell non-Hodgkin's lymphoma (B-NHL) is the most common type of NHL. Although novel immunotherapies represented by anti-CD20 monoclonal antibodies and CAR-T cell therapies have significantly improved the prognosis of B-NHL patients, there are still nearly one-third of patients who are resistant to initial treatment or relapse after remission.

High-grade B-cell lymphoma (HGBL)-DH/TH with MYC/BCL2 and/or BCL6 translocation, accounts for about 7-10% in DLBCL. The remission rate of conventional chemotherapy is low.(ORR:32%,CR:12%). The median OS is 12 months. The survival outcome of induction chemotherapy is improved limited compared to R-CHOP. Currently, there are a lack of effective treatments options for HGBL. How to improve curative effect needs more research.

Zanubrutinib is an oral small molecule BTK inhibitor, and has shown good efficacy and safety in multiple subtypes of B-cell lymphoma. Zanubrutinib received FDA approval for adult mantle-cell lymphoma (MCL) and small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) patients who have received at least one previous treatment on 15 Nov 2019, becoming the first US-listed Chinese innovative anti-cancer drug. However, the efficacy of zanubrutinib in highly aggressive B-cell lymphoma remains to be further studied.

Therefore, we present this study protocol to add Zanubrutinib to the first-line treatment of highly aggressive B-NHL, applying zanubrutinib combined with rituximab plus chemotherapy in the treatment of highly aggressive B-NHL compared to rituximab plus chemotherapy.

Connect with a study center

  • Department of Hematology, Shandong Provincial Hospital

    Jinan, Shandong 250021
    China

    Active - Recruiting

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.