A Phase 2 Study of MRD Adapted Therapy With Venetoclax-obinutuzumab in Patients With High or Intermediate BALL Risk Relapsed or Refractory CLL, With Addition of Acalabrutinib in Patients Who Fail to Achieve MRD Eradication

Who is this study for? Patients with chronic lymphocytic leukemia or small lymphocytic lymphoma
What treatments are being studied? Venetoclax+Obinutuzumab+Acalabrutinib
Status: Recruiting
Location: See all (3) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

This research study is studying a combination of drugs as a possible treatment for chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). The names of the study drugs involved in this study are: * obinutuzumab * venetoclax * acalabrutinib

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Diagnosis of CLL or SLL according to WHO criteria

• Participants must require therapy according to iwCLL 2018 guidelines

• Participants must have ≥ 2 points (high or intermediate risk disease) according to the CLL

∙ BALL Risk Model:

• Beta-2 microglobulin If ≥ 5 mg/L, assign 1 point

• Lactate dehydrogenase If \>institutional upper limit of normal, assign 1 point

• Hemoglobin If \<11 g/dL (female) or \<12 g/dL (male), assign 1 point

• Time from start of last therapy If \<24 months, assign 1 point, If 4 points, patient is high risk, If 2-3 points, patient is intermediate risk, If 0-1 points, patient is low risk

‣ Participants must have received prior systemic therapy for CLL

⁃ Age over 18 years

⁃ ECOG performance status ≤2 (Karnofsky ≥60%, see Appendix A)

⁃ Participants must have adequate organ function as defined below:

• total bilirubin ≤2 × institutional upper limit of normal unless considered secondary to Gilbert's syndrome, in which case ≤3 x ULN

• AST(SGOT)/ALT(SGPT) ≤2 × institutional upper limit of normal

• creatinine within normal institutional limits OR

• creatinine clearance ≥30 mL/min according to the Cockcroft-Gault Equation for participants with creatinine levels above institutional normal.

‣ Participants must have adequate marrow function as defined below (unless clearly due to disease under study per investigator discretion)

• absolute neutrophil count ≥1,000/mcL

• platelets ≥75,000/mcL OR

• \> 20,000/mcL if thrombocytopenia is clearly due to disease under study (per investigator discretion).

‣ For females of childbearing potential, a negative serum pregnancy test within 7 days of study treatment

⁃ For female patients of childbearing potential and male patients with partners of childbearing potential, agreement (by patient and/or partner) to use highly effective form(s) of contraception (i.e., one that results in a low failure rate \[\<1% per year\] when used consistently and correctly) and to continue its use for 90 days after the last dose of acalabrutinib or venetoclax AND for 18 months after the last dose of obinutuzumab (whichever date is later)

⁃ The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception.

⁃ Willingness to not donate sperm or oocytes during the entire study treatment period and after treatment discontinuation

⁃ Ability to understand and the willingness to sign a written informed consent document.

Locations
United States
Massachusetts
Beth Israel Deaconess Medical Center
NOT_YET_RECRUITING
Boston
Dana-Farber Cancer Institute
NOT_YET_RECRUITING
Boston
Massachusetts General Hospital Cancer Center
RECRUITING
Boston
Contact Information
Primary
Jacob D Soumerai, MD
jsoumerai@mgh.harvard.edu
617-724-4000
Backup
Jacob D Soumerai, MD
jsoumerai@mgh.harvard.edu
Time Frame
Start Date: 2020-10-19
Estimated Completion Date: 2027-03-01
Participants
Target number of participants: 40
Treatments
Experimental: Venetoclax-Obinutuzumab +/- Acalabrutinib
A treatment cycle is defined as 28 consecutive days. Participants with undetectable MRD (uMRD) at 1 year will complete an additional 1 year of VO then stop therapy.~Participants with high detectable MRD at 1 year will complete an additional 1 year of VO plus acalabrutinib then stop therapy.~Participants with low detectable MRD at 1 year will complete an additional 1 year of VO alone. If this eradicates MRD, they will stop therapy. If there is still residual MRD, they will complete an additional 1 year of IVO then stop therapy.~If progression occurs on VO, I will be added and IV will be administered indefinitely. After 2 years, V may be stopped and I continued as monotherapy at investigator discretion.~* Infused Study Drug: Obinutuzumab on Days 1, 2, 8, and 15 of Cycle 1 and then on Day 1 of Cycles 1-6~* Oral Study Drugs: Venetoclax daily starting on Cycle 1 Day 22~* Oral Drug: acalabrutinib daily for Days 1-28 (if applicable)
Sponsors
Collaborators: Genentech, Inc.
Leads: Massachusetts General Hospital

This content was sourced from clinicaltrials.gov

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