Ibrutinib Plus Venetoclax in Subjects With Treatment-naive Chronic Lymphocytic Leukemia /Small Lymphocytic Lymphoma (CLL/SLL)

NCT ID: NCT02910583

Last Updated: 2024-12-20

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

323 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-28

Study Completion Date

2024-03-27

Brief Summary

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This is a multicenter, 2-cohort Phase 2 study assessing both minimal residual disease (MRD)-guided discontinuation and fixed duration therapy with the combination of ibrutinib + venetoclax in subjects with treatment-naïve CLL or SLL.

Detailed Description

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Conditions

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Leukemia Chronic Lymphocytic Leukemia Small Lymphocytic Lymphoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Participants with confirmed undetectable minimal residual disease (uMRD) in the MRD cohort are triple masked.

Allocation was not randomized for the Fixed Duration (FD) cohort.

Study Groups

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Fixed Duration (FD) Cohort: Open Label Ibrutinib + Venetoclax

Participants receive 420 mg of single-agent ibrutinib for first 3 cycles followed by ibrutinib plus venetoclax combination treatment (ibrutinib 420 mg and venetoclax 400 mg orally once daily on a continuous schedule) for 12 cycles (a cycle is defined by 28 days) or until disease progression or unacceptable toxicity.

Group Type EXPERIMENTAL

ibrutinib

Intervention Type DRUG

ibrutinib administered orally once daily (three 140 mg capsules)

venetoclax

Intervention Type DRUG

venetoclax tablets will be administered orally once daily starting with a 5 week ramp up of 20 mg, 50 mg, 100 mg, 200 mg and 400 mg. After ramp up, venetoclax will be administered at 400 mg.

MRD Cohort/Confirmed Undetectable MRD (uMRD): Randomized to Ibrutinib (Blinded)

Participants receive 420 mg of single-agent ibrutinib for the first 3 cycles followed by ibrutinib plus venetoclax combination treatment for at least 12 cycles (a cycle is defined as 28 days) prior to randomization (pre-randomization phase).

Participants with confirmed uMRD are randomized to receive ibrutinib 420 mg orally once daily on a continuous schedule until MRD-positive relapse, disease progression (PD), or unacceptable toxicity.

After MRD-positive relapse or disease progression (PD) by iwCLL criteria, participants can reintroduce 400 mg venetoclax with a 5-week ramp up. If venetoclax is to be reintroduced, venetoclax treatment is to continue at the dose of 400 mg/day for up to approximately 2 years (cumulative) until PD or unacceptable toxicity.

Group Type EXPERIMENTAL

ibrutinib

Intervention Type DRUG

ibrutinib administered orally once daily (three 140 mg capsules)

venetoclax

Intervention Type DRUG

venetoclax tablets will be administered orally once daily starting with a 5 week ramp up of 20 mg, 50 mg, 100 mg, 200 mg and 400 mg. After ramp up, venetoclax will be administered at 400 mg.

MRD Cohort/Confirmed uMRD: Randomized Placebo (Blinded)

Participants receive 420 mg of single-agent ibrutinib for the first 3 cycles followed by ibrutinib plus venetoclax combination treatment for at least 12 cycles (a cycle is defined as 28 days) prior to randomization (pre-randomization phase).

Participants with confirmed uMRD are randomized to receive placebo orally once daily on a continuous schedule until MRD-positive relapse, PD or unacceptable toxicity.

If MRD-positive relapse or PD is confirmed after restaging per iwCLL criteria, participants can first reintroduce oral daily ibrutinib with the option of subsequently reintroducing 400 mg venetoclax with a 5-week ramp up, if subsequent disease relapse per iwCLL criteria occurs after ibrutinib reintroduction. If venetoclax is to be reintroduced, venetoclax treatment is to continue at the dose of 400 mg/day for up to approximately 2 years (cumulative) until PD or unacceptable toxicity.

Group Type PLACEBO_COMPARATOR

ibrutinib

Intervention Type DRUG

ibrutinib administered orally once daily (three 140 mg capsules)

venetoclax

Intervention Type DRUG

venetoclax tablets will be administered orally once daily starting with a 5 week ramp up of 20 mg, 50 mg, 100 mg, 200 mg and 400 mg. After ramp up, venetoclax will be administered at 400 mg.

Placebo

Intervention Type DRUG

placebo capsules to match ibrutinib administered orally once daily

MRD Cohort/uMRD Not Confirmed: Randomized to Ibrutinib (Open-Label)

Participants receive 420 mg of single-agent ibrutinib for the first 3 cycles followed by ibrutinib plus venetoclax combination treatment for at least 12 cycles (a cycle is defined as 28 days) prior to randomization (pre randomization phase).

Participants with uMRD not confirmed are randomized to receive open-label ibrutinib 420 mg orally once daily on a continuous schedule until PD or unacceptable toxicity.

In case of confirmed PD after restaging per iwCLL criteria, participants can continue ibrutinib and reintroduce venetoclax treatment. If venetoclax is to be reintroduced, venetoclax treatment is to continue at the dose of 400 mg/day for up to approximately 2 years (cumulative) until PD or unacceptable toxicity.

Group Type EXPERIMENTAL

ibrutinib

Intervention Type DRUG

ibrutinib administered orally once daily (three 140 mg capsules)

venetoclax

Intervention Type DRUG

venetoclax tablets will be administered orally once daily starting with a 5 week ramp up of 20 mg, 50 mg, 100 mg, 200 mg and 400 mg. After ramp up, venetoclax will be administered at 400 mg.

MRD Cohort/uMRD Not Confirmed: Randomized Ibrutinib + Venetoclax (Open-Label)

Participants receive 420 mg of single-agent ibrutinib for the first 3 cycles followed by ibrutinib plus venetoclax combination treatment for at least 12 cycles (a cycle is defined as 28 days) prior to randomization (pre randomization phase).

Participants with uMRD not confirmed are randomized to receive open-label ibrutinib 420 mg and venetoclax 400 mg orally once daily on a continuous schedule until PD or unacceptable toxicity. Venetoclax was allowed for administration up to 2 years cumulatively from first dose started in the pre-randomization phase to last dose in the randomization phase.

Group Type EXPERIMENTAL

ibrutinib

Intervention Type DRUG

ibrutinib administered orally once daily (three 140 mg capsules)

venetoclax

Intervention Type DRUG

venetoclax tablets will be administered orally once daily starting with a 5 week ramp up of 20 mg, 50 mg, 100 mg, 200 mg and 400 mg. After ramp up, venetoclax will be administered at 400 mg.

Interventions

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ibrutinib

ibrutinib administered orally once daily (three 140 mg capsules)

Intervention Type DRUG

venetoclax

venetoclax tablets will be administered orally once daily starting with a 5 week ramp up of 20 mg, 50 mg, 100 mg, 200 mg and 400 mg. After ramp up, venetoclax will be administered at 400 mg.

Intervention Type DRUG

Placebo

placebo capsules to match ibrutinib administered orally once daily

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of CLL/SLL that meets 2008 International Workshop on Chronic Lymphocytic Leukemia (IWCLL) diagnostic criteria (Hallek et al), with active disease meeting at least 1 IWCLL criteria for requiring treatment.
* Measurable nodal disease by computed tomography (CT)
* Adequate hepatic, and renal function
* Adequate hematologic function
* absolute neutrophil count \>750/µL
* platelet count \>30,000 /μL
* hemoglobin \>8.0 g/dL

Exclusion Criteria

* Any prior therapy used for treatment of CLL/SLL
* Known allergy to xanthine oxidase inhibitors and/or rasburicase for subjects at risk for tumor lysis syndrome (TLS)
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Janssen Research & Development, LLC

INDUSTRY

Sponsor Role collaborator

Pharmacyclics LLC.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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ABBVIE INC.

Role: STUDY_DIRECTOR

AbbVie

Locations

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City of Hope /ID# 1142-0047

Duarte, California, United States

Site Status

Moores Cancer Center at UC San Diego /ID# 1142-0241

La Jolla, California, United States

Site Status

UC Irvine Medical Center - Chao Family Comprehensive Cancer Center /ID# 1142-0008

Orange, California, United States

Site Status

Norton Cancer Center /ID# 1142-0071

Louisville, Kentucky, United States

Site Status

Rutgers Cancer Institute of New Jersey /ID# 1142-1193

New Brunswick, New Jersey, United States

Site Status

Northwell Health/Long Island Jewish Hospital /ID# 1142-0350

New Hyde Park, New York, United States

Site Status

New York Presbyterian Hospital/Weill Cornell Med College /ID# 1142-0200

New York, New York, United States

Site Status

University of Rochester Cancer Center /ID# 1142-0127

Rochester, New York, United States

Site Status

Charlotte-Mecklenberg Hospital, Carolinas Healthcare System, Levine Cancer Inst /ID# 1142-0733

Charlotte, North Carolina, United States

Site Status

Cleveland Clinic Foundation /ID# 1142-0739

Cleveland, Ohio, United States

Site Status

University of Pennsylvania /ID# 1142-0069

Philadelphia, Pennsylvania, United States

Site Status

Tennessee Oncology - Chattanooga /ID# 1142-0123

Chattanooga, Tennessee, United States

Site Status

MD Anderson Cancer Center /ID# 1142-0032

Houston, Texas, United States

Site Status

Swedish Cancer Institute /ID# 1142-0114

Seattle, Washington, United States

Site Status

St George Hospital /ID# 1142-0654

Kogarah, New South Wales, Australia

Site Status

Flinders Medical Centre /ID# 1142-0163

Bedford Park, South Australia, Australia

Site Status

Monash Medical Centre /ID# 1142-0556

Clayton, Victoria, Australia

Site Status

Peter MacCallum Cancer Centre-East Melbourne /ID# 1142-0633

East Melbourne, Victoria, Australia

Site Status

St Vincent's Hospital Melbourne /ID# 1142-0501

Fitzroy, Victoria, Australia

Site Status

Frankston Hospital /ID# 1142-0715

Frankston, Victoria, Australia

Site Status

Austin Health /ID# 1142-0170

Heidelberg, Victoria, Australia

Site Status

Ospedale San Raffaele IRCCS /ID# 1142-0523

Milan, Lombardy, Italy

Site Status

Ospedale Policlinico San Martino /ID# 1142-0903

Genova, , Italy

Site Status

ASST Grande Ospedale Metropolitano Niguarda /ID# 1142-0581

Milan, , Italy

Site Status

Azienda Ospedaliero-Universitaria di Modena /ID# 1142-0524

Modena, , Italy

Site Status

Azienda Ospedaliero Universitaria Maggiore della Carita di Novara /ID# 1142-0582

Novara, , Italy

Site Status

Azienda Ospedaliera di Padova /ID# 1142-1175

Padua, , Italy

Site Status

Azienda USL di Piacenza - Ospedale Guglielmo da Saliceto /ID# 1142-1182

Piacenza, , Italy

Site Status

Middlemore Hospital /ID# 1142-0662

Otahuhu, Auckland, New Zealand

Site Status

Christchurch Hospital /ID# 1142-0589

Christchurch, Canterbury, New Zealand

Site Status

Palmerston North Hospital /ID# 1142-0585

Palmerston North, Manawatu-Wanganui, New Zealand

Site Status

North Shore Hospital /ID# 1142-0663

Auckland, , New Zealand

Site Status

Malopolskie Centrum Medyczne /ID# 1142-0364

Krakow, Lesser Poland Voivodeship, Poland

Site Status

Duplicate_Samodzielny Publiczny Szpital Kliniczny nr 1 w Lublinie /ID# 1142-0590

Lublin, Lublin Voivodeship, Poland

Site Status

Szpital Specjalistyczny w Brzozowie Podkarpacki Osrodek Onkologiczny im. ks. B. /ID# 1142-0592

Brzozów, Podkarpackie Voivodeship, Poland

Site Status

Samodzielny Publiczny Szpital Klinczny Nr-1- Akademickie Cenrum Klinic /ID# 1142-0529

Gdansk, Pomeranian Voivodeship, Poland

Site Status

Medical Univ. of Lodz and Copernicus Memorial Hospital /ID# 1142-0531

Lodz, , Poland

Site Status

Hospital Duran i Reynals /ID# 1142-0604

L'Hospitalet de Llobregat, Barcelona, Spain

Site Status

Hospital Universitario Puerta de Hierro, Majadahonda /ID# 1142-0536

Majadahonda, Madrid, Spain

Site Status

Complejo Hospitalario de Navarra /ID# 1142-1197

Pamplona, Navarre, Spain

Site Status

Hospital Clinic de Barcelona /ID# 1142-0533

Barcelona, , Spain

Site Status

Hospital Santa Creu i Sant Pau /ID# 1142-0535

Barcelona, , Spain

Site Status

Hospital Universitario Virgen de las Nieves /ID# 1142-1196

Granada, , Spain

Site Status

Hospital Universitario Ramon y Cajal /ID# 1142-0874

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre /ID# 1142-0864

Madrid, , Spain

Site Status

Hospital Clinico Universitario de Salamanca /ID# 1142-0790

Salamanca, , Spain

Site Status

Countries

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United States Australia Italy New Zealand Poland Spain

References

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Moreno C, Solman IG, Tam CS, Grigg A, Scarfo L, Kipps TJ, Srinivasan S, Mali RS, Zhou C, Dean JP, Szafer-Glusman E, Choi M. Immune restoration with ibrutinib plus venetoclax in first-line chronic lymphocytic leukemia: the phase 2 CAPTIVATE study. Blood Adv. 2023 Sep 26;7(18):5294-5303. doi: 10.1182/bloodadvances.2023010236.

Reference Type DERIVED
PMID: 37315225 (View on PubMed)

Wierda WG, Allan JN, Siddiqi T, Kipps TJ, Opat S, Tedeschi A, Badoux XC, Kuss BJ, Jackson S, Moreno C, Jacobs R, Pagel JM, Flinn I, Pak Y, Zhou C, Szafer-Glusman E, Ninomoto J, Dean JP, James DF, Ghia P, Tam CS. Ibrutinib Plus Venetoclax for First-Line Treatment of Chronic Lymphocytic Leukemia: Primary Analysis Results From the Minimal Residual Disease Cohort of the Randomized Phase II CAPTIVATE Study. J Clin Oncol. 2021 Dec 1;39(34):3853-3865. doi: 10.1200/JCO.21.00807. Epub 2021 Oct 7.

Reference Type DERIVED
PMID: 34618601 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2016-002293-12

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

PCYC-1142-CA

Identifier Type: -

Identifier Source: org_study_id