A Study of Zanubrutinib (BGB-3111) Versus Ibrutinib in Participants With Relapsed/Refractory Chronic Lymphocytic Leukemia

NCT ID: NCT03734016

Last Updated: 2025-03-30

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

652 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-01

Study Completion Date

2024-02-28

Brief Summary

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This study is designed to compare the overall response rate of zanubrutinib versus ibrutinib in participants with relapsed/refractory chronic lymphocytic leukemia or small lymphocytic lymphoma.

Detailed Description

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This is a global, Phase 3, randomized study of zanubrutinib versus ibrutinib in 652 participants with relapsed/refractory chronic lymphocytic leukemia or small lymphocytic lymphoma.

The primary efficacy endpoint is overall response rate determined by investigator assessment. Participants were randomized in a 1:1 manner to either zanubrutinib or ibrutinib. Treatment with zanubrutinib and ibrutinib was open label.

Conditions

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Chronic Lymphocytic Leukemia Small Lymphocytic Lymphoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Zanubrutinib

Participants received 160 mg zanubrutinib orally twice daily until disease progression, intolerable toxicity, initiation of alternative anticancer therapy, investigator/Sponsor decision, need for prohibited medication, study withdrawal, or pregnancy.

Group Type EXPERIMENTAL

Zanubrutinib

Intervention Type DRUG

160 mg orally twice daily

Ibrutinib

Participants received Ibrutinib 420 mg orally once daily until disease progression, intolerable toxicity, initiation of alternative anticancer therapy, investigator/Sponsor decision, need for prohibited medication, study withdrawal, or pregnancy.

Group Type ACTIVE_COMPARATOR

Ibrutinib

Intervention Type DRUG

Ibrutinib 420 mg orally once daily

Interventions

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Zanubrutinib

160 mg orally twice daily

Intervention Type DRUG

Ibrutinib

Ibrutinib 420 mg orally once daily

Intervention Type DRUG

Other Intervention Names

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BGB-3111 Brukinsa Imbruvica

Eligibility Criteria

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Inclusion Criteria

1. Confirmed diagnosis of CLL or SLL that meets the 2008 International Workshop on Chronic Lymphocytic Leukemia (IWCLL) criteria
2. CLL/SLL requiring treatment per 2008 IWCLL criteria
3. Relapsed or refractory to at least 1 prior systemic therapy for CLL/SLL
4. Measurable disease by computerized tomography (CT)/magnetic resonance imaging (MRI)
5. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
6. Life expectancy ≥ 6 months
7. Adequate bone marrow function
8. Adequate renal and hepatic function

Exclusion Criteria

1. Known prolymphocytic leukemia or history of, or currently suspected, Richter's transformation
2. Clinically significant cardiovascular disease.
3. Prior malignancy within the past 3 years, except for curatively treated basal or squamous cell skin cancer, non-muscle-invasive bladder cancer, carcinoma in situ of the cervix or breast
4. History of severe bleeding disorder or history of spontaneous bleeding requiring blood transfusion or other medical intervention
5. History of stroke or intracranial hemorrhage within 180 days before first dose of study drug
6. Severe or debilitating pulmonary disease
7. Active fungal, bacterial, and/or viral infection requiring systemic therapy
8. Known central nervous system involvement by leukemia or lymphoma
9. Known infection with HIV or active viral hepatitis B or C infection
10. Moderate or severe hepatic impairment, ie, Child-Pugh class B or C
11. Major surgery within 4 weeks of the first dose of study drug
12. Prior treatment with a (Burton's Kinase) BTK inhibitor
13. Toxicity from prior anticancer therapy that has not recovered to ≤ Grade 1
14. Pregnant or lactating women
15. Vaccination with a live vaccine within 35 days prior to the first dose of study drug
16. Hypersensitivity to zanubrutinib, ibrutinib, or any of the other ingredients in either drug
17. Concurrent participation in another therapeutic clinical trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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BeiGene

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Study Director

Role: STUDY_DIRECTOR

BeiGene

Locations

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Carti Cancer Center

Little Rock, Arkansas, United States

Site Status

David Geffen School of Medicine At UCLA

Los Angeles, California, United States

Site Status

Rocky Mountain Cancer Centers Boulder

Boulder, Colorado, United States

Site Status

Scri Florida Cancer Specialists South

Fort Myers, Florida, United States

Site Status

Scri Florida Cancer Specialists North

St. Petersburg, Florida, United States

Site Status

Augusta University

Augusta, Georgia, United States

Site Status

Norton Cancer Institute Pavilion

Louisville, Kentucky, United States

Site Status

Dana Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

Forrest General Hospital Cancer Center

Hattiesburg, Mississippi, United States

Site Status

Scri Hca Midwest Health

Kansas City, Missouri, United States

Site Status

Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

Comprehensive Cancer Centers of Nevada

Las Vegas, Nevada, United States

Site Status

Atlantic Health System

Morristown, New Jersey, United States

Site Status

Morristown Medical Center

Morristown, New Jersey, United States

Site Status

Columbia University Medical Center

New York, New York, United States

Site Status

Clinical Research Alliance, Inc

Westbury, New York, United States

Site Status

Duke University Hospital

Durham, North Carolina, United States

Site Status

Oregon Health and Science University

Portland, Oregon, United States

Site Status

Willamette Valley Cancer Center

Springfield, Oregon, United States

Site Status

Scri Tennessee Oncology Chattanooga

Chattanooga, Tennessee, United States

Site Status

Sarah Cannon Cancer Center

Nashville, Tennessee, United States

Site Status

Texas Oncology Fort Worth Cancer Center

Fort Worth, Texas, United States

Site Status

The University of Texas Md Anderson Cancer Center

Houston, Texas, United States

Site Status

Joe Arrington Cancer Research and Treatment Center

Lubbock, Texas, United States

Site Status

Texas Oncology San Antonio Medical Center Usor

San Antonio, Texas, United States

Site Status

Texas Oncology Tyler Longview

Tyler, Texas, United States

Site Status

Blue Ridge Cancer Care (Oncology and Hematology Associates of Southwest Virginia)

Roanoke, Virginia, United States

Site Status

Va Puget Sound Health Care System

Seattle, Washington, United States

Site Status

Fred Hutchinson Cancer Research Center

Seattle, Washington, United States

Site Status

Medical Oncology Associates

Spokane, Washington, United States

Site Status

Calvary Mater Newcastle

Waratah, New South Wales, Australia

Site Status

Princess Alexandra Hospital

Brisbane, Queensland, Australia

Site Status

Icon Cancer Foundation

South Brisbane, Queensland, Australia

Site Status

Box Hill Hospital

Box Hill, Victoria, Australia

Site Status

Monash Health

Clayton, Victoria, Australia

Site Status

Peninsula Private Hospital

Frankston, Victoria, Australia

Site Status

Royal Perth Hospital

Perth, Western Australia, Australia

Site Status

Gasthuiszusters Antwerpen Sint Augustinus

Wilrijk, , Belgium

Site Status

Peking University Third Hospital

Beijing, Beijing Municipality, China

Site Status

Beijing Friendship Hospital, Capital Medical University

Beijing, Beijing Municipality, China

Site Status

Peking Union Medical College Hospital

Beijing, Beijing Municipality, China

Site Status

Fujian Medical University Union Hospital

Fuzhou, Fujian, China

Site Status

Quanzhou First Affliated Hospital of Fujian Medical University

Quanzhou, Fujian, China

Site Status

Guangdong Provincial Peoples Hospital

Guangzhou, Guangdong, China

Site Status

Nanfang Hospital of Southern Medical University

Guangzhou, Guangdong, China

Site Status

Henan Cancer Hospital

Zhengzhou, Henan, China

Site Status

Union Hospital of Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, China

Site Status

Jiangsu Province Hospital

Nanjing, Jiangsu, China

Site Status

The First Hospital of Jilin University

Changchun, Jilin, China

Site Status

Shengjing Hospital of China Medical University

Shenyang, Liaoning, China

Site Status

Affiliated Zhongshan Hospital of Fudan University

Shanghai, Shanghai Municipality, China

Site Status

Tongji Hospital of Tongji University

Shanghai, Shanghai Municipality, China

Site Status

West China Hospital, Sichuan University

Chengdu, Sichuan, China

Site Status

Institute of Hematology and Hospital of Blood Disease

Tianjin, Tianjin Municipality, China

Site Status

Tianjin Medical University Cancer Institute and Hospital

Tianjin, Tianjin Municipality, China

Site Status

The First Affiliated Hospital, Zhejiang University School of Medicine

Hangzhou, Zhejiang, China

Site Status

The First Provincial Wenzhou Hospital of Zhejiang

Wenzhou, Zhejiang, China

Site Status

Fakultni Nemocnice Brno

Brno, , Czechia

Site Status

Fakultni Nemocnice Hradec Kralove

Hradec Králové, , Czechia

Site Status

Fakultni Nemocnice Olomouc

Olomouc, , Czechia

Site Status

Fakultni Nemocnice Ostrava

Ostrava, , Czechia

Site Status

Hopital Prive Sevigne

Cesson-Sévigné, , France

Site Status

Centre Hospitalier Departemental de Vendee

La Roche-sur-Yon, , France

Site Status

Centre Hospitalier Le Mans

Le Mans, , France

Site Status

Chu Hopital Lyon Sud

PierreBenite, , France

Site Status

Centre Hospitalier Universitaire de Poitier Hopital de La Miletrie Hopital Jean Bernard

Poitiers, , France

Site Status

Chu Tours Hopital Bretonneau Service Pneumologie

Tours, , France

Site Status

Uniklinik Koln (Aor)

Cologne, , Germany

Site Status

Evangelisches Krankenhaus Hamm

Hamm, , Germany

Site Status

Ospedale San Raffaele

Milan, , Italy

Site Status

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda

Milan, , Italy

Site Status

Fondazione Policlinico Universitario Agostino Gemelli

Roma, , Italy

Site Status

Azienda Ospedaliera Citta Della Salute E Della Scienza Di Torino

Torino, , Italy

Site Status

Gelre Ziekenhuizen

Apeldoorn, , Netherlands

Site Status

Albert Schweitzer Ziekenhuis

Nijmegen, , Netherlands

Site Status

Middlemore Clinical Trials

Auckland, , New Zealand

Site Status

Christchurch Hospital (Canterbury Health Laboratories)

Christchurch, , New Zealand

Site Status

Waikato Hospital

Hamilton, , New Zealand

Site Status

North Shore Hospital

Takapuna, , New Zealand

Site Status

Tauranga Hospital

Tauranga, , New Zealand

Site Status

Wellington Regional Hospital (Ccdhb)

Wellington, , New Zealand

Site Status

Interhem Opieka Szpitalna

Bialystok, , Poland

Site Status

Szpital Specjalist W Brzozowie,Podkarpacki Osrodek Onkologiczny

Brzozów, , Poland

Site Status

Samodzielny Publiczny Zaklad Opieki Zdrowotnej Zespol Szpitali Miejskich

Chorzów, , Poland

Site Status

Copernicus Podmiot Leczniczy Sp Z Oo Wojewodzkie Centrum Onkologii

Gdansk, , Poland

Site Status

Uniwersyteckie Centrum Kliniczne

Gdansk, , Poland

Site Status

Malopolskie Centrum Medyczne Sc

Krakow, , Poland

Site Status

Wojewodzki Szpital Specjalistyczny W Legnicy

Legnica, , Poland

Site Status

Wielospecjalistyczne Centrum Onkologii I Traumatologii Im M Kopernika W Lodzi

Lodz, , Poland

Site Status

Examen Sp Z Oo

Poznan, , Poland

Site Status

Hospital Universitari Germans Trias I Pujol

Badalona, , Spain

Site Status

Hospital de La Santa Creu I Sant Pau

Barcelona, , Spain

Site Status

Hospital Universitario Vall Dhebron

Barcelona, , Spain

Site Status

Hospital Clinic I Provincial

Barcelona, , Spain

Site Status

Ico Girona

Girona, , Spain

Site Status

Hospital Universitario Ramon Y Cajal

Madrid, , Spain

Site Status

Hospital Universitario La Paz

Madrid, , Spain

Site Status

Hospital Universitario Puerta de Hierro Majadahonda

Majadahonda, , Spain

Site Status

Hospital Universitario Marques de Valdecilla

Santander, , Spain

Site Status

Hospital Virgen de La Salud

Toledo, , Spain

Site Status

Skanes Universitetssjukhus I Lund

Lund, , Sweden

Site Status

Karolinska Universitetssjukhuset Solna

Stockholm, , Sweden

Site Status

Namik Kemal University

Tekirdağ, , Turkey (Türkiye)

Site Status

Nhs Grampian Ppds

Aberdeen, , United Kingdom

Site Status

Birmingham Heartlands Hospital

Birmingham, , United Kingdom

Site Status

The Royal Bournemouth and Christchurch Hospitals Nhs Foundation

Bournemouth, , United Kingdom

Site Status

Kent and Canterbury Hospital

Canterbury, , United Kingdom

Site Status

St Jamess Institute of Oncology

Leeds, , United Kingdom

Site Status

Barts Health Nhs Trust

London, , United Kingdom

Site Status

Norfolk and Norwich University Hospitals Nhs Foundation Trust

Norwich, , United Kingdom

Site Status

Nottingham University Hospitals Nhs Trust

Nottingham, , United Kingdom

Site Status

Derriford Hospital

Plymouth, , United Kingdom

Site Status

Southampton General Hospital

Southampton, , United Kingdom

Site Status

Sunderland Royal Hospital

Sunderland, , United Kingdom

Site Status

Genesiscare Oxford

Waterlooville, , United Kingdom

Site Status

Countries

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United States Australia Belgium China Czechia France Germany Italy Netherlands New Zealand Poland Spain Sweden Turkey (Türkiye) United Kingdom

References

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Brown JR, Eichhorst B, Hillmen P, Jurczak W, Kazmierczak M, Lamanna N, O'Brien SM, Tam CS, Qiu L, Zhou K, Simkovic M, Mayer J, Gillespie-Twardy A, Ferrajoli A, Ganly PS, Weinkove R, Grosicki S, Mital A, Robak T, Osterborg A, Yimer HA, Salmi T, Wang MD, Fu L, Li J, Wu K, Cohen A, Shadman M. Zanubrutinib or Ibrutinib in Relapsed or Refractory Chronic Lymphocytic Leukemia. N Engl J Med. 2023 Jan 26;388(4):319-332. doi: 10.1056/NEJMoa2211582. Epub 2022 Dec 13.

Reference Type BACKGROUND
PMID: 36511784 (View on PubMed)

Hillmen P, Eichhorst B, Brown JR, Lamanna N, O'Brien SM, Tam CS, Qiu L, Kazmierczak M, Zhou K, Simkovic M, Mayer J, Gillespie-Twardy A, Shadman M, Ferrajoli A, Ganly PS, Weinkove R, Grosicki S, Mital A, Robak T, Osterborg A, Yimer HA, Salmi T, Ji M, Yecies J, Idoine A, Wu K, Huang J, Jurczak W. Zanubrutinib Versus Ibrutinib in Relapsed/Refractory Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma: Interim Analysis of a Randomized Phase III Trial. J Clin Oncol. 2023 Feb 10;41(5):1035-1045. doi: 10.1200/JCO.22.00510. Epub 2022 Nov 17.

Reference Type BACKGROUND
PMID: 36395435 (View on PubMed)

Hillmen P, Brown JR, Eichhorst BF, Lamanna N, O'Brien SM, Qiu L, Salmi T, Hilger J, Wu K, Cohen A, Huang J, Tam CS. ALPINE: zanubrutinib versus ibrutinib in relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma. Future Oncol. 2020 Apr;16(10):517-523. doi: 10.2217/fon-2019-0844. Epub 2020 Mar 24.

Reference Type RESULT
PMID: 32207333 (View on PubMed)

Brown JR, Li J, Eichhorst BF, Lamanna N, O'Brien SM, Tam CS, Qiu L, Huang R, Shi Y, Idoine A, Salmi T, Cohen AC, Shadman M. Acquired mutations in patients with relapsed/refractory CLL who progressed in the ALPINE study. Blood Adv. 2025 Apr 22;9(8):1918-1926. doi: 10.1182/bloodadvances.2024014206.

Reference Type DERIVED
PMID: 39853273 (View on PubMed)

Brown JR, Eichhorst B, Lamanna N, O'Brien SM, Tam CS, Qiu L, Jurczak W, Zhou K, Simkovic M, Mayer J, Gillespie-Twardy A, Ferrajoli A, Ganly PS, Weinkove R, Grosicki S, Mital A, Robak T, Osterborg A, Yimer HA, Wang M, Salmi T, Wang L, Li J, Wu K, Cohen A, Shadman M. Sustained benefit of zanubrutinib vs ibrutinib in patients with R/R CLL/SLL: final comparative analysis of ALPINE. Blood. 2024 Dec 26;144(26):2706-2717. doi: 10.1182/blood.2024024667.

Reference Type DERIVED
PMID: 39316666 (View on PubMed)

Zhou K, Wang T, Pan L, Xu W, Jin J, Zhang W, Hu Y, Hu J, Feng R, Li P, Liu Z, Liu P, Jing H, Gao S, Zhang H, Yu K, Wang Z, Zhu X, Sun Z, Li F, Yan D, Weng J, Fu L, Wang L, Salmi T, Wu K, Qiu L. Improved efficacy and safety of zanubrutinib versus ibrutinib in patients with relapsed/refractory chronic lymphocytic leukemia (R/R CLL) in China: a subgroup of ALPINE. Ann Hematol. 2024 Oct;103(10):4183-4191. doi: 10.1007/s00277-024-05823-8. Epub 2024 Jun 18.

Reference Type DERIVED
PMID: 38888616 (View on PubMed)

Moslehi JJ, Furman RR, Tam CS, Salem JE, Flowers CR, Cohen A, Zhang M, Zhang J, Chen L, Ma H, Brown JR. Cardiovascular events reported in patients with B-cell malignancies treated with zanubrutinib. Blood Adv. 2024 May 28;8(10):2478-2490. doi: 10.1182/bloodadvances.2023011641.

Reference Type DERIVED
PMID: 38502198 (View on PubMed)

Brown JR, Eichhorst B, Hillmen P, Jurczak W, Kazmierczak M, Lamanna N, O'Brien SM, Tam CS, Qiu L, Zhou K, Simkovic M, Mayer J, Gillespie-Twardy A, Ferrajoli A, Ganly PS, Weinkove R, Grosicki S, Mital A, Robak T, Osterborg A, Yimer HA, Salmi T, Wang MD, Fu L, Li J, Wu K, Cohen A, Shadman M. Plain language summary of zanubrutinib or ibrutinib in chronic lymphocytic leukemia that is resistant to treatment or has come back after treatment. Future Oncol. 2024 Apr;20(12):717-726. doi: 10.2217/fon-2023-0849. Epub 2023 Dec 13.

Reference Type DERIVED
PMID: 38088119 (View on PubMed)

Tam CS, Lamanna N, O'Brien SM, Qiu L, Yang K, Barnes G, Wu K, Salmi T, Brown JR. Health-related quality of life outcomes associated with zanubrutinib versus ibrutinib monotherapy in patients with relapsed/refractory chronic lymphocytic leukemia and small lymphocytic lymphoma: results from the ALPINE Trial. Curr Med Res Opin. 2023 Nov;39(11):1497-1503. doi: 10.1080/03007995.2023.2262378. Epub 2023 Oct 27.

Reference Type DERIVED
PMID: 37752892 (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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2018-001366-42

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

CTR20190098

Identifier Type: REGISTRY

Identifier Source: secondary_id

BGB-3111-305

Identifier Type: -

Identifier Source: org_study_id

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