Early Intervention With Acalabrutinib in Patients With High Risk CLL

NCT ID: NCT04660045

Last Updated: 2022-04-05

Basic Information

• Recruitment Status: WITHDRAWN
• Clinical Phase: PHASE2
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-05-31
• Study Completion Date: 2026-06-30

Brief Summary

This study evaluates the effectiveness of acalabrutinib treatment in patients with chronic lymphocytic leukemia (CLL) deemed at high risk for Richter's Transformation (RT). This is a single arm study. Enrolled patients will initiate therapy with acalabrutinib and will dose continuously. While on study, subjects will be monitored monthly for the first 3 months, then every three months thereafter until disease progression, discontinuation due to toxicity, death, or study completion.

Detailed Description

This is a multi-center, single arm, Phase II clinical trial to investigate the effectiveness of acalabrutinib treatment within 6 months of chronic lymphocytic leukemia (CLL) diagnosis for patients with CLL deemed at high risk for Richter's Transformation (RT).

Conditions

Chronic Lymphocytic Leukemia; CLL/SLL

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Acalabrutinib

Acalabrutinib 100 mg will be administered orally twice daily continuously in 28-day cycles until treatment is discontinued for any reason.

Group Type: EXPERIMENTAL

Acalabrutinib

Intervention Type: DRUG

Acalabrutinib, oral, 100 mg BID, continuous

Interventions

Acalabrutinib

Acalabrutinib, oral, 100 mg BID, continuous

Intervention Type: DRUG

Other Intervention Names

CALQUENCE; ACP-196

Eligibility Criteria

Inclusion Criteria

• Subject must be able to voluntarily sign and date an informed consent, approved by an Independent Ethics Committee (IEC)/Institutional Review Board (IRB), prior to the initiation of any screening or study specific procedures.
• The time from diagnosis to consent should be ≤6 months.
• Subject must be ≥ 18 years of age.
• Subject must have diagnosis of CLL/SLL based upon 2018 iwCLL Guidelines.
• Rai stage 0-2 disease without indication for treatment as defined by the 2018 iwCLL guidelines
• Subject must have high risk CLL as defined by any one of the following:

• NOTCH1 mutated (classic frameshift mutation only)
• Unmutated V4-39 B cell receptor usage
• Pathogenic c-MYC mutations
• Complex karyotype, (by CpG/oligodeoxynucleotide stimulation)
• Deletion 17p, or presence of TP53 mutation
• Subject has an Eastern Cooperative Oncology Group (ECOG) performance score of ≤ 2.
• PT/PTT/INR within 1.5 x the ULN
• Adequate renal function defined by serum creatinine less than 2 x ULN
• Adequate hepatic function:

• ALT/AST less than 2x ULN
• Tbili less than 1.5 X ULN unless bilirubin elevation is due to Gilbert's syndrome (total bilirubin <3)
• Subject must have adequate bone marrow function.

• Absolute neutrophil count ≥1.0 x103/μL
• Hemoglobin ≥ 11.0 g/dL
• Platelets ≥ 100 x 103/μL

Exclusion Criteria

• Previous exposure to any systemic anti-cancer therapy as a treatment for CLL, including but not limited to chemotherapy, immunotherapy, radiotherapy, or investigational therapy. Note, patients treated with chemotherapy for a prior non-hematologic malignancy if more than 5 years earlier are eligible.
• Subject with a history of malignancy except for non-melanoma skin cancers. Subjects treated with curative intent via methods of local resection and or locally targeted anticancer treatment and are free of malignancy for at least 5 years from treatment end will be allowed to enroll.
• Subject requires chronic immunosuppressive therapy for any reason or was treated with immunosuppressive therapy within 6 months of study entry.
• Subjects with a history of autoimmune hemolytic anemia or immune thrombocytopenia purpura.
• Subject has prolymphocytic leukemia.
• Active bleeding, or history of bleeding diathesis (e.g., hemophilia or von Willebrand disease)
• Subject requires warfarin or equivalent vitamin K antagonist
• Uncontrolled or active significant infection,
• History of or suspected or confirmed PML
• Clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of screening, or any Class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification. Subjects with controlled, asymptomatic atrial fibrillation during screening can enroll on study.
• Patients with stroke or CNS hemorrhage within 6 months
• Pregnant or breastfeeding

• Women of childbearing potential (WCBP) who are sexually active with heterosexual partners must agree to use highly effective methods of contraception during treatment and for 2 days after the last dose of acalabrutinib.
• Major surgical procedure within 28 days of first dose of study drug. If a subject had surgery, they must have recovered adequately from any toxicity or complications before the first dose of study drug.
• Has difficulty with or is unable to swallow oral medication or has significant gastrointestinal disease that would limit absorption of oral medication.
• Subject is known to be positive for human immunodeficiency virus (HIV)
• Active hepatitis C, as confirmed by being positive for Hep C RNA by PCR
• Active hepatitis B infection documented by a positive PCR for Hep B DNA. If hepatitis B serology is positive for hepatitis B core antibody, but Hep B DNA PCR is negative, patient is eligible to enroll.
• Subject requires strong CYP 3A4/5 inhibitors or inducers (Appendix B).
• Subject requires proton pump inhibitors. (Subjects that can transition to an H2 antagonist are allowed to enroll.)

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

AstraZeneca

INDUSTRY

Sponsor Role: collaborator

Weill Medical College of Cornell University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

John N Allan, M.D.

Role: PRINCIPAL_INVESTIGATOR

Weill Medical College of Cornell University

Locations

Weill Cornell Medicine

New York, New York, United States

Countries

United States

Related Links

https://jcto.weill.cornell.edu/

WCM Joint Clinical Trials Office

Other Identifiers

20-11022876

Identifier Type: -

Identifier Source: org_study_id