A Study of Nemtabrutinib Plus Venetoclax vs Venetoclax + Rituximab (VR) in Second-line (2L) + Relapsed/Refractory (R/R) Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) (MK-1026-010/BELLWAVE-010).

NCT ID: NCT05947851

Last Updated: 2025-11-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

735 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-08

Study Completion Date

2035-07-01

Brief Summary

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The purpose of this study is to assess the safety and tolerability and to confirm the dose of nemtabrutinib in combination with venetoclax in participants with R/R CLL/SLL. The primary study hypotheses are that the combination of nemtabrutinib plus venetoclax is superior to VR with respect to progression-free survival (PFS) per 2018 International Workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria as assessed by blinded independent central review (BICR).

Detailed Description

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Conditions

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Leukemia, Lymphocytic, Chronic, B-Cell Leukemia, Chronic Lymphocytic Small-Cell Lymphoma Lymphoma, Small Lymphocytic CLL SLL

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

In Part 1, Dose Confirmation will be determined by modified toxicity probability interval (mTPI) design, where participants will be assigned to two treatment groups, Nemtabrutinib + Venetoclax in parallel with Nemtabrutinib + Venetoclax. Part 2 will be an Efficacy Expansion where all participants will be randomized 1:1 to Nemtabrutinib Part 1 Dose Selection plus Venetoclax or Venetoclax plus Rituximab (VR) (or Rituximab biosimilar) for the duration of the study.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Nemtabrutinib + Venetoclax

Participants will receive nemtrabrutinib oral tablets at specified doses daily starting at Cycle 1 Day 1 (C1D1) and venetoclax oral tablets at doses of 20 mg up to 400 mg daily starting at Cycle 2 Day 1 (C2D1) up to 2 years post C2D1 or until progressive disease (PD) or discontinuation. A cycle = 4 weeks.

Group Type EXPERIMENTAL

Nemtabrutinib

Intervention Type DRUG

5, 20, 45, and 65 mg tablets

Venetoclax

Intervention Type DRUG

10, 50, and 100 mg tablets

Venetoclax + Rituximab

Participants will receive venetoclax oral tablets at doses from 20 mg up to 400 mg daily starting at C1D1 on 4-week cycles up to 2 years and rituximab or biosimilar at 375 mg/m\^2 up to 500 mg/m2 intravenous infusion once per 28-day cycle starting at C2D1, for 6 total cycles. Treatment will continue until progressive disease (PD) or discontinuation.

Group Type ACTIVE_COMPARATOR

Venetoclax

Intervention Type DRUG

10, 50, and 100 mg tablets

Rituximab

Intervention Type BIOLOGICAL

100 mg/10 mL, 500 mg/50 mL (10 mg/mL) IV Infusion

Interventions

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Nemtabrutinib

5, 20, 45, and 65 mg tablets

Intervention Type DRUG

Venetoclax

10, 50, and 100 mg tablets

Intervention Type DRUG

Rituximab

100 mg/10 mL, 500 mg/50 mL (10 mg/mL) IV Infusion

Intervention Type BIOLOGICAL

Other Intervention Names

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ARQ 531 MK-1026 ABT-199 GDC-0199

Eligibility Criteria

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Inclusion Criteria

* Confirmed diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and active disease clearly documented to initiate therapy
* Deletion (Del) (17p) status, tumor protein 53 (TP53) mutation status, and immunoglobulin heavy chain gene (IGHV) mutation status results required before randomization for Part 2 participants only
* Relapsed or refractory to at least 1 prior available therapy
* Have at least 1 marker of disease burden
* Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 within 7 days before randomization
* Has a life expectancy of at least 3 months
* Has the ability to swallow and retain oral medication
* Participants who are hepatitis B surface antigen (HBsAg) positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV deoxyribonucleic acid (DNA) viral load before randomization
* Participants with history of hepatitis C virus (HCV) infection are eligible if HCV ribonucleic acid (RNA) viral load is undetectable at screening
* Participants with human immunodeficiency virus (HIV) who meet ALL eligibility criteria
* Participants with adequate organ function with specimens collected within 7 days before the start of study intervention
* If capable of producing sperm, participant agrees to eliminate Nemtabrutinib: 12 days, Venetoclax: 1 month (30 days), Rituximab (rituximab biosimilar): not applicable; abstains from penile-vaginal intercourse as their preferred and usual lifestyle; OR uses prescribed contraception
* Participant assigned female sex at birth are eligible to participate if not pregnant or breastfeeding and are not a person of childbearing potential (POCBP) OR is a POCBP and uses a contraceptive method that is highly effective, has a negative highly sensitive pregnancy test, and abstains from breastfeeding

Exclusion Criteria

* Has an active hepatitis B virus/ hepatitis C virus (HBV/HCV) infection
* Has gastrointestinal (GI) dysfunction that may affect drug absorption
* Has a known additional malignancy that is progressing or has required active treatment within the past 2 years
* Has diagnosis of Richter Transformation or active central nervous system (CNS) involvement by CLL/SLL
* Has an active infection requiring systemic therapy, such as intravenous (IV) antibiotics, during screening
* HIV-infected participants with a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease and/or acquired immune deficiency syndrome (AIDS)-defining opportunistic infection in the past 12 months before screening
* Clinically significant cardiovascular disease
* Has a known allergy/sensitivity to nemtabrutinib or contraindication to venetoclax/rituximab (or rituximab biosimilar), or any of the excipients
* Has history of severe bleeding disorders (eg, hemophilia)
* Has received prior systemic anticancer therapy within 5 half-lives or 4 weeks (if prior therapy was a monoclonal antibody) before randomization
* Has received prior B-cell lymphoma 2 inhibitor(s) (BCL2i) within ≤ 12 months before randomization or has received prior radiotherapy within 2 weeks of start of study intervention, or radiation related toxicities, requiring corticosteroids
* Is currently being treated with p-glycoprotein (P-gp) substrates with a narrow therapeutic index, cytochrome P450 3A (CYP3A) strong or moderate inducers or CYP3A strong inhibitors.
* Has received a live or live attenuated vaccine within 30 days before the first dose of study intervention
* Has received an investigational agent or has used an investigational device within 4 weeks before study intervention administration
* Has a known psychiatric or substance use disorder that would interfere with the participant's ability to cooperate with the requirements of the study
* Participants who have not adequately recovered from major surgery or have ongoing surgical complications
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Merck Sharp & Dohme LLC

Locations

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Highlands Oncology Group ( Site 5405)

Springdale, Arkansas, United States

Site Status RECRUITING

MemorialCare Health System - Long Beach Medical Center ( Site 5421)

Long Beach, California, United States

Site Status RECRUITING

Memorial Hospital West ( Site 5410)

Pembroke Pines, Florida, United States

Site Status RECRUITING

Oregon Health and Science University ( Site 5425)

Portland, Oregon, United States

Site Status RECRUITING

Medical Oncology Associates, PS ( Site 5406)

Spokane, Washington, United States

Site Status RECRUITING

University of Wisconsin Hospital and Clinics-Carbone Cancer Center ( Site 5423)

Madison, Wisconsin, United States

Site Status RECRUITING

Instituto Alexander Fleming ( Site 1005)

Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

Site Status RECRUITING

Instituto de Investigaciones Clínicas Mar del Plata ( Site 1007)

Mar del Plata, Buenos Aires, Argentina

Site Status RECRUITING

Sanatorio Parque ( Site 1003)

Rosario, Santa Fe Province, Argentina

Site Status RECRUITING

Centro Medico Fleischer ( Site 1006)

Buenos Aires, , Argentina

Site Status RECRUITING

Hospital Aleman-oncohematologic diseases ( Site 1001)

Buenos Aires, , Argentina

Site Status RECRUITING

Royal Adelaide Hospital ( Site 1104)

Adelaide, South Australia, Australia

Site Status RECRUITING

Western Health-Sunshine & Footscray Hospitals-Cancer Services-Cancer Research ( Site 1103)

Melbourne, Victoria, Australia

Site Status RECRUITING

UZ Leuven-Hematology ( Site 1200)

Leuven, Vlaams-Brabant, Belgium

Site Status RECRUITING

ZAS Cadix ( Site 1203)

Antwerp, , Belgium

Site Status RECRUITING

ICESP - INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO-Pesquisa Clinica ( Site 1308)

São Paulo, , Brazil

Site Status ACTIVE_NOT_RECRUITING

The Moncton Hospital ( Site 1414)

Moncton, New Brunswick, Canada

Site Status RECRUITING

IC La Serena Research ( Site 1506)

La Serena, Coquimbo Region, Chile

Site Status RECRUITING

Centro de Estudios Clínicos SAGA-CECSAGA ( Site 1509)

Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

FALP-UIDO ( Site 1500)

Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

Clínica Inmunocel ( Site 1511)

Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

Biocenter ( Site 1507)

Concepción, Región del Biobío, Chile

Site Status RECRUITING

Fundación Valle del Lili ( Site 1703)

Cali, Valle del Cauca Department, Colombia

Site Status RECRUITING

Hopital Claude Huriez - CHU de Lille ( Site 2107)

Lille, Nord, France

Site Status RECRUITING

Centre Hospitalier Universitaire Estaing ( Site 2105)

Clermont-Ferrand, Puy-de-Dome, France

Site Status RECRUITING

CHD Vendee ( Site 2100)

La Roche-sur-Yon, Vendee, France

Site Status RECRUITING

Klinikum Mutterhaus der Borromäerinnen-Innere Medizin I ( Site 2203)

Trier, Rhineland-Palatinate, Germany

Site Status RECRUITING

Universitätsklinikum Leipzig-Medical Department I - Hematology and Celltherapy ( Site 2201)

Leipzig, Saxony, Germany

Site Status RECRUITING

Rambam Health Care Campus ( Site 2801)

Haifa, , Israel

Site Status RECRUITING

Hadassah Medical Center-Hemato-Oncology ( Site 2812)

Jerusalem, , Israel

Site Status RECRUITING

Sheba Medical Center-Hemato Oncology ( Site 2809)

Ramat Gan, , Israel

Site Status RECRUITING

Sourasky Medical Center ( Site 2811)

Tel Aviv, , Israel

Site Status RECRUITING

Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo ( Site 2906)

Alessandria, Ancona, Italy

Site Status RECRUITING

Ospedale San Raffaele-Programma di Ricerca Strategica sulla LLC ( Site 2902)

Milan, , Italy

Site Status RECRUITING

Arcispedale Santa Maria Nuova-Hematology ( Site 2900)

Reggio Emilia, , Italy

Site Status RECRUITING

Centro de Infusion Superare ( Site 3314)

Mexico City, Mexico City, Mexico

Site Status RECRUITING

Health Pharma Professional Research S.A. de C.V: ( Site 3301)

Mexico City, Mexico City, Mexico

Site Status RECRUITING

Centro de Investigacion Clinica Chapultepec ( Site 3309)

Morelia, Michoacán, Mexico

Site Status RECRUITING

Auxilio Mutuo Cancer Center ( Site 3900)

San Juan, , Puerto Rico

Site Status RECRUITING

Netcare Pretoria East Hospital-Albert Alberts Stem Cell Transplant Centre ( Site 4401)

Moreletapark, Gauteng, South Africa

Site Status RECRUITING

Groote Schuur Hospital ( Site 4400)

Cape Town, Western Cape, South Africa

Site Status RECRUITING

Haemalife ( Site 4407)

Kuilsriver, Western Cape, South Africa

Site Status RECRUITING

Instituto Catalan de Oncologia - Hospital Duran i Reynals-Haematology Department ( Site 4601)

L'Hospitalet Del Llobregat, Barcelona, Spain

Site Status RECRUITING

HOSPITAL UNIVERSITARIO QUIRONSALUD MADRID ( Site 4602)

Pozuelo de Alarcón, Madrid, Spain

Site Status RECRUITING

HOSPITAL CLINICO DE VALENCIA-HEMATOLOGY ( Site 4603)

Valencia, Valenciana, Comunitat, Spain

Site Status RECRUITING

Namik Kemal University Medical Faculty-Hematology ( Site 4912)

Tekirdağ, Tekirdas, Turkey (Türkiye)

Site Status RECRUITING

Ankara Universitesi Tip Fakultesi Hastanesi-hematology ( Site 4913)

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Mega Medipol-Hematology ( Site 4904)

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

TC Saglik Bakanligi Goztepe Prof. Dr. Suleyman Yalcin Sehir Hastanesi ( Site 4906)

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Ege Universitesi Hastanesi ( Site 4902)

Izmir, , Turkey (Türkiye)

Site Status RECRUITING

City Hospital, Nottingham University Hospitals-Hematology ( Site 5002)

Nottingham, England, United Kingdom

Site Status RECRUITING

University College London Hospital-Cancer Clinical Trials Unit ( Site 5001)

London-Camden, London, City of, United Kingdom

Site Status RECRUITING

Countries

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United States Argentina Australia Belgium Brazil Canada Chile Colombia France Germany Israel Italy Mexico Puerto Rico South Africa Spain Turkey (Türkiye) United Kingdom

Central Contacts

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Toll Free Number

Role: CONTACT

Phone: 1-888-577-8839

Email: [email protected]

Facility Contacts

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Related Links

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Other Identifiers

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MK-1026-010

Identifier Type: OTHER

Identifier Source: secondary_id

BELLWAVE-010

Identifier Type: OTHER

Identifier Source: secondary_id

2022-501560-17-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

U1111-1281-1520

Identifier Type: REGISTRY

Identifier Source: secondary_id

1026-010

Identifier Type: -

Identifier Source: org_study_id