A Study of Vemurafenib and Obinutuzumab Compared to Cladribine and Rituximab in People With Hairy Cell Leukemia (HCL)

NCT ID: NCT06561360

Last Updated: 2025-10-07

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: PHASE2
• Total Enrollment: 86 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-09-09
• Study Completion Date: 2027-09-09

Brief Summary

The researchers are doing this study to compare the safety of vemurafenib in combination with obinutuzumab to the standard of approach of cladribine in combination with rituximab. The researchers will look at which treatment causes fewer or milder side effects. Researchers think vemurafenib and obinutuzumab (non-chemotherapy drugs) may cause fewer side effects compared with the usual approach of chemotherapy drugs. They will also compare the two approaches to see which approach is more effective at eliminating cancer cells.

Conditions

Hairy Cell Leukemia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Vemurafenib plus Obinutuzumab

Patients assigned to the study arm will receive vemurafenib orally twice daily (b.i.d.) continuously in cycles of 4 weeks (28 days) for a total of 4 cycles. Obinutuzumab will be administered concomitantly with vemurafenib starting at cycle 2 of treatment in cycles of 4 weeks. Obinutuzumab infusions will be administered on days 1, 8 and 15 during the cycle 2 and every 4 weeks during the cycle 3 and 4 of treatment.

Group Type: EXPERIMENTAL

Vemurafenib

Intervention Type: DRUG

Vemurafenib orally twice daily (b.i.d.) continuously in cycles of 4 weeks (28 days) for a total of 4 cycles.

Obinutuzumab

Intervention Type: DRUG

Obinutuzumab will be administered concomitantly with vemurafenib starting at cycle 2 of treatment in cycles of 4 weeks.

Standard treatment of Cladribine plus Rituximab

Patients assigned to the SOC arm will receive cladribine IV on days 1-5 concurrently with rituximab IV per week for 8 times, i.e., weekly x8 from day 1.

Group Type: ACTIVE_COMPARATOR

Cladribine

Intervention Type: DRUG

Cladribine IV on days 1-5 concurrently with rituximab.

Rituximab

Intervention Type: DRUG

Rituximab on days 1-5 concurrently with rituximab.

Interventions

Vemurafenib

Vemurafenib orally twice daily (b.i.d.) continuously in cycles of 4 weeks (28 days) for a total of 4 cycles.

Intervention Type: DRUG

Obinutuzumab

Obinutuzumab will be administered concomitantly with vemurafenib starting at cycle 2 of treatment in cycles of 4 weeks.

Intervention Type: DRUG

Cladribine

Cladribine IV on days 1-5 concurrently with rituximab.

Intervention Type: DRUG

Rituximab

Rituximab on days 1-5 concurrently with rituximab.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Patients must be ≥ 18 years of age
• Histologically confirmed classical HCL by the enrolling institution
• Presence of BRAF V600E mutation as confirmed by PCR, NGS or immunohistochemistry. If patient is known to have negative BRAF mutation, repeat testing is advisable as well as discussion with the main study principal investigator.
• Has not received any prior therapy for the disease
• Patients who meet the standard treatment initiation criteria, as defined by ANC ≤1.0, Hgb ≤ 10.0 or PLT ≤100K
• ECOG performance status of 0 - 2
• Acceptable pre-study organ function during screening as defined as:

• Total bilirubin ≤ 1.5 times the upper limit of normal (ULN);
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5x ULN; and
• Serum creatinine ≤ 1.5x ULN
• Electrocardiogram (ECG) without evidence of clinically significant ventricular arrhythmias or ischemia as determined by the investigator and a rate-corrected QT interval (QTc, Bazett's formula) of < 480 msec
• For women of childbearing potential, agreement to the use of two acceptable methods of contraception, including one barrier method, during the study and for 6 months after discontinuation of vemurafenib and cladribine, and 18 months after discontinuation of rituximab and obinutuzumab
• For men with female partners of childbearing potential, agreement to use a latex condom and to advise their female partner to use an additional method of contraception during the study and for 6 months after discontinuation of vemurafenib
• Negative serum pregnancy test within 7 days of commencement of treatment in women of childbearing potential

Exclusion Criteria

• Have had previous treatment for HCL, including purine analogs, vemurafenib, rituximab, obinutuzumab, and other investigational agents. Previous treatment with transfusions and other supportive care such as G-CSF and erythropoietin are allowed.
• Known hypersensitivity to any of the study drugs.
• Patients with known long QT syndrome or uncorrectable electrolyte abnormalities
• Clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis.
• Presence of positive test results for hepatitis B virus (HBV), hepatitis B surface antigen (HBsAg) or hepatitis C (HCV) antibody

° Patients with occult or prior HBV infection (defined as positive total hepatitis B core antibody [HBcAb] and negative HBsAg) may be included if HBV DNA is undetectable. These patients must be willing to undergo monthly DNA testing and take HBV viral prophylaxis such as entecavir.

• Known infection with HIV or human T-cell leukemia virus 1 (HTLV-1)
• Active uncontrolled infection, e.g. persistent bacteremia, supplemental oxygen or pressor supports, etc.
• Live vaccination within 28 days of randomization
• Patients with concurrent active malignancies as defined by malignancies requiring any therapy other than expectant observation or hormonal therapy, with the exception of squamous and basal cell carcinoma of the skin, in situ cervical cancer, adequately treated stage I/II cancer from which the patient is current in complete remission, or any other cancer from which the patient has been disease free for five years
• Malabsorption syndrome or other condition that precludes enteral route of administration
• Patients with HCL variant (as defined by absence of expression of CD25)
• Pregnant or lactating, or intending to become pregnant during the study

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

Sponsors

Genentech, Inc.

INDUSTRY

Sponsor Role: collaborator

Memorial Sloan Kettering Cancer Center

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Jae Park, MD

Role: PRINCIPAL_INVESTIGATOR

Memorial Sloan Kettering Cancer Center

Locations

Dana Farber Cancer Institute

Boston, Massachusetts, United States

Site Status: NOT_YET_RECRUITING

Mayo Clinic Cancer Center

Rochester, Minnesota, United States

Site Status: NOT_YET_RECRUITING

Memorial Sloan Kettering at Basking Ridge (All Protocol Activities)

Basking Ridge, New Jersey, United States

Site Status: RECRUITING

Memorial Sloan Kettering Monmouth (Limited Protocol Activities)

Middletown, New Jersey, United States

Site Status: RECRUITING

Memorial Sloan Kettering Bergen (Limited Protocol Activities)

Montvale, New Jersey, United States

Site Status: RECRUITING

Memorial Sloan Kettering Cancer Commack - Suffolk (Limited Protocol Activities)

Commack, New York, United States

Site Status: RECRUITING

Memorial Sloan Kettering Westchester (All Protocol Activities)

Harrison, New York, United States

Site Status: RECRUITING

Memorial Sloan Kettering Cancer Center (All Protocol Activities)

New York, New York, United States

Site Status: RECRUITING

Memorial Sloan Kettering Nassau (Limited Protocol Activities)

Uniondale, New York, United States

Site Status: RECRUITING

Ohio State University

Columbus, Ohio, United States

Site Status: NOT_YET_RECRUITING

Countries

United States

Central Contacts

Jae Park, MD

Role: CONTACT

parkj6@mskcc.org

646-608-3743

Mark Geyer, MD

Role: CONTACT

646-608-3745

Facility Contacts

Eric Winer, MD

Role: primary

617-632-6876

Sameer Parikh, M.B.B.S.

Role: primary

507-218-0772

Jae Park, MD

Role: primary

646-608-3743

Jae Park, MD

Role: primary

646-608-3743

Jae Park, MD

Role: primary

646-608-3743

Jae Park, MD

Role: primary

646-608-3743

Jae Park, MD

Role: primary

646-608-3743

Jae Park, MD

Role: primary

646-608-3743

Jae Park, MD

Role: primary

646-608-3743

Michael Grever, MD

Role: primary

614-293-3196

Related Links

http://www.mskcc.org/mskcc/html/44.cfm

Memorial Sloan Kettering Cancer Center

Other Identifiers

24-160

Identifier Type: -

Identifier Source: org_study_id