ClinicalTrials.gg
RecruitingNCT05645718Updated Sep 23, 2026

Study of Pedi-cRIB: Mini-Hyper-CVD With Condensed Rituximab, Inotuzumab Ozogamicin and Blinatumomab (cRIB) for Relapsed Therapy for Pediatric With B-Cell Lineage Acute Lymphocytic Leukemia

A Phase 2 interventional study of Cyclophosphamide and Vincristine in Leukemia, sponsored by M.D. Anderson Cancer Center. Recruiting at 1 site in United States. Open to participants aged 1 Year to 25 Years. Per ClinicalTrials.gov, last updated 2026-09-23.

Sponsored by M.D. Anderson Cancer Center · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jul 2023; still recruiting 3 years 3 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
27
Allocation
Non-randomized
Ages
1 Year to 25 Years
Sex
All
01

Study summary

To learn if cyclophosphamide, vincristine, and dexamethasone (called mini hyper-CVD) in combination with intrathecal (delivered into the spine) chemotherapy (methotrexate, hydrocortisone, cytarabine) and compressed rituximab, blinatumomab, and inotuzumab ozogamicin (called cRIB) can help to control the disease.

Read the detailed description

Primary Objective:

--To evaluate the clinical efficacy of the sequential combination of mini-hyper-CVD with inotuzumab ozogamicin and blinatumomab and rituximab in relapsed B-cell acute lymphoblastic leukemia (ALL) patients, based upon the complete response rate (CR).

Secondary Objectives:

  • To summarize efficacy per response rate, overall survival (OS), event free survival (EFS), and minimal residual disease (MRD) negativity rate.
  • To evaluate the safety of this combination.

Exploratory Objectives:

--To summarize associations between genomic alterations in ALL (current biomarker expression of the disease) with relation to the incidence of transition to HSCT in patients with PR or stable disease (SD) after the induction cycle(s).

02

Conditions studied

  • Leukemia

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03

In context

Leukemia

2,381 studies on the registry are indexed under Leukemia; 253 are open to participants now.

This study's planned enrollment of 27 is below the median of 40 across 1,769 interventional studies indexed under Leukemia.

Browse Leukemia studies →

Lead sponsor

M.D. Anderson Cancer Center is the lead sponsor of 3,047 studies on the registry; 578 are open to participants now.

Of its 612 completed or terminated interventional studies of FDA-regulated products, 409 (67%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
1 Year to 25 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Pediatric, adolescent, or young adult patients with B-ALL as per NCCN v2.2021 and WHO classification in relapse or primary and, either/both of the following: • Unable to receive anthracyclines (see section 3.1.8) or is PEG-asparaginase intolerant.

    • For leukemia: Patients must have ≥ 5% blasts expressing CD19 and CD22 in the bone marrow as assessed by morphology or flow cytometry. However, if an adequate bone marrow sample cannot be obtained, patients may be enrolled if there is unequivocal evidence of leukemia with ≥ 5% blasts in the peripheral blood.
    • If patient does not have CD20, they can still be enrolled but will not receive rituximab.
  • Performance status: Lansky ≥ 50 for patients who are ≤ 16 years old and ≥ 50% for patients who are > 16 years old.
  • Patients with asymptomatic CNS leukemia are eligible (see also Exclusion Criterion 3.2.2.)
  • Age > = 1 years of age and less than 25 years of age.
  • The following baseline laboratory data:

    • Total serum ≤1.5x (ULN). Patients with known Gilbert's syndrome may have a total bilirubin up to ≤3 x ULN.
    • Adequate renal function per age51 unless related to the disease. Estimated ≥ 60 mL/min/1.73 m2 based on local institutional practice for age-appropriate determination (eg, Schwartz formula for pediatric patients or formula for adults).
    • (ALT) and/or aspartate aminotransferase (AST) ≤3 x ULN; ≤5 x ULN in case of suspected leukemic liver involvement
  • Females of must have a negative serum or urine beta human chorionic gonadotropin (β-HCG) pregnancy test result within 14 days prior to the first dose of study drugs and must agree to use one of the following effective methods during the study and 30 days after the last treatment and 8 months after the last dose of inotuzumab and 12 months after the last dose of rituximab. Effective methods of birth control include:

    • Birth control pills, shots, implants (placed under the skin by a health care provider) or patches (placed on the skin)
    • Intrauterine devices (IUDs)
    • Condom or occlusive cap (diaphragm or cervical/vault caps) used with Spermicide
    • Abstinence
  • Males need to inform the doctor right away if the partner becomes pregnant or suspects pregnancy. While in this study and for 30 days after the last treatment the patient should not donate sperm for the purposes of reproduction. He will need to use a condom while in this study and for 30 days after the last treatment and 5 months after the last dose of inotuzumab.
  • Patients with cardiac disease, include but not limited to: ( (EF) \< 50% (as determined by the Biplane Simpson method) (but not per exclusion criteria 3.2.3.1), or who have received >450mg/m2 of doxorubicin and cannot receive anthracyclines.

Exclusion criteria

Exclusion Criteria:

  • Past or current history of a secondary or other primary tumor or a chronic myeloid leukemia (CML) blast crisis with exception of:

    • Curatively treated non-melanomatous skin cancer
    • Other primary solid tumor treated with curative intent and no known active disease present and no treatment administered during the last 2 years
  • Presence of uncontrolled CNS pathology such as epilepsy, childhood seizure, paresis, aphasia, stroke, severe brain injuries, organic brain syndrome, or psychosis. Presence of the following are allowed: headaches, vomiting, nerve palsy
  • Medical history of cardiovascular disease such as:

    ° Clinically significant cardiac disease including congestive heart failure ( class III or IV) or arrhythmia or conduction abnormality requiring medication

  • Patients with uncontrolled, active infections (viral, bacterial, or fungal). Infections controlled on concurrent anti-microbial agents are acceptable, and anti-microbial prophylaxis per institutional guidelines are acceptable.
  • Known active or C infection or known seropositivity for .
  • Patients with liver cirrhosis or other serious active liver disease or with suspected active alcohol abuse.
  • Active acute/chronic (GvHD) requiring systemic treatment; or receiving for GvHD prophylaxis within 2 weeks from the start of study therapy.
  • If patient has not recovered (as deemed by the investigator) from previous chemotherapy, surgery, radiation before the start of study drugs.

    ° To reduce the circulating blast count or palliation, the following are allowed prior to starting: Single dose intravenous cytarabine, or hydroxyurea. No washout necessary for these agents.

  • Females who are pregnant or lactating.
  • Male or female subjects of , unwilling to use an approved, effective means of in accordance with institution's standards.
  • Other severe, uncontrolled acute or chronic medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risk associated Protocol 2022-0312 V3 Dated 11/9/2023 Property of Leukemia at MD Anderson 17 with study participation or product administration or may interfere with the interpretation of study results and/or would make the patient inappropriate for enrollment into this study.
  • Patients with Trisomy 21, or bone marrow failure syndromes are not eligible.
  • Prior history of allergic reaction to any of the agents.
  • Patients who are unable or unwilling to comply with all study requirements for clinical visits, examinations, tests, and procedures.
  • Patients may be excluded if they are currently enrolled in another ongoing clinical trial with investigational products
Terms in these criteria, in plain language(18)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

GVHD (graft-versus-host disease)

After a transplant from a donor, the donor’s immune cells attack the recipient’s body, often the skin, gut or liver.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
27 participants (estimated)

Study arms

  • Experimental
    Leukemia CNS1 or 2

    Each study block, or cycle, is 28 days. Between every cycle below, Participants will have a 7-day rest period in which no study drug is given.

    Drug: Cyclophosphamide · Drug: Vincristine · Drug: Blinatumomab · Drug: Methotrexate · Drug: Cytarabine · Drug: Mercaptopurine · Drug: Prednisone · Drug: Pegfilgrastim · Drug: Inotuzumab ozogamicin · Drug: Rituximab · Drug: Dexamethasone

  • Experimental
    Leukemia CNS 3

    Each study block, or cycle, is 28 days. Between every cycle below, Participants will have a 7-day rest period in which no study drug is given.

    Drug: Cyclophosphamide · Drug: Vincristine · Drug: Blinatumomab · Drug: Methotrexate · Drug: Cytarabine · Drug: Mercaptopurine · Drug: Prednisone · Drug: Pegfilgrastim · Drug: Inotuzumab ozogamicin · Drug: Rituximab · Drug: Dexamethasone

Interventions

06

What researchers measure

Primary outcomes

  1. Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0

    Time frame: through study completion; an average of 1 year.

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Davis KL, Yao CC, Zimmerman JAO, Rau RE. Immunotherapy in B-Cell Acute Lymphoblastic Leukemia. J Natl Compr Canc Netw. 2025 Dec;23(12):e257067. doi: 10.6004/jnccn.2025.7067. PubMed 41671463 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jul 2023 (actual). Primary completion is estimated for Dec 2027, 53 months after the start.

Of 144 non-industry phase 2 interventional studies under Leukemia, half reached primary completion within 92 months of starting (the median), counting those still running; a quarter within 60 and three quarters within 129. This study's planned 53 months is below that.

Counting every sponsor, half of 176 studies reached it within 76 months; a quarter within 44 and three quarters within 123.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 29, 2022
First posted
Dec 9, 2022
StartActual
Jul 14, 2023
Primary completionEst.
Dec 31, 2027
CompletionEst.
Dec 31, 2029
Last update
Sep 23, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05645718
Responsible party
Sponsor
First posted
Dec 9, 2022
Start date
Jul 14, 2023
Primary completion
Dec 31, 2027 (estimated)
Completion
Dec 31, 2029 (estimated)
Last update
Sep 23, 2026

Study contacts

David McCall, MD
Contact
dmccall1@mdanderson.org
(713) 792-6604
David McCall, MD
principal investigator · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Blinatumomab · Inotuzumab Ozogamicin · Rituximab

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