ClinicalTrials.gg
RecruitingNCT05820841ARCHEDUpdated Jun 29, 2026

Acalabrutinib in Combination With R-miniCHOP in Older Adults With Untreated Diffuse Large B-Cell Lymphoma

A Phase 3 interventional study of R-miniCHOP + Acalabrutinib and R-miniCHOP in Large B-cell Lymphoma and Diffuse Large B Cell Lymphoma, sponsored by Universität des Saarlandes. Recruiting at 17 sites in Germany. Open to participants aged 61 Years and older. Per ClinicalTrials.gov, last updated 2026-06-29.

Sponsored by Universität des Saarlandes · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2023; still recruiting 3 years 5 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
330
Allocation
Randomized
Ages
61 Years and older
Sex
All
01

Study summary

The goal of this clinical trial is to study the addition of Acalabrutinib to standard R-miniCHOP in older adults with DLBCL. The main question it aims to answer is whether progression free survival kann be prolonged with the addition of Acalabrutinib.

Participants will be randomised to receive either R-miniCHOP alone or R-miniCHOP with Acalabrutinib.

02

Conditions studied

  • Large B-cell Lymphoma
  • Diffuse Large B Cell Lymphoma

Keywords

  • Diffuse large B cell lymphoma
  • Older adults
  • Geriatric
  • Large B cell lymphoma
  • Aggressive B cell lymphoma
  • Acalabrutinib
  • R-miniCHOP
  • R-mini-CHOP
  • BTK inhibitor
03

In context

Lymphoma, Large B-Cell, Diffuse

1,868 studies on the registry are indexed under Lymphoma, Large B-Cell, Diffuse; 355 are open to participants now.

This study's planned enrollment of 330 is above the median of 45 across 1,497 interventional studies indexed under Lymphoma, Large B-Cell, Diffuse.

Browse Lymphoma, Large B-Cell, Diffuse studies →

Lead sponsor

Universität des Saarlandes is the lead sponsor of 68 studies on the registry; 17 are open to participants now.

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

04

Who can participate

Ages eligible
61 Years and older
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

  1. Ability to understand the purpose and risks of the study and capable of giving signed informed consent which includes:

    1. Compliance with the requirements and restrictions listed in the informed consent form (ICF).
    2. Authorization to use protected health information/data [in accordance with the General Data Protection Regulation (GDPR)].
  2. Provision of signed and dated, written ICF prior to any mandatory study specific procedures, sampling, and analyses
  3. Willing and able to participate in all required evaluations and procedures in this study protocol, including swallowing capsules and tablets without difficulty.

    Age/Sex

  4. Men and women >80 years of age or >60 up to 80 years of age and ineligible for full dose R-CHOP according to investigator assessment*.

    We recommend classifying patients aged 61-80 as full-dose R-CHOP ineligible if they fulfill one of the following criteria: ADL \<5, IADL \<6, CIRS-G ≥1 score = 3, or > 8 score = 2.

  5. Male patients who are sexually active with women of (definitions see section 17.8) must agree to use highly effective forms of with the addition of a barrier method (condom) during the study (see section 17.8.1) as well as to the restrictions mentioned in section 9.13.
  6. Female patients of childbearing potential (definitions see 17.8) who are sexually active must agree to use highly effective forms of contraception while on the study as well as to the restrictions mentioned in section 9.13.

    Disease characteristics

  7. proven, previously untreated CD20+ diffuse large B-cell lymphoma (DLBCL) according to the 2017 WHO classification including:

    1. diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS)
    2. primary cutaneous DLBCL leg type
    3. intravascular large B-cell lymphoma
    4. EBV+ DLBCL, NOS
    5. HHV8+DLBCL, NOS
    6. primary mediastinal (thymic) large B-cell lymphoma
    7. B-cell lymphoma, with intermediate features between DLBCL and classical Hodgkin lymphoma
    8. follicular lymphoma grade 3B
    9. high-grade B-cell lymphoma, NOS
    10. high-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements
    11. T-cell/histiocyte-rich large B-cell lymphoma
    12. DLBCL associated with chronic inflammation
    13. ALK+ large B-cell lymphoma
    14. large B-cell lymphoma with IRF4 rearrangement Please note: patients in whom indolent lymphoma is diagnosed concurrently with the one of the above listed diagnoses can also be included.
  8. Disease Stage I with bulk ≥7.5cm, II, III or IV according to Ann Arbor Classification Type of patient and clinical characteristics
  9. (ECOG) performance status of 0, 1, or 2. An ECOG Score of 3 is acceptable only if this is directly attributable to lymphoma.
  10. Meet the following laboratory parameters:

    1. (ANC) ≥ 1500 cells/µl or count ≥ 100.000/µl unless directly attributable to lymphoma.
    2. Serum and ALT ≤3 x (ULN) unless directly attributable to lymphoma.
    3. Total ≤1.5 x ULN, unless directly attributable to Gilbert's syndrome or lymphoma.
    4. Estimated of ≥30 mL/min, calculated by Cockcroft-Gault (using actual body weight) (if male, [140-Age] x Mass [kg] / [72 x creatinine mg/dL]; multiply by 0.85 if female), or serum creatinine ≤2.5 x ULN.

Exclusion criteria

Exclusion Criteria:

Medical conditions

  1. Evidence of disease (such as severe or uncontrolled systemic diseases, including uncontrolled hypertension and renal transplant) that, in the investigator's opinion, make it undesirable for the patient to participate in the study or that would jeopardize compliance with the protocol [e.g. a single score of 4 on one single category on the CIRS-G-Score (but not a cumulative score of 4)].
  2. Significant cardiovascular disease such as symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of randomization or any Class 3 or 4 cardiac disease as defined by the Functional Classification, or \< 40%. Patients with controlled, asymptomatic atrial fibrillation are allowed to enroll on study.
  3. Severe pulmonary dysfunction ( grade 3 or 4) unless associated with lymphoma.
  4. Severe psychiatric or neurologic disease that, in the investigator's opinion, make it undesirable for the patient to participate in the study or that would jeopardize compliance with the protocol.
  5. Persistent neuropathy CTCAE grade 3 or 4.
  6. nausea and vomiting, inability to swallow acalabrutinib, or malabsorption syndrome; chronic severe gastrointestinal disease, gastric restrictions, or bariatric surgery such as gastric bypass; partial or complete bowel obstruction, or previous significant bowel resection that would preclude adequate absorption, distribution, metabolism, or excretion of study treatment.
  7. History of prior that could affect compliance with the protocol or interpretation of results, except for the following:

    1. Curatively treated localised basal cell carcinoma or localised squamous cell carcinoma of the skin or carcinoma in situ of the cervix or carcinoma in situ / low risk carcinoma of the prostate requiring only observation, as well as untreated low grade lymphoma except chronic lymphocytic leukemia.
    2. Other cancers not specified above that have been curatively treated by surgery and/or radiation therapy from which patient is disease-free for ≥2 years (≥5 years for those treated with chemotherapy) without further treatment or which are not expected to limit survival to \< 2 years.
  8. Received a within 28 days of randomization.
  9. Known history of infection with .
  10. Any active significant infection (e.g., bacterial, viral or fungal) as assessed by the investigator.
  11. History of or ongoing confirmed progressive multifocal leukoencephalopathy (PML).
  12. Serologic status reflecting active or C infection.

    1. Patients who are hepatitis B core antibody (anti-HBc) positive and who are hepatitis B surface antigen (HBsAg) negative will need to have a negative PCR result before randomization and must be willing to undergo DNA PCR testing during the study. Those who are HBsAg-positive or hepatitis B PCR positive will be excluded.
    2. Patients who are antibody positive will need to have a negative PCR result before randomization. Those who are hepatitis C PCR positive will be excluded.
  13. History of stroke or intracranial hemorrhage within 6 months before randomization.
  14. History of bleeding diathesis (e.g., hemophilia, von Willebrand disease).
  15. Major surgical procedure within 30 days before randomization. Note: If a patient had major surgery, they must have recovered adequately from any toxicity and/or complications from the intervention before the first dose of study drug.
  16. Breastfeeding or pregnant women.
  17. Current life-threatening illness, medical condition, organ system dysfunction, social, geographical or economic condition which, in the Investigator's opinion, could compromise the patient's safety or put the study at risk.
  18. Diagnosis of primary central nervous system lymphoma or secondary central nervous system or meningeal involvement by lymphoma
  19. Diagnosis of Richter's Transformation/transformed CLL Prior/Concomitant therapy
  20. Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists. Patients using therapeutic low molecule weight heparin, direct oral anticoagulants or low dose aspirin will be eligible. Switching from vitamin K antagonists to one of the allowed anticoagulants above prior to trial entry is permitted.
  21. Requires treatment with a strong cytochrome P450 3A () inhibitor or inducer. The use of strong CYP3A inhibitors within 1 week or strong CYP3A inducers within 3 weeks of the first dose of study drug is prohibited. See details in section 9.12.1.
  22. Prior exposure to a BTK inhibitor.
  23. Prior anthracycline use ≥300 mg/m2.
  24. Already initiated lymphoma therapy except for (max. total dose of 1000mg), vincristine (max. 1 mg once) or rituximab (max. 375mg/m2) prephase.
  25. Concurrent participation in another therapeutic clinical trial.
  26. Requires treatment with proton-pump inhibitors (e.g., omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, or pantoprazole). Patients receiving proton pump inhibitors who switch to H2-receptor antagonists or antacids are eligible for enrolment into this study.
  27. Received any drug within 30 days or 5 half-lives (whichever is shorter) before first dose of study drug.
Terms in these criteria, in plain language(24)

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.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

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.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

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.

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.

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.

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.

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.

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.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

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.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

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.

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.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

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.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

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 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
330 participants (estimated)

Study arms

  • Active comparator
    Standard arm

    6x R-miniCHOP + 2x Rituximab.

    Drug: R-miniCHOP

  • Experimental
    Experimental arm

    6x R-miniCHOP + 2x Rituximab + Acalabrutinib.

    Drug: R-miniCHOP + Acalabrutinib

Interventions

  • DrugR-miniCHOP + Acalabrutinib

    Drug page: Acalabrutinib

    * Rituximab i.v.: 375 mg/m2 (D0) * Cyclophosphamide i.v.: 400 mg/m² (D1) * Doxorubicin i.v.: 25 mg/m² (D1) * Vincristine i.v.: 1 mg (D1) * Prednisolone p.o.: 40 mg/m² (D1 to D5) * Acalabrutinib 100 mg p.o. twice daily starting from D1 of first R-miniCHOP cycle continuously to D21 of cycle 8. Cycles repeated every 3 weeks

  • DrugR-miniCHOP

    * Rituximab i.v.: 375 mg/m2 (D0) * Cyclophosphamide i.v.: 400 mg/m² (D1) * Doxorubicin i.v.: 25 mg/m² (D1) * Vincristine i.v.: 1 mg (D1) * Prednisolone p.o.: 40 mg/m² (D1 to D5). Cycles repeated every 3 weeks

06

What researchers measure

Primary outcomes

  1. Progression-free survival (PFS) investigator assessed

    PFS, defined by the time between the day of randomization until one of the following events occurs, whichever comes first: Disease progression (PD), relapse after complete remission (CR) or death due to any cause, as per Lugano Classification of 2014. Patients who have not experienced an event at the time of analysis will be censored at the most recent date of disease assessment.

    Time frame: Up to 5 years

Secondary outcomes

  1. Overall survival (OS)

    OS, defined by the time between the day of randomization until death due to any cause. Patients who have not experienced an event at the time of analysis will be censored at the date when the patient was last known to be alive.

    Time frame: Up to 5 years

  2. PFS based on blinded independent central review (BICR)

    Time frame: Up to 5 years

  3. Event-free survival (EFS)

    EFS, defined by the time between the day of randomization until one of the following events occurs, whichever comes first: Progressive disease (PD), relapse after complete remission (CR), initiation of subsequent systemic anti-lymphoma treatment and/or irradiation or death due to any cause, as per Lugano Classification of 2014.

    Time frame: Up to 5 years

  4. PFS according to Cell of Origin as per immunohistochemistry

    Time frame: Up to 5 years

  5. OS according to Cell of Origin as per immunohistochemistry

    Time frame: Up to 5 years

  6. EFS according to Cell of Origin as per immunohistochemistry

    Time frame: Up to 5 years

  7. PFS according to molecular genotype

    Time frame: Up to 5 years

  8. OS according to molecular genotype

    Time frame: Up to 5 years

  9. EFS according to molecular genotype

    Time frame: Up to 5 years

  10. Complete (CR) partial (PR) and overall (ORR) remission rates

    Time frame: Up to 5 years

  11. Duration of Response (DoR)

    Time frame: Up to 5 years

  12. Progression rate, relapse rate and central nervous system (CNS) relapse rate

    Time frame: Up to 5 years

  13. Adverse events (AEs), Serious AEs, AEs of special interest, events of clinical interest, AEs leading to study treatment discontinuation or dose modification.

    Time frame: Up to 5 years

  14. Rate of secondary malignancies

    Time frame: Up to 5 years

  15. Treatment-related death rate

    Time frame: Up to 5 years

  16. Dose intensity of miniCHOP, rituximab and acalabrutinib.

    Time frame: Up to 5 years

07

Study locations

9 of 17 sites recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

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 Jun 2023 (actual). Primary completion is estimated for Feb 2029, 68 months after the start.

Of 73 phase 3 interventional studies under Lymphoma, Large B-Cell, Diffuse, half reached primary completion within 57 months of starting (the median), counting those still running; a quarter within 39 and three quarters within 99. This study's planned 68 months is above that.

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

Registered
Mar 8, 2023
First posted
Apr 20, 2023
StartActual
Jun 7, 2023
Primary completionEst.
Feb 2029
CompletionEst.
Feb 2029
Last update
Jun 29, 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 Jun 29, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05820841
Lead sponsor
Universität des Saarlandes
Collaborators
University of Leipzig, University Hospital Regensburg, Wuerzburg University Hospital, University Hospital Giessen and Marburg, Saarland University Medical Center, AstraZeneca
Responsible party
Sponsor
First posted
Apr 20, 2023
Start date
Jun 7, 2023
Primary completion
Feb 2029 (estimated)
Completion
Feb 2029 (estimated)
Last update
Jun 29, 2026

Study contacts

Konstantinos Christofyllakis, MD MSc
principal investigator · Saarland University Medical Center
Moritz Bewarder, MD, PD
principal investigator · Saarland University Medical Center

Oversight

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

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Studies of the drug tested here: Acalabrutinib

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