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Not yet recruitingNCT06367374Updated Apr 16, 2024

MRD Guided Sonrotoclax and Zanubrutinib in Newly Diagnosed CLL/SLL

A Phase 2 interventional study of Sonrotoclax and Zanubrutinib in Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma, sponsored by Institute of Hematology & Blood Diseases Hospital, China. Not yet recruiting. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2024-04-16.

Sponsored by Institute of Hematology & Blood Diseases Hospital, China · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
66
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
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Study summary

This is a single-arm, open-label study of sonrotoclax plus zanubrutinib with MRD-driven treatment duration in patients with previously untreated Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL).

The primary goal of this study is to evaluate the efficacy of MRD-guided zanubrutinib plus sonrotoclax for first-line CLL/SLL treatment.

Read the detailed description

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are often considered different variations of the same disease due to their many similarities. There is an urgent need for new treatments to improve patients' quality of life, prolong survival, and manage disease-related symptoms.

There are several different methods for treating front-line therapy, including Chemoimmunotherapy (CIT), Bruton tyrosine kinase inhibitors (BTKis), and BCL-2 inhibitors (BCL2is). Continuous treatment with BTK inhibitors is necessary for the treatment of CLL or SLL. However, younger patients may need to limit their therapeutic duration. The combination of BTK inhibitors and BCL-2 inhibitors is believed to be an optimizing regimen that provides a limited duration of therapy.

The main aim of this study is to assess whether MRD-guided zanubrutinib, in combination with sonrotoclax, can be an effective first-line treatment option for adult patients with treatment-naïve CLL or SLL. The goal is to achieve long-lasting and more profound responses, which could allow for the possibility of discontinuing treatment.

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Conditions studied

  • Chronic Lymphocytic Leukemia
  • Small Lymphocytic Lymphoma
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In context

Lymphoma

5,578 studies on the registry are indexed under Lymphoma; 825 are open to participants now.

This study's planned enrollment of 66 is above the median of 40 across 4,508 interventional studies indexed under Lymphoma.

Browse Lymphoma studies →

Lead sponsor

Institute of Hematology & Blood Diseases Hospital, China is the lead sponsor of 398 studies on the registry; 293 are open to participants now.

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

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Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Treatment naïve adult patients with diagnosis of CLL/SLL requiring treatment according to iwCLL guidelines 2018
  2. Measurable nodal disease by CT/MRI.
  3. Adequate hematologic function
  4. Adequate hepatic and renal function
  5. Eastern Cooperative Oncology Group
  6. (ECOG) performance status of 0-2
  7. Expected survival period > 6 months

Exclusion criteria

Exclusion Criteria:

  1. Any prior systemic therapy used for treatment of CLL/SLL
  2. With history of prolymphocytic leukemia, known or currently suspected Richter's transformation
  3. Known central nervous system involvement by leukemia or lymphoma
  4. Confirmed progressive multifocal leukoencephalopathy (PML)
  5. Severe or debilitating pulmonary disease
  6. Clinically significant cardiovascular disease
  7. Uncontrolled autoimmune hemolytic anemia or idiopathic thrombocytopenia purpura requiring treatment
  8. History of other malignancies
  9. Prior therapy with study drugs within 4 weeks before screening
  10. Active fungal, bacterial, and/or viral infection requiring systemic therapy
  11. Known allergy to zanubrutinib or sonrotoclax or any pharmaceutical excipients
  12. Pregnant or lactating women
  13. Vaccinated with live vaccines within 28 days prior to enrollment
  14. Serologically positive of human immunodeficiency virus (HIVAb), or active infection with hepatitis B virus (HBV) or hepatitis C virus (HCV)
  15. History of stroke or intracranial hemorrhage within 6 months
  16. Requires treatment with a strong cytochrome P450 (CYP) 3A inhibitor
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Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
66 participants (estimated)

Study arms

  • Experimental
    Sonrotoclax Plus Zanubrutinib

    * Participants will receive from the start of Cycle 1 a standard dose of zanubrutinib twice daily orally for three cycles and in combination with sonrotoclax starting from Cycle 4 onwards at increasing doses twice a week until the target dose is reached from Cycle 5 and continuing until the end of Cycle 15 (each cycle is 28 days). Patients with a measurable minimal residual disease (MRD) will receive another 12 cycles of Zanubrutinib in combination with sonrotoclax until their MRD is undetectable. * Interventions: * Drug: Sonrotoclax * Drug: Zanubrutinib

    Drug: Sonrotoclax · Drug: Zanubrutinib

Interventions

  • DrugSonrotoclax

    Participants receive zanubrutinib orally 160mg bid from start of Cycle 1, and in combination with sonrotoclax (SZ) from Cycle 4 onwards at increasing doses until 320mg daily target dose is reached and continuing for at least 12 cycles (each cycle is 28 days). Participants with uMRD and PR/CR by the end of Cycle 15 will stop SZ treatment, others will continue to receive SZ for another 12 cycles and stop SZ if uMRD and PR/CR. Participants will receive sonrotoclax up to 2 years, and receive zanubrutinib for those with MRD-positive by then.

    Also known as: BGB-11417

  • DrugZanubrutinib

    Participants receive zanubrutinib orally 160mg bid from start of Cycle 1,Participants with uMRD and PR/CR by the end of Cycle 15 will stop SZ treatment, others will continue to receive SZ for another 12 cycles and stop SZ if uMRD and PR/CR. Participants will receive sonrotoclax up to 2 years, and receive zanubrutinib for those with MRD-positive by then.

    Also known as: BGB- 3111

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What researchers measure

Primary outcomes

  1. 4-Year Progressive Free Survival (PFS) Rate

    PFS is defined as the time from the date of enrollment to the date of first confirmed disease progression or death due to any cause, whichever occurs first, as determined by investigators

    Time frame: 4 years after enrollment

Secondary outcomes

  1. Rate of peripheral blood (PB) and Bone marrow (BM) undetectable minimal residual disease (uMRD)

    Rate of PB and BM uMRD is defined as proportion of participants achieving remission based on flow cytometry (FCM) result of \< 1 CLL cell per 100,000 leukocytes (\< 10 \^-4 ), after completion of 12 and 24 cycles of sonrotoclax treatment.

    Time frame: At screening, the end of Cycle 14 and Cycle 26 (each cycle is 28 days)

  2. Complete Response Rate (CRR; Complete Response/Complete Response with Incomplete Blood Count Recovery [CR/CRi]) Rate

    CR/CRi rate is defined as the percentage of participants achieving a response of complete response (CR), CR with incomplete blood count recovery (CRi) per 2018 IWCLL criteria, as determined by investigators

    Time frame: Up to 4 years

  3. Overall Response Rate (ORR)

    ORR is defined as the percentage of participants achieving a response of complete response (CR), CR with incomplete blood count recovery (CRi), nodular partial response (nPR), partial response (PR), or PR with lymphocytosis (PRL) evaluated under the 2018 IWCLL criteria, as determined byinvestigators

    Time frame: Up to 4 years

  4. Duration of Response (DOR)

    DOR was calculated for participants achieving a response (CR, CRi, nPR, PR) based on 2018 IWCLL response criteria in CLL or a response (PR or better) based on 2014 Lugano response criteria and defined as the interval between the date of initial documentation of a response mentioned above until disease progression (PD) or death from any cause, whichever occurred first

    Time frame: Up to 4 years

  5. Progression Free Survival (PFS)

    PFS is defined as the time from the date of enrollment to the date of first confirmed disease progression or death due to any cause, whichever occurs first, as determined by investigators

    Time frame: Up to 4 years

  6. Overall Survival (OS)

    OS is defined as time from the date of enrollment to the date of death because of any cause

    Time frame: Up to 4 years

  7. Time to Next Therapy (TTNT)

    Time to next CLL or SLL therapy is defined as the time from the first administration of study drugs to the first administration of the next CLL/SLL treatment, as determined by investigators

    Time frame: Up to 4 years

  8. Overall survival rate

    Number, time frame and seriousness of participants with Treatment-Emergent Adverse Events (NCI-TEAE v5.0)

    Time frame: Up to 4 years

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Study locations

No study locations are listed for this record.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 16, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06367374
Lead sponsor
Institute of Hematology & Blood Diseases Hospital, China
Responsible party
Qiu Lugui (Institute of Hematology & Blood Diseases Hospital, China, Institute of Hematology & Blood Diseases Hospital, China) — Principal investigator
First posted
Apr 16, 2024
Start date
May 30, 2024 (estimated)
Primary completion
Feb 28, 2030 (estimated)
Completion
Jul 30, 2030 (estimated)
Last update
Apr 16, 2024

Study contacts

Shuhua Yi
Contact
yishuhua@ihcams.ac.cn
15900265415
Yexiang Wang
Contact
yexiang.wang@ashermed.com
13810279737
Lugui Qiu
principal investigator · Institute of Hematology & Blood Diseases Hospital, China

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Apr 2024. You cannot join it, but the record below documents what was studied.

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