ClinicalTrials.gg
RecruitingNCT07341191Updated Oct 14, 2026

Sonrotoclax Plus Zanubrutinib in Patients With Relapsed/Refractory Mantle Cell Lymphoma Planned for Standard of Care CAR-T Cell Therapy

A Phase 2 interventional study of Zanubrutinib and Sonrotoclax in Mantle Cell Lymphoma, sponsored by Canadian Cancer Trials Group. Recruiting at 5 sites in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-14.

Sponsored by Canadian Cancer Trials Group · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Aug 2026; still recruiting 2 months later.
Updated Oct 14, 2026Site recruiting status changed1 site addedGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to evaluate the effects of adding two oral medications (sonrotoclax plus zanubrutinib) to standard of care chimeric antigen receptor (CAR-T) cell therapy in participants with mantle cell lymphoma.

Read the detailed description

Combining sonrotoclax (a next-generation BCL-2 inhibitor) with zanubrutinib (a selective BTK inhibitor) in mantle cell lymphoma (MCL)-is expected to be driven by strong biologic synergy, complementary mechanisms, and more durable responses without chemotherapy. Patients participating in this study must already be planning, and be eligible for CAR-T cell therapy outside of this protocol. CAR-T will be administered according to local or provincial guidelines.

If a patient decides to take part in this study, the patient will first get zanubrutinib (if not on it before starting the study), then during the induction phase they will get a combination of sonrotoclax (with a ramp-up dosing schedule) plus zanubrutinib followed by CAR-T cell therapy, followed zanubrutinib alone/ maintenance.

After finishing study treatment, and even if patients stop treatment early, the study doctor will continue to follow the patient's condition for the rest of their life or until all study results are known

02

Conditions studied

  • Mantle Cell Lymphoma

Keywords

  • CAR-T
  • Relapsed
  • Refractory
  • BTK inhibitor
  • BCL2 inhibitor
03

In context

Lymphoma, Mantle-Cell

1,220 studies on the registry are indexed under Lymphoma, Mantle-Cell; 154 are open to participants now.

This study's planned enrollment of 40 is close to the median of 37 across 1,001 interventional studies indexed under Lymphoma, Mantle-Cell.

Browse Lymphoma, Mantle-Cell studies →

Lead sponsor

Canadian Cancer Trials Group is the lead sponsor of 93 studies on the registry; 29 are open to participants now.

Of its 8 completed or terminated interventional studies of FDA-regulated products, 7 (88%) have results posted.

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

04

Who can participate

Ages eligible
18 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

  • Have confirmed mantle cell lymphoma that is after at least one
  • Eligible for and planned to receive Health Canada approved CAR-T.
  • Have a formalin fixed paraffin embedded tumour tissue block available and must have provided for the release of the block.
  • Presence of radiologically documented disease.
  • (one site bidimensionally measurable).
  • Age ≥ 18 years.
  • Have an performance status of 0, 1 or 2
  • Anticipated of ≥ 6 months
  • Adequate hematologic and biochemical parameters
  • Must have received prior systemic therapy as shown below;
  • At least one line of systemic therapy including a Bruton's Tyrosine Kinase inhibitor (BTKi).
  • Participants who have previously received venetoclax, sonrotoclax, or any other BCL2 inhibitor (BCL2i) are eligible as long as progressive disease did not occur within 6 months of the last dose of BCL2i. Participants with progressive disease during BCL2i therapy or within 6 months of last dose are not eligible.
  • Participants must enter the study while on a BTKi or enroll to a substudy of the protocol to receive zanubrutinib for a minimum duration prior to enrolling to the main study.
  • Participants previously exposed to zanubrutinib are eligible irrespective of response to treatment.
  • Participants entering the study while on a BTKi must have their BTKi switched to zanubrutinib supplied through the study.
  • Participants must have recovered to ≤ grade 1 from all reversible toxicity related to prior therapies.
  • Adequate must be followed per protocol.
  • Prior high-dose myelosuppresive radiation is permitted ≥28 prior to enrollment.
  • Previous major surgery is permitted ≥28 days prior to enrollment. Participants of must have agreed to use a highly effective method.

Exclusion criteria

Exclusion Criteria

    • Participants on active anticancer therapy for other advanced or .
  • Concurrent treatment with other anti-cancer therapy
  • Serious illnesses or medical conditions which would not permit the participant to be managed according to the protocol.
  • Known to the study drug(s) or their components.
  • Prior CD19-directed CAR-T at any time, hematopoietic cell transplantation within 6 weeks, or allogeneic hematopoietic cell transplantation within 3 months. Allogeneic hematopoietic cell transplantation recipients must be free of clinically-significant (GvHD) and must be off for GvHD for at least 4 weeks before enrollment.
  • Untreated and/or uncontrolled cardiovascular conditions and/or symptomatic cardiac dysfunction (including cardiac ventricular arrhythmias requiring medication, history of 2nd or 3rd degree atrioventricular conduction defects) or unstable angina congestive heart failure or myocardial infarction within the previous year.
  • Active, uncontrolled bacterial, fungal, or viral infection within 14 days prior to enrollment
  • Pregnant or breastfeeding women.
  • Inability to discontinue use of moderate or strong inducers or inhibitors during the ramp-up treatment period with sonrotoclax.
  • within 4 weeks prior to enrollment or who plan to receive a live vaccine during treatment or within 90 days post last dose.
  • Inability to swallow capsules or tablets or have any diseases significantly affecting GI function
  • Active central nervous system (CNS) disease; Participants with stable CNS disease are eligible.
  • Growth factors within 28 days prior to enrollment.
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.

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.

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.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

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.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

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.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

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.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

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.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

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.

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.

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.

05

Study design

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

Study arms

  • Experimental
    Zanubrutinib + Sonrotoclax

    Drug: Zanubrutinib · Drug: Sonrotoclax · Biological: CAR-T Cell Therapy

Interventions

  • assigned at enrollment

  • assigned at enrollment

  • BiologicalCAR-T Cell Therapy

    Standard of Care

06

What researchers measure

Primary outcomes

  1. Complete response post CAR-T

    Time frame: 3.5 years

Secondary outcomes

  1. Objective Response Rate assessed by the Lugano Classification

    Time frame: 3.5 years

  2. 1 year Progression-Free Survival

    Time frame: 4 years

  3. Overall Survival

    Time frame: 4 years

  4. Number and Severity of Adverse Events

    Time frame: 3.5 years

07

Study locations

5 of 5 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

1 registry update 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 Aug 2026 (actual). Primary completion is estimated for Dec 2029, 40 months after the start.

Of 153 non-industry phase 2 interventional studies under Lymphoma, Mantle-Cell, half reached primary completion within 64 months of starting (the median), counting those still running; a quarter within 40 and three quarters within 108. This study's planned 40 months is below that.

Counting every sponsor, half of 183 studies reached it within 63 months; a quarter within 38 and three quarters within 106.

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

Registered
Jan 6, 2026
First posted
Jan 14, 2026
StartActual
Aug 24, 2026
Primary completionEst.
Dec 31, 2029
CompletionEst.
Dec 31, 2030
Last update
Oct 14, 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.
Sites
1 site added. Cross Cancer Institute is now Recruiting
Show site
  • Juravinski Cancer Centre at Hamilton Health Sciences · Hamilton, Canada
Oct 14, 2026
Show all 1 update
  1. Oct 14, 2026
    1 site added. Cross Cancer Institute is now Recruiting
    Show site
    • Juravinski Cancer Centre at Hamilton Health Sciences · Hamilton, Canada

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07341191
Lead sponsor
Canadian Cancer Trials Group
Collaborators
BeOne Medicines
Responsible party
Sponsor
First posted
Jan 14, 2026
Start date
Aug 24, 2026
Primary completion
Dec 31, 2029 (estimated)
Completion
Dec 31, 2030 (estimated)
Last update
Oct 14, 2026

Study contacts

Annette Hay
Contact
ahay@ctg.queensu.ca
613-533-6430
Laura Pearce
Contact
lpearce@ctg.queensu.ca
613-533-6430
Diego Villa
study chair · BCCA-Vancouver Cancer Centre
Robert Puckrin
study chair · Tom Baker Cancer Centre, Calgary, AB Canada

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 drugs tested here: Zanubrutinib · Sonrotoclax

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