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RecruitingNCT07441993MZL-IIT-OUpdated Mar 2, 2026

Exploratory Study of Orelabrutinib in the Treatment of Early-stage Untreated MZL

A Phase 2 interventional study of Orelabrutinib in Marginal Zone Lymphoma, sponsored by Institute of Hematology & Blood Diseases Hospital, China. Recruiting at 14 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-02.

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

From the registry’s dates

  • Started Jan 2026; still recruiting 9 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
30
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This is a single-arm, multicenter, prospective, phase II study. The primary objective is to assess the efficacy and safety of orelabrutinib in treatment-naïve patients with marginal zone lymphoma.

Read the detailed description

Marginal zone lymphoma (MZL) is a group of indolent B-cell malignancies originating from B lymphocytes, primarily occurring in the marginal zones of the spleen, lymph nodes, and mucosa-associated lymphoid tissues. Its histological features are characterized by abnormal proliferation of marginal zone cells surrounding lymphoid follicles. The Bruton tyrosine kinase (BTK) signaling pathway plays a critical role in B-cell receptor-mediated signal transduction and is significant in the development and progression of various B-cell malignancies. Ibrutinib, as the first BTK inhibitor, has demonstrated remarkable efficacy in the treatment of B-cell lymphomas. However, its poor kinase selectivity leads to a high incidence of off-target toxicities, including thrombocytopenia, neutropenia, bleeding, fatigue, rash, and atrial fibrillation in clinical settings, which limits its long-term use. Orelabrutinib is a highly selective oral small-molecule BTK inhibitor belonging to the nicotinamide class of compounds. It covalently binds to BTK and represents a new generation of selective irreversible BTK inhibitors. Due to its higher selectivity for BTK and favorable safety profile observed in previous human studies, orelabrutinib holds promise as a superior therapeutic option for B-cell malignancies. To further improve clinical outcomes for MZL patients, there is an urgent need to explore treatment strategies with better efficacy and lower toxicity. This study aims to evaluate the efficacy and safety of orelabrutinib in previously untreated localized-stage MZL patients, providing new therapeutic evidence for this population.

This study is a multicenter, prospective trial involving previously untreated patients with MZL. During the induction phase (cycles 1-6), patients will receive orelabrutinib 150 mg, administered in 28-day treatment cycles. Following completion of the induction phase, patients will be followed during a post-treatment follow-up period.

02

Conditions studied

  • Marginal Zone Lymphoma

Keywords

  • Lymphoma
  • Marginal zone lymphoma
  • Orelabrutinib
03

In context

Lymphoma, B-Cell, Marginal Zone

414 studies on the registry are indexed under Lymphoma, B-Cell, Marginal Zone; 108 are open to participants now.

This study's planned enrollment of 30 is below the median of 43 across 365 interventional studies indexed under Lymphoma, B-Cell, Marginal Zone.

Browse Lymphoma, B-Cell, Marginal Zone 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.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age ≥18 years, regardless of gender;
  2. Patients with histopathologically confirmed stage I/II marginal zone lymphoma;
  3. ECOG performance status score of 0-2;
  4. Major organ functions meeting the following criteria:

    1. Blood tests: Absolute neutrophil count (ANC) ≥1.5×10\^9/L, platelets ≥75×10\^9/L, hemoglobin ≥75g/L; if accompanied by bone marrow involvement, ANC ≥1.0×10\^9/L, platelets ≥50×10\^9/L, hemoglobin ≥50g/L;
    2. Blood biochemistry: Total bilirubin ≤1.5×ULN, AST or ALT ≤2×ULN; serum creatinine ≤1.5×ULN;
  5. Coagulation function: International normalized ratio (INR) ≤1.5×ULN;
  6. Expected survival time ≥12 months;
  7. Voluntary written informed consent signed before trial screening.

Exclusion criteria

Exclusion Criteria:

  1. Lymphoma involving the central nervous system or transformation to high-grade;
  2. Uncontrolled or significant cardiovascular diseases, including:

    1. New York Heart Association (NYHA) Class II or higher congestive heart failure, unstable angina, myocardial infarction within 6 months prior to the first dose of the study drug, or arrhythmia requiring treatment at screening, with left ventricular ejection fraction (LVEF) \<50%;
    2. Primary cardiomyopathy (e.g., dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, restrictive cardiomyopathy, or unclassified cardiomyopathy);
    3. History of clinically significant QTc interval prolongation, or QTc interval >470 ms for females or >450 ms for males at screening;
    4. Subjects with symptomatic coronary artery disease requiring medication;
    5. Poorly controlled hypertension (failure to achieve target blood pressure after at least one month of lifestyle modification and treatment with three or more antihypertensive drugs, including diuretics, at maximally tolerated doses, or requiring four or more antihypertensive drugs for effective control).
  3. Active bleeding within 2 months prior to screening, or current use of anticoagulants, or investigator-determined clear bleeding tendency;
  4. History of deep vein thrombosis or pulmonary embolism within the past six months;
  5. Urine protein ≥2+ and 24-hour urine protein quantification ≥2 g/24 hours;
  6. Clinically significant gastrointestinal abnormalities that may affect drug intake, transport, or absorption (e.g., inability to swallow, chronic diarrhea, intestinal obstruction), or subjects with total gastrectomy;
  7. Current pulmonary fibrosis, interstitial pneumonia, pneumoconiosis, radiation pneumonitis, drug-related pneumonia, or other conditions affecting lung function;
  8. Pregnant or breastfeeding women, or subjects of childbearing potential unwilling to use contraception;
  9. Continuous use of drugs with moderate to strong cytochrome P450 CYP3A inhibition or strong induction effects;
  10. Other conditions deemed by the investigator as unsuitable for participation in this trial.
05

Study design

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

Study arms

  • Experimental
    Marginal zone lymphoma: orelabrutinib

    Drug: Orelabrutinib

Interventions

  • DrugOrelabrutinib

    Induction phase (cycle 1-6): Orelabrutinib (150 mg)

06

What researchers measure

Primary outcomes

  1. Overall response rate (ORR)

    The ORR is defined as the proportion of patients with a response of CR or PR.

    Time frame: From the initiation of treatment to the end of induction therapy of cycle 6 (each cycle is 28 days)

Secondary outcomes

  1. Complete response rate (CRR)

    Complete response rate is defined as the proportion of patients with a response of CR.

    Time frame: From the initiation of treatment to the end of induction therapy of cycle 6 (each cycle is 28 days)

  2. Time to response (TTR)

    TTR is defined as the time from the start of therapy to the first response.

    Time frame: 1years

  3. Duration of Response (DOR)

    DOR is defined as the time from documentation of response to treatment to the first documentation of tumor progression or death due to any cause, whichever comes first.

    Time frame: From the first demonstration of response until disease progression/death, up to 1 years

  4. Progression-free survival (PFS)

    PFS is defined as the time from enrollment to disease progression or death from any cause. For patients who remain alive and progression-free at the data cutoff date, PFS will be censored at the last tumor assessment date.

    Time frame: From the date of enrollment until the date of first documented progression, up to 2 years

  5. Overall survival (OS)

    OS is defined as the time from the initiation of treatment to death from any cause. Patients alive at the data cutoff date will have their OS censored at the date of the last follow-up.

    Time frame: From the date of the initiation of treatment until the date of death, up to 2 years

  6. Adverse events (AEs)

    AEs will be graded according to the NCI-CTCAE Version 5.0.

    Time frame: From the date of enrollment until the date of death, up to 1 years

07

Study locations

14 of 14 sites recruiting
  • Nanfang Hospital, Southern Medical University
    Guangzhou, Guangdong, China
    Recruiting
  • Henan Cancer Hospital
    Zhengzhou, Henan, China
    Recruiting
  • Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
    Wuhan, Hubei, China
    Recruiting
  • Xiangyang Central Hospital
    Xiangyang, Hubei, China
    Recruiting
  • The Second Xiangya Hospital of Central South University
    Changsha, Hunan, China
    Recruiting
  • Jiangsu Province People's Hospital
    Nanjing, Jiangsu, China
    Recruiting
  • Affiliated Hospital of Nantong University
    Nantong, Jiangsu, China
    Recruiting
  • The First Affiliated Hospital of Nanchang University
    Nanchang, Jiangxi, China
    Recruiting
  • The First Bethune Hospital of Jilin University
    Changchun, Jilin, China
    Recruiting
  • Qilu Hospital of Shandong University
    Jinan, Shandong, China
    Recruiting
  • Shandong Cancer Hospital & Institute
    Jinan, Shandong, China
    Recruiting
  • Shandong Provincial Hospital
    Jinan, Shandong, China
    Recruiting
  • Beijing Tongren Hospital, Capital Medical University
    Beijing, China
    Recruiting
  • Hematology Hospital, Chinese Academy of Medical Sciences
    Tianjin, China
    Recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 2, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07441993
Lead sponsor
Institute of Hematology & Blood Diseases Hospital, China
Collaborators
Beijing Tongren Hospital
Responsible party
Sponsor
First posted
Mar 2, 2026
Start date
Jan 5, 2026
Primary completion
Dec 2027 (estimated)
Completion
Dec 2028 (estimated)
Last update
Mar 2, 2026

Study contacts

Shuhua Yi
Contact
yishuhua@ihcams.ac.cn
022-23909035
Liang Wang
Contact
wangliangtrhos@126.com
15001108693
Shuhua yi
principal investigator · Hematology Hospital, Chinese Academy of Medical Sciences
Liang Wang
principal investigator · Beijing Tongren Hospital

Oversight

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

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