ClinicalTrials.gg
Enrolling by invitationNCT07690761Rituximab+ ZanUpdated Jul 8, 2026

Rituximab+ Zanubrutinib for Patients With Hairy Cell Leukemia and Hairy Cell Variant

A Phase 2 interventional study of Zanubrutinib in Hairy Cell Leukemia and Hairy Cell Leukemia Variant, sponsored by Bnai Zion Medical Center. Enrolling by invitation at 1 site in Israel. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-08.

Sponsored by Bnai Zion Medical Center · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
12
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

investigators propose a phase II, open label-nonrandomized, single arm, multicenter study aiming to assess the safety and efficacy with the combination of Rituximab and Zanubrutinib in patients with HAIRY CELL LUKEMIA HCL, or HAIRY CELL LEUKEMIA VARIANT-HCLv.

Read the detailed description

Patients will receive Zanubrutinib orally (PO) ) 160 mg twice daily OR 320 mg once daily on days 1-28. (However, if participants preference is 320 mg once a day, it is recommended that participants continues to use the same dosing schedule throughout the treatment cycles to support better treatment adherence (ie., recommend patients to take the medication at approximately the same time each day). This dosing preference will be recorded in the eCRF." ) Cycles will repeat every 28 days up to lack of response to therapy, or continually at per physician discretion in the absence of disease progression or unacceptable toxicity.

IV rituximab will be administrated every 7 days starting from day 1, for a total of 8 doses. Dose of rituximab will be 375 mg/M2.

After completion of study treatment, patients will be followed up every 3 months for a total of 60 months.

02

Conditions studied

  • Hairy Cell Leukemia
  • Hairy Cell Leukemia Variant

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03

In context

Leukemia, Hairy Cell

237 studies on the registry are indexed under Leukemia, Hairy Cell; 18 are open to participants now.

This study's planned enrollment of 12 is below the median of 40 across 152 interventional studies indexed under Leukemia, Hairy Cell.

Browse Leukemia, Hairy Cell studies →

Lead sponsor

Bnai Zion Medical Center is the lead sponsor of 104 studies on the registry; 13 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

Eligibility criteria

Inclusion Criteria:• confirmed diagnosis of hairy cell leukemia or variant according to World Health Organization (WHO) criteria with any of the following indications for therapy:

  • \< 11 g/dL, count \< 100,000/mL, \< 1,000/mL
  • Progressive or symptomatic splenomegaly or hepatomegaly or Enlarging lymphadenopathy >= 2 cm
  • Disease related constitutional symptoms consisting of unexplained weight loss exceeding 10% of body weight over the preceding 6 months, Cancer Therapy Evaluation Program (CTEP) active version of the (CTCAE) grade 2 or 3 fatigue, fevers > 100.5 degrees Fahrenheit (F) or night sweats for greater than 2 weeks without evidence of infection

    • Patients may receive therapy under the following conditions:
  • After at least 1 prior purine nucleoside analog-containing regimen (fludarabine, pentostatin, or cladribine), or
  • or de novo disease if deemed medically unfit for therapy with a purine nucleoside analog

    • (ECOG) performance status =\< 2 ( >= 60%)
    • Creatinine =\< 2.0 mg/dL, and/or (estimated [GFR] [Cockcroft-Gault]) >= 30 mL/min (Annex 1)
    • Total =\< 1.5 x (ULN) (unless disease related or due to Gilbert's disease) or (AST) =\< 3.0 x ULN (unless disease related)
    • The effects of BTKi on the developing human fetus are unknown; for this reason, and because tyrosine kinase inhibitors may be teratogenic, women of and men must agree to use adequate (hormonal or barrier method of birth control; abstinence) prior to study entry; female patients who are of non- (i.e., by history - no menses for >= 1 year; or history of hysterectomy; or history of bilateral tubal ligation; or history of bilateral oophorectomy); female patients of childbearing potential must have a negative serum pregnancy test upon study entry; male and female patients who agree to use highly effective methods of birth control (e.g., condoms, implants, injectables, combined oral contraceptives, some intrauterine devices [IUDs], complete sexual abstinence, or sterilized partner) during the period of therapy and for 90 days after the last dose of study drug; should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately
    • Ability to understand and the willingness to sign a written document.

Exclusion Criteria:

  • Prior exposure to a Bruton's tyrosine kinase (BTK) inhibitor
  • Zanubrutinib is extensively metabolized by /5; patients who received a strong cytochrome P450 (CYP) 3A inhibitor within 7 days prior to the first dose of Zanubrutinib or patients who require continuous treatment with a strong CYP3A inhibitor; therefore, any medications or substances that are strong inhibitors of CYP3A4/5 should be discontinued if possible; Zanubrutinib dose modification to 80 mg QD is recommended when patients are on strong CYP3A inhibitors; because the lists of these agents are constantly changing, it is important to regularly consult a frequently-updated list; medical reference texts such as the Physicians' Desk Reference may also provide this information; as part of the enrollment/informed consent procedures, the patient will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the patient is considering a new over-the-counter medicine or herbal product
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements; recent infections requiring systemic treatment need to have completed therapy > 14 days before the first dose of study drug
  • Pregnant or breast-feeding or intending to become pregnant during the study
  • Have had chemotherapy (including purine analogs), rituximab, and other agents within four weeks prior to entering the study.
  • Invasive within the past 2 years prior to first study drug administration, except for adequately treated (with curative intent) basal or squamous cell carcinoma, melanoma, in situ carcinoma of the cervix, in situ ductal adenocarcinoma of the breast, in situ prostate cancer, or limited stage bladder cancer or other cancers from which the patient has been disease-free for at least 2 years
  • Active , and or any history of liver disease. Hepatitis B prior infection is not a though will require therapy.
  • Known to any of the study drugs
  • Known bleeding disorders (e.g., von Willebrand's disease) or hemophilia
  • Patient is unable to swallow capsules, or has disease significantly affecting gastrointestinal function or resection of the stomach or small bowel, or symptomatic inflammatory bowel disease or ulcerative colitis, or partial or complete bowel obstruction
  • History of intracranial hemorrhage within 6 months prior to enrollment
Terms in these criteria, in plain language(27)

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

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.

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.

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.

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.

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.

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.

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.

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.

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.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

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.

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.

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.

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.

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.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

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.

05

Study design

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

Study arms

  • Experimental
    ZANUBRUTINIB+ RITUXIMAB

    Drug: Zanubrutinib

Interventions

  • Patients will receive Zanubrutinib orally (PO) ) 160 mg twice daily OR 320 mg once daily on days 1-28. (However, if patients' preference is 320 mg once a day, it is recommended that he/she continues to use the same dosing schedule throughout the treatment cycles to support better treatment adherence (ie., recommend patients to take the medication at approximately the same time each day). This dosing preference will be recorded in the eCRF." ) Cycles will repeat every 28 days up to lack of response to therapy, or continually at per physician discretion in the absence of disease progression or unacceptable toxicity. IV rituximab will be administrated every 7 days starting from day 1, for a total of 8 doses. Dose of rituximab will be 375 mg/M2. After completion of study treatment, patients will be followed up every 3 months for a total of 60 months.

06

What researchers measure

Primary outcomes

  1. CR

    • To determine the overall response rate (complete response \[CR\] and partial response \[PR\]) of hairy cell leukemia (HCL) at 32, week after beginning therapy with Rituximab+ Zanubrutinib (in comparison to ibrutinib study)

    Time frame: 32 weeks

07

Study locations

1 site
08

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 2026 (actual). Primary completion is estimated for Dec 2028, 30 months after the start.

Of 22 phase 2 interventional studies under Leukemia, Hairy Cell, half reached primary completion within 111 months of starting (the median), counting those still running; a quarter within 64 and three quarters within 149. This study's planned 30 months is below that.

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

Registered
Jun 25, 2026
First posted
Jul 8, 2026
StartActual
Jun 1, 2026
Primary completionEst.
Dec 31, 2028
CompletionEst.
Dec 31, 2033
Last update
Jul 8, 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 Jul 8, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07690761
Responsible party
tamar.tadmor (Head of Hematology unit Bnai Zion, Bnai Zion Medical Center) — Principal investigator
First posted
Jul 8, 2026
Start date
Jun 1, 2026
Primary completion
Dec 31, 2028 (estimated)
Completion
Dec 31, 2033 (estimated)
Last update
Jul 8, 2026

Oversight

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

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