Study of Acalabrutinib (ACP-196) Versus Ibrutinib in Previously Treated Subjects With High Risk CLL
Primary Purpose
Chronic Lymphocytic Leukemia
Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
ACP-196
ibrutinib
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Lymphocytic Leukemia
Eligibility Criteria
Inclusion Criteria:
- Men and women ≥ 18 years of age.
- ECOG performance status of 0 to 2.
- Diagnosis of CLL.
Must have ≥ 1 of the following high-risk prognostic factors:
- Presence of 17p del by central laboratory.
- Presence of 11q del by central laboratory.
- Active disease meeting ≥ 1 of the following IWCLL 2008 criteria for requiring treatment
- Must have received ≥ 1 prior therapies for CLL.
Meet the following laboratory parameters:
- ANC ≥ 750 cells/μL or ≥ 500 cells/μL in subjects with documented bone marrow involvement, and independent of growth factor support 7 days before assessment.
- Platelet count ≥ 30,000 cells/μL without transfusion support 7 days before assessment. Subjects with transfusion-dependent thrombocytopenia are excluded.
- Serum AST/SGOT and ALT/SGPT ≤ 3.0 x ULN.
- Total bilirubin ≤ 1.5 x ULN.
- Estimated creatinine clearance ≥ 30 mL/min.
Exclusion Criteria:
- Known CNS lymphoma or leukemia.
- Known prolymphocytic leukemia or history of, or currently suspected, Richter's syndrome.
- Uncontrolled autoimmune hemolytic anemia or idiopathic thrombocytopenia purpura.
- Prior exposure to ibrutinib or to a BCR inhibitor or a BCL-2 inhibitor.
- Received any chemotherapy, external beam radiation therapy, anticancer antibodies, or investigational drug within 30 days before first dose of study drug.
- Prior radio- or toxin-conjugated antibody therapy.
- Prior allogeneic stem cell or autologous transplant.
- Major surgery within 4 weeks before first dose of study drug.
- Prior malignancy, except for adequately treated lentigo maligna melanoma, non-melanomatous skin cancer, in situ cervical carcinoma or other malignancy treated with no evidence of active disease > 3 years before Screening and at low risk for recurrence.
- Significant cardiovascular disease within 6 months of screening.
- Known history of infection with HIV.
- History of stroke or intracranial hemorrhage within 6 months before randomization.
- History of bleeding diathesis.
- Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists within 7 days of first dose of study drug.
- Requires treatment with a strong CYP3A inhibitor/inducer.
Sites / Locations
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Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
ACP-196
ibrutinib
Arm Description
acalabrutinib 100 mg BID (Arm A; N=250)
ibrutinib 420 mg QD (Arm B; N=250)
Outcomes
Primary Outcome Measures
Progression Free Survival (PFS) by Independent Review Committee (IRC) Assessment
The time from date of randomization to the date of first IRC-assessed disease progression or death due to any cause. Progression by IRC is defined per International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria as lymphocyte count >/= 50% from baseline; >/= 50% increase in lymph nodes, liver or spleen; >/= 50% decrease in platelets from baseline or decrease in hemoglobin > 2 g/dL from baseline and related to CLL.
Secondary Outcome Measures
Number of Patients With Atrial Fibrillation
Includes MedDRA preferred terms 'atrial fibrillation' and 'atrial flutter'.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02477696
Brief Title
Study of Acalabrutinib (ACP-196) Versus Ibrutinib in Previously Treated Subjects With High Risk CLL
Official Title
A Randomized, Multicenter, Open-Label, Non-Inferiority, Phase III Study of Acalabrutinib (ACP-196) Versus Ibrutinib in Previously Treated Subjects With High Risk Chronic Lymphocytic Leukemia
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 28, 2015 (Actual)
Primary Completion Date
September 15, 2020 (Actual)
Study Completion Date
October 16, 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Acerta Pharma BV
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study is designed to evaluate PFS endpoint for acalabrutinib vs ibrutinib in previously treated chronic lymphocytic leukemia.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Lymphocytic Leukemia
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
533 (Actual)
8. Arms, Groups, and Interventions
Arm Title
ACP-196
Arm Type
Experimental
Arm Description
acalabrutinib 100 mg BID (Arm A; N=250)
Arm Title
ibrutinib
Arm Type
Active Comparator
Arm Description
ibrutinib 420 mg QD (Arm B; N=250)
Intervention Type
Drug
Intervention Name(s)
ACP-196
Intervention Description
acalabrutinib 100 mg BID (Arm A; N=250)
Intervention Type
Drug
Intervention Name(s)
ibrutinib
Intervention Description
ibrutinib 420 mg QD (Arm B; N=250)
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS) by Independent Review Committee (IRC) Assessment
Description
The time from date of randomization to the date of first IRC-assessed disease progression or death due to any cause. Progression by IRC is defined per International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria as lymphocyte count >/= 50% from baseline; >/= 50% increase in lymph nodes, liver or spleen; >/= 50% decrease in platelets from baseline or decrease in hemoglobin > 2 g/dL from baseline and related to CLL.
Time Frame
Randomization to Disease Progression, Death, or Censoring. Assessed for up to 5 years at the time of analysis.
Secondary Outcome Measure Information:
Title
Number of Patients With Atrial Fibrillation
Description
Includes MedDRA preferred terms 'atrial fibrillation' and 'atrial flutter'.
Time Frame
Date of first dose until 30 days after the last dose of study drug or the start of new anticancer therapy (whichever comes first). Median follow-up was 41 months.
10. Eligibility
Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Men and women ≥ 18 years of age.
ECOG performance status of 0 to 2.
Diagnosis of CLL.
Must have ≥ 1 of the following high-risk prognostic factors:
Presence of 17p del by central laboratory.
Presence of 11q del by central laboratory.
Active disease meeting ≥ 1 of the following IWCLL 2008 criteria for requiring treatment
Must have received ≥ 1 prior therapies for CLL.
Meet the following laboratory parameters:
ANC ≥ 750 cells/μL or ≥ 500 cells/μL in subjects with documented bone marrow involvement, and independent of growth factor support 7 days before assessment.
Platelet count ≥ 30,000 cells/μL without transfusion support 7 days before assessment. Subjects with transfusion-dependent thrombocytopenia are excluded.
Serum AST/SGOT and ALT/SGPT ≤ 3.0 x ULN.
Total bilirubin ≤ 1.5 x ULN.
Estimated creatinine clearance ≥ 30 mL/min.
Exclusion Criteria:
Known CNS lymphoma or leukemia.
Known prolymphocytic leukemia or history of, or currently suspected, Richter's syndrome.
Uncontrolled autoimmune hemolytic anemia or idiopathic thrombocytopenia purpura.
Prior exposure to ibrutinib or to a BCR inhibitor or a BCL-2 inhibitor.
Received any chemotherapy, external beam radiation therapy, anticancer antibodies, or investigational drug within 30 days before first dose of study drug.
Prior radio- or toxin-conjugated antibody therapy.
Prior allogeneic stem cell or autologous transplant.
Major surgery within 4 weeks before first dose of study drug.
Prior malignancy, except for adequately treated lentigo maligna melanoma, non-melanomatous skin cancer, in situ cervical carcinoma or other malignancy treated with no evidence of active disease > 3 years before Screening and at low risk for recurrence.
Significant cardiovascular disease within 6 months of screening.
Known history of infection with HIV.
History of stroke or intracranial hemorrhage within 6 months before randomization.
History of bleeding diathesis.
Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists within 7 days of first dose of study drug.
Requires treatment with a strong CYP3A inhibitor/inducer.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Acerta Clinical Trials
Organizational Affiliation
1-888-292-9613
Official's Role
Study Director
Facility Information:
Facility Name
Research Site
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
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United States
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Research Site
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Anaheim
State/Province
California
ZIP/Postal Code
92801
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United States
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Research Site
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Berkeley
State/Province
California
ZIP/Postal Code
94704
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United States
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Research Site
City
Duarte
State/Province
California
ZIP/Postal Code
91010
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United States
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Research Site
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La Jolla
State/Province
California
ZIP/Postal Code
92093
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United States
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Research Site
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Los Angeles
State/Province
California
ZIP/Postal Code
90095
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United States
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Research Site
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Palo Alto
State/Province
California
ZIP/Postal Code
94304
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United States
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Research Site
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Santa Rosa
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California
ZIP/Postal Code
95403
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United States
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Research Site
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Jacksonville
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Florida
ZIP/Postal Code
32224
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United States
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Research Site
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Tampa
State/Province
Florida
ZIP/Postal Code
33612
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United States
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City
Athens
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Georgia
ZIP/Postal Code
30607
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United States
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Harvey
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Illinois
ZIP/Postal Code
60426
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United States
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Peoria
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Illinois
ZIP/Postal Code
61615
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United States
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Wichita
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Kansas
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67214
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United States
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Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55426
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United States
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Rochester
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Minnesota
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55905
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United States
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Billings
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Montana
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59102
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United States
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Hackensack
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New Jersey
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?07601
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United States
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Lake Success
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New York
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11042
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United States
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New Hyde Park
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New York
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11042
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United States
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City
New York
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New York
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10021
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United States
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City
New York
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New York
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10029
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United States
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City
New York
State/Province
New York
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10065
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United States
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Durham
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North Carolina
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27710
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United States
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Columbus
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Ohio
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43210
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United States
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Philadelphia
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Pennsylvania
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19104
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United States
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Houston
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Texas
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77030
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United States
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Round Rock
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Texas
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78665
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United States
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Charlottesville
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Virginia
ZIP/Postal Code
22908
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United States
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Tacoma
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Washington
ZIP/Postal Code
98405
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United States
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Northwest WA
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Wisconsin
ZIP/Postal Code
20007
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Darlinghurst
ZIP/Postal Code
2010
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Australia
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Frankston
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3199
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Australia
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Melbourne
ZIP/Postal Code
3000
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Australia
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St Leonards
ZIP/Postal Code
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Australia
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Waratah NSW
ZIP/Postal Code
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Wollongong
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Australia
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Brugge
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Bruxelles
ZIP/Postal Code
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Belgium
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Ghent
ZIP/Postal Code
9000
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Belgium
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Leuven
ZIP/Postal Code
3000
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Belgium
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Yvoir
ZIP/Postal Code
5530
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Belgium
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Aalborg
ZIP/Postal Code
9100
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Denmark
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City
Indgang 27B
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DK-4000
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Denmark
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Bobigny
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93000
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France
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Creteil
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94010
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France
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Pierre-Benite
ZIP/Postal Code
69310
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France
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Rennes Cedex
ZIP/Postal Code
35000
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France
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Rouen
ZIP/Postal Code
76038
Country
France
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City
Toulouse Cedex
ZIP/Postal Code
31059
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France
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City
München
ZIP/Postal Code
81241
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Germany
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City
Ulm
ZIP/Postal Code
89081
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Germany
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Budapest
ZIP/Postal Code
1083
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Hungary
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City
Budapest
ZIP/Postal Code
1122
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Hungary
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Debrecen
ZIP/Postal Code
4032
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Hungary
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Kaposvár
ZIP/Postal Code
7400
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Hungary
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Haifa
ZIP/Postal Code
31000
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Israel
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City
Haifa
ZIP/Postal Code
31096
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Israel
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City
Haifa
ZIP/Postal Code
34362
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Israel
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Jerusalem
ZIP/Postal Code
9103102
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Israel
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Nahariya
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22100
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Israel
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Petah Tikvah
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49102
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Israel
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Tel Hashomer
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52621
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Israel
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Tiberias
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15208
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Israel
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City
Bologna
ZIP/Postal Code
40138
Country
Italy
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City
Cagliari
ZIP/Postal Code
9121
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Italy
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City
Cona
ZIP/Postal Code
44124
Country
Italy
Facility Name
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City
Firenze
ZIP/Postal Code
50134
Country
Italy
Facility Name
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City
Meldola
ZIP/Postal Code
47014
Country
Italy
Facility Name
Research Site
City
Milano
ZIP/Postal Code
20132
Country
Italy
Facility Name
Research Site
City
Milan
ZIP/Postal Code
20162
Country
Italy
Facility Name
Research Site
City
Modena
ZIP/Postal Code
41100
Country
Italy
Facility Name
Research Site
City
Ravenna
ZIP/Postal Code
48121
Country
Italy
Facility Name
Research Site
City
Rome
ZIP/Postal Code
168
Country
Italy
Facility Name
Research Site
City
Almere
ZIP/Postal Code
1315 RA
Country
Netherlands
Facility Name
Research Site
City
Amsterdam
ZIP/Postal Code
1105 AZ
Country
Netherlands
Facility Name
Research Site
City
Blaricum
ZIP/Postal Code
1261
Country
Netherlands
Facility Name
Research Site
City
Breda
ZIP/Postal Code
4818 CK
Country
Netherlands
Facility Name
Research Site
City
Delft
ZIP/Postal Code
2600 GA
Country
Netherlands
Facility Name
Research Site
City
Dordrecht
ZIP/Postal Code
3317
Country
Netherlands
Facility Name
Research Site
City
Geleen
ZIP/Postal Code
6162 BG
Country
Netherlands
Facility Name
Research Site
City
Groningen
ZIP/Postal Code
9700
Country
Netherlands
Facility Name
Research Site
City
Haarlem
ZIP/Postal Code
2035 RC
Country
Netherlands
Facility Name
Research Site
City
Leiden
ZIP/Postal Code
2333
Country
Netherlands
Facility Name
Research Site
City
Rotterdam
ZIP/Postal Code
3062 PA
Country
Netherlands
Facility Name
Research Site
City
Rotterdam
ZIP/Postal Code
3083 AN
Country
Netherlands
Facility Name
Research Site
City
Utrecht
ZIP/Postal Code
3584
Country
Netherlands
Facility Name
Research Site
City
Zutphens
ZIP/Postal Code
7207 AE
Country
Netherlands
Facility Name
Research Site
City
Addington
ZIP/Postal Code
8011
Country
New Zealand
Facility Name
Research Site
City
Auckland
ZIP/Postal Code
?0620
Country
New Zealand
Facility Name
Research Site
City
Tauranga
ZIP/Postal Code
3112
Country
New Zealand
Facility Name
Research Site
City
Bydgoszcz
ZIP/Postal Code
85-168
Country
Poland
Facility Name
Research Site
City
Gdansk
ZIP/Postal Code
80-129
Country
Poland
Facility Name
Research Site
City
Gdynia
ZIP/Postal Code
81-519
Country
Poland
Facility Name
Research Site
City
Krakow
ZIP/Postal Code
30-510
Country
Poland
Facility Name
Research Site
City
Lodz
ZIP/Postal Code
93-510
Country
Poland
Facility Name
Research Site
City
Olsztyn
ZIP/Postal Code
10-228
Country
Poland
Facility Name
Research Site
City
Opole
ZIP/Postal Code
46-020
Country
Poland
Facility Name
Research Site
City
Slupsk
ZIP/Postal Code
76-200
Country
Poland
Facility Name
Research Site
City
Wroclaw
ZIP/Postal Code
50-001
Country
Poland
Facility Name
Research Site
City
Barcelona
ZIP/Postal Code
8907
Country
Spain
Facility Name
Research Site
City
Barcelona
ZIP/Postal Code
?08041
Country
Spain
Facility Name
Research Site
City
Madrid
ZIP/Postal Code
28006
Country
Spain
Facility Name
Research Site
City
Madrid
ZIP/Postal Code
28009
Country
Spain
Facility Name
Research Site
City
Madrid
ZIP/Postal Code
28031
Country
Spain
Facility Name
Research Site
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Research Site
City
Majadahonda
ZIP/Postal Code
28222
Country
Spain
Facility Name
Research Site
City
Murcia
ZIP/Postal Code
30008
Country
Spain
Facility Name
Research Site
City
Santander
ZIP/Postal Code
39008
Country
Spain
Facility Name
Research Site
City
Ankara
ZIP/Postal Code
6230
Country
Turkey
Facility Name
Research Site
City
Ankara
ZIP/Postal Code
6560
Country
Turkey
Facility Name
Research Site
City
Instabul
ZIP/Postal Code
34365
Country
Turkey
Facility Name
Research Site
City
Istanbul
ZIP/Postal Code
34452
Country
Turkey
Facility Name
Research Site
City
Izmir
ZIP/Postal Code
35040
Country
Turkey
Facility Name
Research Site
City
Izmir
ZIP/Postal Code
35340
Country
Turkey
Facility Name
Research Site
City
Kayseri
ZIP/Postal Code
38030
Country
Turkey
Facility Name
Research Site
City
Birmingham
ZIP/Postal Code
B9 5SS
Country
United Kingdom
Facility Name
Research Site
City
Bournemouth
ZIP/Postal Code
BH7 7DW
Country
United Kingdom
Facility Name
Research Site
City
Cambridge
ZIP/Postal Code
CB2 0QQ
Country
United Kingdom
Facility Name
Research Site
City
Cardiff
ZIP/Postal Code
CF14 4XW
Country
United Kingdom
Facility Name
Research Site
City
Greater London
ZIP/Postal Code
E1 2AD
Country
United Kingdom
Facility Name
Research Site
City
Hull
ZIP/Postal Code
HU32JZ
Country
United Kingdom
Facility Name
Research Site
City
Leeds
ZIP/Postal Code
LS9 7TF
Country
United Kingdom
Facility Name
Research Site
City
Leicester
ZIP/Postal Code
LE1 7RH
Country
United Kingdom
Facility Name
Research Site
City
Liverpool
ZIP/Postal Code
L7 8XP
Country
United Kingdom
Facility Name
Research Site
City
London
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Facility Name
Research Site
City
Manchester
ZIP/Postal Code
M20 4BX
Country
United Kingdom
Facility Name
Research Site
City
Nottingham
ZIP/Postal Code
NG5 1PB
Country
United Kingdom
Facility Name
Research Site
City
Plymouth
ZIP/Postal Code
PL6 8DH
Country
United Kingdom
Facility Name
Research Site
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
Research Site
City
Surrey
ZIP/Postal Code
SM2 5PT
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal.
All request will be evaluated as per the AZ disclosure commitment:
https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.
IPD Sharing Time Frame
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing Access Criteria
When a request has been approved AstraZeneca will provide access to the deidentified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing URL
https://astrazenecagroup-dt.pharmacm.com/DT/Home
Citations:
PubMed Identifier
34398557
Citation
Kipps TJ. Mining the Microenvironment for Therapeutic Targets in Chronic Lymphocytic Leukemia. Cancer J. 2021 Jul-Aug 01;27(4):306-313. doi: 10.1097/PPO.0000000000000536.
Results Reference
derived
PubMed Identifier
34310172
Citation
Byrd JC, Hillmen P, Ghia P, Kater AP, Chanan-Khan A, Furman RR, O'Brien S, Yenerel MN, Illes A, Kay N, Garcia-Marco JA, Mato A, Pinilla-Ibarz J, Seymour JF, Lepretre S, Stilgenbauer S, Robak T, Rothbaum W, Izumi R, Hamdy A, Patel P, Higgins K, Sohoni S, Jurczak W. Acalabrutinib Versus Ibrutinib in Previously Treated Chronic Lymphocytic Leukemia: Results of the First Randomized Phase III Trial. J Clin Oncol. 2021 Nov 1;39(31):3441-3452. doi: 10.1200/JCO.21.01210. Epub 2021 Jul 26.
Results Reference
derived
Links:
URL
https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&parentIdentifier=ACE-CL-006&attachmentIdentifier=939fcaa0-05d0-4eeb-901b-543dfc69a943&fileName=ace-cl-006-clinical-study-report_synopsis-redact.pdf&versionIdentifier=
Description
Redacted CSR Synopsis
URL
https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&parentIdentifier=ACE-CL-006&attachmentIdentifier=48862a92-675d-444e-bdd0-df4a7b6c70b3&fileName=ace-cl-006-csp-v-amendment-5-global-redact.pdf&versionIdentifier=
Description
Redacted CSP
URL
https://filehosting-v2.pharmacm.com/api/Attachment/Download?tenantId=80217111&parentIdentifier=ACE-CL-006&attachmentIdentifier=62830b27-5baf-4d43-b70a-7b62304b80d0&fileName=ace-cl-006-SAP-redact.pdf&versionIdentifier=
Description
Redacted SAP
Learn more about this trial
Study of Acalabrutinib (ACP-196) Versus Ibrutinib in Previously Treated Subjects With High Risk CLL
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