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Zanubrutinib Monotherapy in Relapsed/Refractory Central Nervous System Lymphoma

Primary Purpose

CNS Lymphoma

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Zanubrutinib
Sponsored by
Peking University People's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for CNS Lymphoma focused on measuring CNSL

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Key inclusion criteria:

  1. Able to understand and willing to sign a written informed consent document
  2. Men and woman at least 18 years of age on the day of consenting to the study
  3. Histologically documented DLBCL.
  4. Relapsed/refractory PCNSL or relapsed/refractory SCNSL
  5. Patients with parenchymal lesions must have unequivocal evidence of disease progression on imaging (MRI or the brain or head CT) prior to study enrollment. For patients with leptomeningeal disease only, CSF cytology must document lymphoma cells and/or imaging findings consistent with CSF disease prior to study enrollment.
  6. An ECOG performance status≤2
  7. Adequate bone marrow and organ function shown by:

(1) Neutrophils ≥ 0.75 x 109/L independent of growth factor support within 7 days of study entry (2) Platelets ≥ 50 x 109/L independent of growth factor support or transfusion within 7 days of study entry (3) Creatinine clearance of ≥ 30 mL/min (4) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 x upper limit of normal (ULN) (5) Bilirubin ≤ 1.5 x ULN (6) International normalized ratio ≤ 1.5 and activated partial thromboplastin time ≤ 1.5 x ULN.

8. Recovered to grade 1 toxicity from prior therapy before the first dose of study drug 9. Agree to use highly effective methods of birth control during the period of therapy and for 3 months after the last dose of the study drug.

Exclusion Criteria:

  1. Patients with SCNSL actively receiving treatment for extra-CNS disease
  2. Concurrently using other approved or investigational antineoplastic agents
  3. Prior chemotherapy, targeted therapy, or radiation therapy within 4 weeks
  4. Prior exposure to a BTK inhibitor
  5. Concurrently using more than 8mg of dexamethasone daily or the equivalent
  6. History of other active malignancies within 2 years of study entry
  7. Major surgery within 4 weeks of screening or not recovered from the side effects of such surgery
  8. Known to have human immunodeficiency virus (HIV) infection
  9. Known to have a history of active or chronic infection with hepatitis C virus (HCV) or hepatitis B virus (HBV) as determined by serologic tests
  10. Active infection systemic including infections requiring oral or intravenous antimicrobials
  11. Currently active clinically significant cardiovascular disease
  12. QTcF > 480 msecs or other significant electrocardiogram (ECG) abnormalities
  13. Unable to swallow capsules or disease significantly affecting gastrointestinal function
  14. Any life-threatening illness, medical condition or organ system dysfunction which, in the investigator's opinion, could have compromised the patient's safety, or put the study at risk
  15. Required ongoing treatment with medication that are strong cytochrome P450, family 3, subfamily A (CYP3A) inhibitors or strong CYP3A inducers
  16. History of stroke or intracranial hemorrhage within 6 months prior to enrollment
  17. Inability to comply with study procedures
  18. Pregnant or lactating women
  19. Prior allogenic hematopoietic stem cell transplantation (autologous stem cell transplant is NOT an exclusion)

Sites / Locations

  • Peking University People's HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Zanubrtuinib

Arm Description

Zanubrutinib 320mg Qd

Outcomes

Primary Outcome Measures

Overall response rate (ORR)
Based on the Investigator assessed CR and PR, with the enhanced CT scan, the cerebrospinal fluid (CSF) examination, and the ophthalmological examination.

Secondary Outcome Measures

Time to response (TTR)
Time from the first dose of zanubrutinib to the first assessment of >=PR
Duration of response (DOR)
Time from the first assessment of >=PR to symptom, CT scan, and/ or CSF confirmed progressive disease (PD)
The concentration of zanunbrutinib in CSF and plasma
The concentration of zanunbrutinib in CSF and plasma 2 hours after taking the drug
Progression-free survival (PFS)
The time from the first dose to PD or death whichever occurs earlier.
Treatment-related adverse events (TRAE)
Adverse events during zanubrutinib treatment.

Full Information

First Posted
September 25, 2021
Last Updated
August 1, 2022
Sponsor
Peking University People's Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05117814
Brief Title
Zanubrutinib Monotherapy in Relapsed/Refractory Central Nervous System Lymphoma
Official Title
Zanubrutinib Monotherapy in Relapsed/Refractory Central Nervous System Lymphoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 2021 (Anticipated)
Primary Completion Date
January 2023 (Anticipated)
Study Completion Date
July 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking University People's Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Zanubrutinib is a novel BTK inhibitor with proven activity in patients with various B-cell lymphomas addicted to the B-cell receptor signaling pathway.
Detailed Description
Studies involving gene expression profiling and next generation sequencing have demonstrated that CNS lymphomas mostly are of the ABC-subtype and harbor mutations that reinforce BCR signaling. Ibrutinib, as the first BTK inhibitor, showed substantial activity in patients with R/R PCNSL and R/R SCNSL. Zanubrutinib is a novel BTK inhibitor with proven activity in patients with various B-cell lymphomas addicted to the B-cell receptor signaling pathway. In addition, pharmacological studies demonstrated the free drug exposure of zanubrutinib at 160 mg BID is roughly 10 times that of ibrutinib at 560 mg QD, and penetration into the CNS by zanubrutinib and ibrutinib is similar, suggesting the potential activity of zanubrutinib in the treatment of CNS lymphomas. However, the outcome of R/R PCNSL and R/R SCNSL patients treated with zanubrutinib monotherapy is still unclear.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
CNS Lymphoma
Keywords
CNSL

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Zanubrtuinib
Arm Type
Experimental
Arm Description
Zanubrutinib 320mg Qd
Intervention Type
Drug
Intervention Name(s)
Zanubrutinib
Other Intervention Name(s)
BGB-3111, BRUKINSA®
Intervention Description
as long as 24 months or consolidated with ASCT or WBRT after achieving PR or CR
Primary Outcome Measure Information:
Title
Overall response rate (ORR)
Description
Based on the Investigator assessed CR and PR, with the enhanced CT scan, the cerebrospinal fluid (CSF) examination, and the ophthalmological examination.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Time to response (TTR)
Description
Time from the first dose of zanubrutinib to the first assessment of >=PR
Time Frame
2 years
Title
Duration of response (DOR)
Description
Time from the first assessment of >=PR to symptom, CT scan, and/ or CSF confirmed progressive disease (PD)
Time Frame
2 years
Title
The concentration of zanunbrutinib in CSF and plasma
Description
The concentration of zanunbrutinib in CSF and plasma 2 hours after taking the drug
Time Frame
2 months
Title
Progression-free survival (PFS)
Description
The time from the first dose to PD or death whichever occurs earlier.
Time Frame
2 years
Title
Treatment-related adverse events (TRAE)
Description
Adverse events during zanubrutinib treatment.
Time Frame
During zanubrutinib treatment until 30+/-7 days after discontinuation.
Other Pre-specified Outcome Measures:
Title
Overall survival (OS)
Description
The time from the first dose to death.
Time Frame
4 years
Title
ctDNA
Description
ctDNA In CSF.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Key inclusion criteria: Able to understand and willing to sign a written informed consent document Men and woman at least 18 years of age on the day of consenting to the study Histologically documented DLBCL. Relapsed/refractory PCNSL or relapsed/refractory SCNSL Patients with parenchymal lesions must have unequivocal evidence of disease progression on imaging (MRI or the brain or head CT) prior to study enrollment. For patients with leptomeningeal disease only, CSF cytology must document lymphoma cells and/or imaging findings consistent with CSF disease prior to study enrollment. An ECOG performance status≤2 Adequate bone marrow and organ function shown by: (1) Neutrophils ≥ 0.75 x 109/L independent of growth factor support within 7 days of study entry (2) Platelets ≥ 50 x 109/L independent of growth factor support or transfusion within 7 days of study entry (3) Creatinine clearance of ≥ 30 mL/min (4) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 x upper limit of normal (ULN) (5) Bilirubin ≤ 1.5 x ULN (6) International normalized ratio ≤ 1.5 and activated partial thromboplastin time ≤ 1.5 x ULN. 8. Recovered to grade 1 toxicity from prior therapy before the first dose of study drug 9. Agree to use highly effective methods of birth control during the period of therapy and for 3 months after the last dose of the study drug. Exclusion Criteria: Patients with SCNSL actively receiving treatment for extra-CNS disease Concurrently using other approved or investigational antineoplastic agents Prior chemotherapy, targeted therapy, or radiation therapy within 4 weeks Prior exposure to a BTK inhibitor Concurrently using more than 8mg of dexamethasone daily or the equivalent History of other active malignancies within 2 years of study entry Major surgery within 4 weeks of screening or not recovered from the side effects of such surgery Known to have human immunodeficiency virus (HIV) infection Known to have a history of active or chronic infection with hepatitis C virus (HCV) or hepatitis B virus (HBV) as determined by serologic tests Active infection systemic including infections requiring oral or intravenous antimicrobials Currently active clinically significant cardiovascular disease QTcF > 480 msecs or other significant electrocardiogram (ECG) abnormalities Unable to swallow capsules or disease significantly affecting gastrointestinal function Any life-threatening illness, medical condition or organ system dysfunction which, in the investigator's opinion, could have compromised the patient's safety, or put the study at risk Required ongoing treatment with medication that are strong cytochrome P450, family 3, subfamily A (CYP3A) inhibitors or strong CYP3A inducers History of stroke or intracranial hemorrhage within 6 months prior to enrollment Inability to comply with study procedures Pregnant or lactating women Prior allogenic hematopoietic stem cell transplantation (autologous stem cell transplant is NOT an exclusion)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shenmiao Yang, MD
Phone
134399999810
Email
yangshenmiao@hotmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shenmiao Yang, MD
Organizational Affiliation
Peking University Peoples' Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peking University People's Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100044
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shenmiao Yang, MD

12. IPD Sharing Statement

Learn more about this trial

Zanubrutinib Monotherapy in Relapsed/Refractory Central Nervous System Lymphoma

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