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Study of Acalabrutinib and Rituximab in Untreated Elderly and/or Frail Patients With DLBCL (ACRUE)

Primary Purpose

Diffuse Large B-Cell Lymphoma

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Acalabrutinib
Rituximab
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diffuse Large B-Cell Lymphoma focused on measuring Chemoimmunotherapy treatments, Treatment-naïve elderly patients

Eligibility Criteria

65 Years - 99 Years (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: ≥ 80 years of age at the time of screening, or ≥ 65 to 79 years of age at the time of screening and considered ineligible for chemoimmunotherapy Histologically documented DLBCL No prior treatment for DLBCL Stage II, III, or IV disease by the Ann Arbor Classification . Eastern Cooperative Oncology Group performance status of 0, 1, or 2 with no deterioration over the previous 2 weeks prior to baseline or day of the first dosing except when due to underlying lymphoma. At least 1 lesion that can be accurately measured at baseline as ≥ 10 mm in the longest diameter with computed tomography or magnetic resonance imaging and is suitable for accurate repeated measurements. Adequate organ and marrow function independent of growth factor or transfusion support within 1 week of Screening. Exclusion Criteria: Any evidence of diseases (such as severe or uncontrolled systemic diseases, including uncontrolled hypertension, renal transplant, and active bleeding diseases), that would make the study undesirable for the patient or that would impact compliance with the protocol. History of prior or current malignancy, that would affect compliance with the protocol or interpretation of the results. Serologic status reflecting active hepatitis B or C infection. Known to have tested positive for HIV. Active central nervous system involvement by lymphoma, leptomeningeal disease, or spinal cord compression. Any comorbidity or organ system impairment rated with a single Cumulative Illness Rating Scale-Geriatric score (CIRS-G) of 4 or a total CIRS-G score of > 6. History of or ongoing confirmed Progressive Multifocal Leukoencephalopathy. Known history of infection with HIV or any active significant infection. History of stroke or intracranial haemorrhage within 6 months before the first dose of study drug. History of bleeding diathesis (eg, haemophilia, von Willebrand disease). Any concurrent anticancer treatment. Major surgical procedure within 30 days of first dose of study intervention or anticipated major surgery during the study timeframe. Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists. Received a live virus vaccination within 28 days of the first dose of study drug.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Acalabrutinib and Rituximab

    Arm Description

    Patients will receive Dose A of acalabrutinib orally in X dosing schedule beginning on Cycle 1 Day 1 for a maximum of 28 cycles or until 2014 Lugano Classification for Non-Hodgkin's Lymphoma (NHL)-defined disease progression or another discontinuation criterion is met. Patients will also receive an intravenous (IV) infusion of Dose B rituximab on Cycle 1 Day 15 and Dose C of rituximab as an subcutaneous (SC) injection on Day 1 of Cycle 2 through Cycle 8.

    Outcomes

    Primary Outcome Measures

    Percentage of patients with Grade 3 to 4 treatment emergent adverse events (TEAEs)

    Secondary Outcome Measures

    Objective response rate (ORR)
    Progression free survival (PFS)
    Event-Free Survival (EFS)
    Overall survival (OS)
    Duration of response (DoR)
    Change from baseline in Timed Up and Go test (TUG)
    Number of patients with adverse events

    Full Information

    First Posted
    July 11, 2023
    Last Updated
    July 11, 2023
    Sponsor
    AstraZeneca
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05952024
    Brief Title
    Study of Acalabrutinib and Rituximab in Untreated Elderly and/or Frail Patients With DLBCL
    Acronym
    ACRUE
    Official Title
    A Prospective, Open-Label, Single-Arm, Phase II Study of Acalabrutinib and Rituximab in Untreated Elderly and/or Frail Patients With Diffuse Large B-Cell Lymphoma (ACRUE)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 4, 2023 (Anticipated)
    Primary Completion Date
    May 24, 2027 (Anticipated)
    Study Completion Date
    May 24, 2027 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    AstraZeneca

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The study will measure the safety, tolerability, and efficacy with acalabrutinib in combination with rituximab in treatment-naïve elderly and/or frail patients with diffuse large B-cell lymphoma (DLBCL), who are otherwise unsuitable for standard front line chemoimmunotherapy treatments.
    Detailed Description
    Treatment-naïve elderly and/or frail patients with DLBCL will be treated with acalabrutinib in combination with rituximab in a single arm. Study details include the following: The study duration will be up to 108 weeks for each patient, including up to 28 days for screening and 104 weeks of treatment and follow-up. The treatment duration will be up to 8 cycles for rituximab and 28 cycles for acalabrutinib both beginning at cycle 1.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Diffuse Large B-Cell Lymphoma
    Keywords
    Chemoimmunotherapy treatments, Treatment-naïve elderly patients

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    80 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Acalabrutinib and Rituximab
    Arm Type
    Experimental
    Arm Description
    Patients will receive Dose A of acalabrutinib orally in X dosing schedule beginning on Cycle 1 Day 1 for a maximum of 28 cycles or until 2014 Lugano Classification for Non-Hodgkin's Lymphoma (NHL)-defined disease progression or another discontinuation criterion is met. Patients will also receive an intravenous (IV) infusion of Dose B rituximab on Cycle 1 Day 15 and Dose C of rituximab as an subcutaneous (SC) injection on Day 1 of Cycle 2 through Cycle 8.
    Intervention Type
    Drug
    Intervention Name(s)
    Acalabrutinib
    Other Intervention Name(s)
    CALQUENCE®
    Intervention Description
    Patients will receive acalabrutinib orally with dosing schedule of X.
    Intervention Type
    Biological
    Intervention Name(s)
    Rituximab
    Intervention Description
    Patients will receive rituximab via IV infusion on Cycle 1 Day 15 and via SC injection on Day 1 of Cycle 2 through Cycle 8.
    Primary Outcome Measure Information:
    Title
    Percentage of patients with Grade 3 to 4 treatment emergent adverse events (TEAEs)
    Time Frame
    Cycle 1 Day 1 (Cycles 1 to 8 is 21 days and Cycles 9 to 28 is 28 days) through End of treatment EoT [30 days of discontinuation] (Up to 3.5 Years)
    Secondary Outcome Measure Information:
    Title
    Objective response rate (ORR)
    Time Frame
    Cycle 1 Day 1 (Cycles 1 to 8 is 21 days and Cycles 9 to 28 is 28 days) Until disease progression or last evaluable assessment in the absence of progression (Up to 3.5 Years)
    Title
    Progression free survival (PFS)
    Time Frame
    Cycle 1 Day 1 (Cycles 1 to 8 is 21 days and Cycles 9 to 28 is 28 days) Until disease progression or last evaluable assessment in the absence of progression (Up to 3.5 Years)
    Title
    Event-Free Survival (EFS)
    Time Frame
    Cycle 1 Day 1 (Cycles 1 to 8 is 21 days and Cycles 9 to 28 is 28 days) Until disease progression or last evaluable assessment in the absence of progression (Up to 3.5 Years)
    Title
    Overall survival (OS)
    Time Frame
    Cycle 1 Day 1 (Cycles 1 to 8 is 21 days and Cycles 9 to 28 is 28 days) Until Post-treatment follow-up (Up to 3.5 Years)
    Title
    Duration of response (DoR)
    Time Frame
    Cycle 1 Day 1 (Cycles 1 to 8 is 21 days and Cycles 9 to 28 is 28 days) Until disease progression or last evaluable assessment in the absence of progression (Up to 3.5 Years)
    Title
    Change from baseline in Timed Up and Go test (TUG)
    Time Frame
    Cycle 1 Day 1 (Cycles 1 to 8 is 21 days and Cycles 9 to 28 is 28 days) Until Post-treatment follow-up (Up to 3.5 Years)
    Title
    Number of patients with adverse events
    Time Frame
    Screening (up to 28 days before day 1) Until Post-treatment follow-up (Up to 3.5 Years)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    65 Years
    Maximum Age & Unit of Time
    99 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: ≥ 80 years of age at the time of screening, or ≥ 65 to 79 years of age at the time of screening and considered ineligible for chemoimmunotherapy Histologically documented DLBCL No prior treatment for DLBCL Stage II, III, or IV disease by the Ann Arbor Classification . Eastern Cooperative Oncology Group performance status of 0, 1, or 2 with no deterioration over the previous 2 weeks prior to baseline or day of the first dosing except when due to underlying lymphoma. At least 1 lesion that can be accurately measured at baseline as ≥ 10 mm in the longest diameter with computed tomography or magnetic resonance imaging and is suitable for accurate repeated measurements. Adequate organ and marrow function independent of growth factor or transfusion support within 1 week of Screening. Exclusion Criteria: Any evidence of diseases (such as severe or uncontrolled systemic diseases, including uncontrolled hypertension, renal transplant, and active bleeding diseases), that would make the study undesirable for the patient or that would impact compliance with the protocol. History of prior or current malignancy, that would affect compliance with the protocol or interpretation of the results. Serologic status reflecting active hepatitis B or C infection. Known to have tested positive for HIV. Active central nervous system involvement by lymphoma, leptomeningeal disease, or spinal cord compression. Any comorbidity or organ system impairment rated with a single Cumulative Illness Rating Scale-Geriatric score (CIRS-G) of 4 or a total CIRS-G score of > 6. History of or ongoing confirmed Progressive Multifocal Leukoencephalopathy. Known history of infection with HIV or any active significant infection. History of stroke or intracranial haemorrhage within 6 months before the first dose of study drug. History of bleeding diathesis (eg, haemophilia, von Willebrand disease). Any concurrent anticancer treatment. Major surgical procedure within 30 days of first dose of study intervention or anticipated major surgery during the study timeframe. Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists. Received a live virus vaccination within 28 days of the first dose of study drug.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    AstraZeneca Clinical Study Information Center
    Phone
    1-877-240-9479
    Email
    information.center@astrazeneca.com

    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 Vivli.org. All requests 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 approved.
    IPD Sharing Time Frame
    AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA/PhRMA Data-Sharing Principles. For details of our timelines, please refer 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 anonymized individual patient-level data via secure research environment Vivli.org. A Signed Data Usage Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information.
    IPD Sharing URL
    https://vivli.org/

    Learn more about this trial

    Study of Acalabrutinib and Rituximab in Untreated Elderly and/or Frail Patients With DLBCL

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