NCT06547944

Zanubrutinib, Obinutuzumab and Lenalidomide in Newly Diagnosed Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL)

A Phase 1b Clinical Study of Lenalidomide in Combination With Zanubrutinib and Obinutuzumab (ZGR) in the Treatment of Newly Diagnosed Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) With Therapeutic Indications

• Status: Active Not Recruiting
• Phase: Phase 1
• Study type: Interventional
• Enrollment: 30 (estimated)
• Sponsor: Institute of Hematology & Blood Diseases Hospital, China · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The ZGR regimen limited-course regimen was designed to combine three targeted agents, zanubrutinib, obinutuzumab (a third-generation CD20 monoclonal antibody), and lenalidomide, to deepen the depth of remission in patients with new-diagnosis CLL/SLL, with a view to achieving the goal of discontinuation of the drug and long-term remission after discontinuation of the drug, and prolonging the PFS, and at the same time, the regimen no longer includes cytotoxic chemotherapeutic agents, such as fludarabine and cyclophosphamide, which improves the CLL/ SLL patients' treatment tolerance, and can eliminate the treatment limitation for elderly or poorly tolerated CLL/SLL patients.

Detailed description

BTK inhibitor monotherapy for CLL/SLL can obtain 80-90% ORR and give patients long-term survival, but most patients only obtain PR efficacy, even after up to 7-8 years of continuous treatment, the proportion of patients with CR can only be improved from less than 10% to about 30%, and it is very difficult for any patient to achieve MRD negativity, so it is determined that the mode of treatment of BTK inhibitor monotherapy is long-term continuous administration for tumor control. In order to change this pattern of long-term continuous treatment, and to shorten the long-term continuous treatment to a limited cycle of treatment, it is necessary to deepen the depth of remission by combining the treatment with other mechanisms of drugs, or even to achieve MRD-negativity in order to realize the discontinuation of the drug. Lenalidomide is an oral immunomodulatory drug with direct antitumor effects and indirect antitumor effects by acting on a variety of immune cells in the tumor microenvironment. Lenalidomide alone, in combination with CD20 monoclonal antibody (rituximab), or (and) BTK inhibitors for the treatment of R/R CLL/SLL has shown therapeutic responses, with the best response to triple therapy of lenalidomide in combination with rituximab and BTK inhibitors. combination therapy showed the best response. The ZGR limited-course regimen that combines zanubrutinib, obinutuzumab, and lenalidomide in the treatment of patients with primary diagnosis of CLL/SLL, which can deepen the depth of remission, with a view to achieving the goal of discontinuation of the drug and long-term remission after discontinuation of the drug, and prolonging the PFS, and at the same time, the regimen are removed cytotoxic chemotherapeutic agents, such as fludarabine, to increase the tolerance of the treatment in patients with CLL/SLL, and can eliminate the need for treatment of elderly or poorly tolerated patients with CLL/SLL. treatment limitations in poorly tolerated CLL/SLL patients.

Conditions

• Chronic Lymphocytic Leukemia
• Small Lymphocytic Lymphoma
• Newly Diagnosed

Interventions

Type	Name	Description
DRUG	Zanubrutinib	160mg bid/d, from C1 to CR and MRD-negative or C24
DRUG	Lenalidomide	From C3 dose escalation, all 3 dose groups climbed from 5 mg/d to 10 mg/d, 15 mg/d, and 20 mg/d respectively, Taking 21 days of medication and 7 days of rest, 1 cycle every 28 days to CR and MRD-negative or C24
DRUG	Obinutuzumab	1000 mg C1, d1/d8/15; 1000 mg C2-6, d1

Timeline

• Start date: 2024-01-01
• Primary completion: 2025-12-01
• Completion: 2026-12-01
• First posted: 2024-08-09
• Last updated: 2024-08-09

Locations

1 site across 1 country: China