Acalabrutinib, Obinutuzumab and Chlorambucil in Treatment naïve CLL

Running, not enrolling · Phase 3

Conditions studied: Chronic Lymphocytic Leukemia

In brief

This Primary objective is evaluating the efficacy of obinutuzumab in combination with chlorambucil (Arm A) compared with acalabrutinib in combination with obinutuzumab (Arm B) for the treatment of previously untreated chronic lymphocytic leukemia (CLL). Secondary objectives: 1) To evaluate the efficacy of obinutuzumab in combination with chlorambucil (Arm A) versus acalabrutinib monotherapy (Arm C) based on IRC assessment of PFS per IWCLL 2008 criteria. 2)To compare obinutuzumab plus chlorambucil (Arm A) versus acalabrutinib plus obinutuzumab (Arm B) and obinutuzumab plus chlorambucil (Arm A) versus acalabrutinib monotherapy (Arm C) in terms of: IRC-assessed objective response rate (ORR); Tine to next treatment (TTNT); Overall Survival (OS)

Key facts

Study ID: NCT02475681
Run by: Acerta Pharma BV
People needed: 535
Starts: 2015-06-26
Expected to finish: 2025-09-30
Last updated by the study team: 2025-08-27

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Men and women:
a. ≥ 65 years of age OR b. > 18 and < 65 years of age, provided that they meet at least one of the following criteria: i. Creatinine clearance 30 to 69 mL/min using the Cockcroft-Gault equation ii. A score higher than 6 on the CIRS-G (Appendix L).
ECOG performance status of 0, 1, or 2.
Diagnosis of CD20+ CLL that meets published diagnostic criteria (Hallek 2008):
Monoclonal B cells (either kappa or lambda light chain restricted) that are clonally co-expressing ≥ 1 B-cell marker (CD19, CD20, or CD23) and CD5.
Prolymphocytes may comprise ≤ 55% of blood lymphocytes.
Presence of ≥ 5 x 109 B lymphocytes/L (5000 μL) in the peripheral blood (at any point since diagnosis)
Active disease meeting ≥ 1 of the following IWCLL 2008 criteria for requiring treatment:
Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia (hemoglobin < 10 g/dL) and/or thrombocytopenia (platelets < 100,000/μL).
Massive (i.e., ≥ 6 cm below the left costal margin), progressive, or symptomatic splenomegaly.
Massive nodes (i.e., ≥ 10 cm in the longest diameter), progressive, or symptomatic lymphadenopathy.
Progressive lymphocytosis with an increase of > 50% over a 2-month period or a LDT of < 6 months. LDT may be obtained by linear regression extrapolation of ALC obtained at intervals of 2 weeks over an observation period of 2 to 3 months. In subjects with initial blood lymphocyte counts of < 30 x 109/L (30,000/μL), LDT should not be used as a single parameter to define indication for treatment. In addition, factors contributing to lymphocytosis or lymphadenopathy other than CLL (e.g., infections) should be excluded.
Autoimmune anemia and/or thrombocytopenia that is poorly responsive to standard therapy.
Constitutional symptoms documented in the subject's chart with supportive objective measures, as appropriate, defined as ≥ 1 of the following disease-related symptoms or signs:
i. Unintentional weight loss ≥ 10% within the previous 6 months before Screening.
ii. Significant fatigue (i.e., ECOG performance status 2; inability to work or perform usual activities).
iii. Fevers higher than 100.5°F or 38.0°C for 2 or more weeks before Screening without evidence of infection.
iv. Night sweats for > 1 month before Screening without evidence of infection.
This criterion was deleted as of Protocol Amendment 3.
Meet the following laboratory parameters:
ANC ≥ 750 cells/μL (0.75 x 109/L), or ≥ 500 cells/μL (0.50 x 109/L) in subjects with documented bone marrow involvement, and independent of growth factor support 7 days before assessment.
Platelet count ≥ 50,000 cells/μL (50 x 109/L), or ≥ 30,000 cells/μL (30 x 109/L) in subjects with documented bone marrow involvement, and without transfusion support 7 days before assessment. Subjects with transfusion-dependent thrombocytopenia are excluded.
Serum AST and ALT/SGPT ≤ 3.0 x ULN.
Total bilirubin ≤ 1.5 x ULN.
Estimated creatinine clearance (i.e., eGFR using Cockcroft-Gault) ≥ 30 mL/min

You may not qualify if…

Any prior systemic treatment for CLL (note: Prior localized radiotherapy is allowed).
Known CNS lymphoma or leukemia.
Known prolymphocytic leukemia or history of, or currently suspected, Richter's syndrome.
Missing or incomplete documentation of FISH results reflecting the presence or absence of 17p del and the percentage of cells with the deletion in subject records before randomization.
Uncontrolled AIHA or ITP defined as declining hemoglobin or platelet count secondary to autoimmune destruction within the screening period or requirement for high doses of steroids (> 20 mg daily of prednisone daily or equivalent).
Corticosteroid use > 20 mg within 1 week before first dose of study drug, except as indicated for other medical conditions such as inhaled steroid for asthma, topical steroid use, or as premedication for administration of study drug or contrast. For example, subjects requiring steroids at daily doses > 20 mg prednisone equivalent systemic exposure daily, or those who are administered steroids for leukemia control or WBC count lowering are excluded.
Major surgery within 4 weeks before first dose of study drug.
History of prior malignancy except for the following:
Malignancy treated with curative intent and with no evidence of active disease present for more than 3 years before Screening and felt to be at low risk for recurrence by treating physician.
Adequately treated lentigo maligna melanoma without current evidence of disease or adequately controlled non-melanomatous skin cancer.
Adequately treated cervical carcinoma in situ without current evidence of disease.
Significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of screening, or any Class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification, or QTc > 480 msec at screening.
Unable to swallow capsules or malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel or gastric bypass, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction.
Uncontrolled active systemic fungal, bacterial, viral, or other infection (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment) or ongoing intravenous anti-infective treatment.
Known history of infection with HIV. 13. Vaccinated with live, attenuated vaccines within 4 weeks of first dose of study drug.
Serologic status reflecting active hepatitis B or C infection. Subjects with hepatitis B core antibody positive who are surface antigen negative or who are hepatitis C antibody positive will need to have a negative PCR result before randomization. Those who are hepatitis B surface antigen positive or hepatitis B PCR positive and those who are hepatitis C PCR positive will be excluded.
History of stroke or intracranial hemorrhage within 6 months before randomization.
Known history of a bleeding diathesis (e.g., hemophilia, von Willebrand disease).
Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists (e.g., phenprocoumon) within 7 days of first dose of study drug.
Requires treatment with proton-pump inhibitors (e.g., omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, or pantoprazole).
Breast feeding or pregnant. 20. Current life-threatening illness, medical condition, or organ system dysfunction which, in the Investigator's opinion, could compromise the subject's safety or put the study at risk.
Concurrent participation in another therapeutic clinical trial. 22. Requires treatment with a strong CYP3A inhibitor/inducer. 23. Presence of a gastrointestinal ulcer diagnosed by endoscopy within 3 months before screening.

Where it is running

Research Site — Phoenix, Arizona, United States
Research Site — Anaheim, California, United States
Research Site — Los Angeles, California, United States
Research Site — Los Angeles, California, United States
Research Site — Los Angeles, California, United States
Research Site — Oxnard, California, United States
Research Site — Palo Alto, California, United States
Research Site — Aurora, Colorado, United States
Research Site — Lone Tree, Colorado, United States
Research Site — Washington D.C., District of Columbia, United States
Research Site — Fort Myers, Florida, United States
Research Site — Jacksonville, Florida, United States
Research Site — Tallahassee, Florida, United States
Research Site — Tallahassee, Florida, United States
Research Site — Tampa, Florida, United States
Research Site — Niles, Illinois, United States
Research Site — Lafayette, Indiana, United States
Research Site — Wichita, Kansas, United States
Research Site — Louisville, Kentucky, United States
Research Site — New Orleans, Louisiana, United States
Research Site — COL, Maryland, United States
Research Site — Rochester, Minnesota, United States
Research Site — Saint Cloud, Minnesota, United States
Research Site — Billings, Montana, United States
Research Site — Goodyear, Arizona, United States

Full record on ClinicalTrials.gov

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