Clinical trial • Phase II • Haematology

ACALABRUTINIB for Mantle cell lymphoma

Phase II trial of ACALABRUTINIB for Mantle cell lymphoma.

Overview

Trial Therapeutic Area
Haematology
Trial Disease
Mantle cell lymphoma
Trial Stage
Phase II
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
07-08-2024
First CTIS Authorization Date
04-09-2024

Trial design

None/Not specified (study evaluates acalabrutinib + rituximab in patients with untreated MCL and compares results to historical data from the NLG-MCL4 trial)-controlled Phase II trial across 17 sites in Denmark, Finland, Sweden and others.

Comparator
None/Not specified (study evaluates acalabrutinib + rituximab in patients with untreated MCL and compares results to historical data from the NLG-MCL4 trial)
Target Sample Size
80

Eligibility

Recruits 80 No vulnerable populations selected (isVulnerablePopulationSelected: false). Participants must be able to give voluntary written informed consent as stated in the inclusion criteria..

Pregnancy Exclusion
Breastfeeding or pregnant women
Vulnerable Population
No vulnerable populations selected (isVulnerablePopulationSelected: false). Participants must be able to give voluntary written informed consent as stated in the inclusion criteria.

Inclusion criteria

  • {"criterion_text":"- Age ≥60 years\n- Pathologically confirmed MCL (according to the WHO 2016 classification), with documentation of monoclonal B cells that have a chromosome translocation t(11;14)(q13;q32) and/or overexpress cyclin D1\n- Stage II-IV, measurable by imaging and requiring treatment in the opinion of the treating clinician\n- No previous treatment for MCL (other than localised radiotherapy or 7-day pulse of steroids for symptom control)\n- ECOG performance status 0 – 2\n- Absolute neutrophil count (ANC) > 1.0 x 10^9 and platelet count > 100 x 10^9, unless related to lymphoma - in this situation, the threshold for inclusion is ANC >0.5 x 10^9 and platelet count > 50 x 10^9\n- Creatinine clearance >30 ml/min (Cockcroft-Gault)\n- AST and/or ALT <3x ULN and/or P-bilirubin <3x ULN\n- Able to give voluntary written informed consent\n- Woman of childbearing potential (WOCBP) who are sexually active must use highly effective methods of contraception (see appendix 2) during treatment and for 2 days after the last dose of acalabrutinib or for 12 months after last dose of rituximab, whichever is longer"}

Exclusion criteria

  • {"criterion_text":"- Patients considered fit enough to undergo autologous or allogeneic stem cell transplant for MCL\n- Major surgery within two weeks prior to day 1 of cycle 1\n- Patients who are unable to swallow capsules/tablets, or who have disease significantly affecting gastrointestinal function that would limit oral absorption of medication\n- Known serological positivity for HBV, HCV, HIV. Patients who are hepatitis B core antibody (anti-HBc) positive and who are surface antigen negative will need to have a negative polymerase chain reaction (PCR) result. Those who are hepatitis B surface antigen (HbsAg) positive or hepatitis B PCR positive will be excluded. Patients who are hepatitis C antibody positive will need to have a negative PCR result. Those who are hepatitis C PCR positive will be excluded\n- Diagnosed with or treated for any other malignancy than MCL within 2 years prior to day 1 of cycle 1 (except basal cell carcinoma, cutaneous squamous cell carcinoma or any other in situ malignancy)\n- Active infection requiring treatment\n- Serious medical or psychiatric illness likely to interfere with participation in this clinical study\n- Concurrent treatment with another investigational agent outside of this protocol\n- Known history of drug-specific hypersensitivity or anaphylaxis to rituximab or acalabrutinib (including active product or excipient components)\n- Active bleeding, history of bleeding diathesis (eg, hemophilia or von Willebrand disease)\n- Uncontrolled AIHA (autoimmune hemolytic anemia) or ITP (idiopathic thrombocytopenic purpura)\n- The use of strong CYP3A inhibitors within 1 week or strong CYP3A inducers within 3 weeks of the first dose of study drug is prohibited\n- Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists (eg, phenprocoumon) within 7 days of first dose of study drug.\n- Prothrombin time/INR or aPTT (in the absence of Lupus anticoagulant) > 2x ULN.\n- Requires treatment with proton pump inhibitors (eg, omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, or pantoprazole). Patients receiving proton pump inhibitors who switch to H2-receptor antagonists or antacids are eligible for enrollment to this study\n- History of significant cerebrovascular disease or event, including stroke or intracranial hemorrhage, within 6 months before the first dose of study drug\n- Breastfeeding or pregnant women\n- Concurrent participation in another therapeutic clinical trial\n- History of or ongoing confirmed progressive multifocal leukoencephalopathy (PML)\n- Significant cardiovascular disease such as 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 at Screening. Note: Subjects with controlled, asymptomatic atrial fibrillation are allowed to enroll on study"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Progression-free survival. This is defined as the interval between date of obtaining informed consent and date of documented progression, first relapse, or death of any cause. Otherwise, patients will be censored at the last date they were known to be alive.","definition_or_measurement_approach":"Defined as interval between date of obtaining informed consent and date of documented progression, first relapse, or death from any cause; censoring at last known alive date."}

Secondary endpoints

  • {"endpoint_text":"- Complete response rate at 6 months","definition_or_measurement_approach":"Complete response assessed at 6 months"}
  • {"endpoint_text":"- Molecular remission rate (MRR) by PCR","definition_or_measurement_approach":"Assessed by PCR (molecular remission rate)"}
  • {"endpoint_text":"- Overall response rate","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Progression-free survival (median)","definition_or_measurement_approach":"Median progression-free survival"}
  • {"endpoint_text":"- Response duration (median)","definition_or_measurement_approach":"Median duration of response"}
  • {"endpoint_text":"- Duration of molecular remission (median)","definition_or_measurement_approach":"Median duration of molecular remission"}
  • {"endpoint_text":"- Overall survival (median)","definition_or_measurement_approach":"Median overall survival"}
  • {"endpoint_text":"- CR, MRR and ORR in TP53-mutated MCL","definition_or_measurement_approach":"Subgroup analyses in TP53-mutated MCL"}
  • {"endpoint_text":"- Safety, in terms of all grade 3-5 AE","definition_or_measurement_approach":"Safety assessed by incidence of all grade 3-5 adverse events"}

Recruitment

Planned Sample Size
80
Recruitment Window Months
84
Consent Approach
Participants must be able to give voluntary written informed consent. Subject information and informed consent forms are provided (documents present for Denmark: L1_SIS and ICF_DK; Finland: L1_SIS and ICF_FI; Sweden: L1_SIS and ICF_SE; Norway: L1_SIS and ICF_NO). No assent procedure or minor consent processes are indicated; vulnerable population not selected.

Geography

Total Number Of Sites
17
Total Number Of Participants
80

Denmark

Earliest CTIS Part Ii Submission Date
22-08-2024
Latest Decision Or Authorization Date
10-09-2024
Processing Time Days
19
Number Of Sites
2
Number Of Participants
13

Sites

Site Name
Odense University Hospital
Department Name
Department of Hematology
Contact Person Name
Jacob Haaber
Contact Person Email
jacob.h.christensen@rsyd.dk
Site Name
Region Sjaelland
Department Name
Department
Contact Person Name
Sif Gudbrandsdottir
Contact Person Email
sgu@regionsjaelland.dk

Finland

Earliest CTIS Part Ii Submission Date
22-08-2024
Latest Decision Or Authorization Date
04-09-2024
Processing Time Days
13
Number Of Sites
2
Number Of Participants
6

Sites

Site Name
Oulu University Hospital
Department Name
Department of Hematology
Contact Person Name
Hanne Kuitunen
Contact Person Email
hanne.kuitunen@pohde.fi
Site Name
HUS-Yhtymae
Department Name
Department of Hematology
Contact Person Name
Annika Pasanen
Contact Person Email
annika.pasanen@hus.fi

Sweden

Earliest CTIS Part Ii Submission Date
22-08-2024
Latest Decision Or Authorization Date
05-09-2024
Processing Time Days
14
Number Of Sites
9
Number Of Participants
45

Sites

Site Name
NU Hospital Group-Vastra Gotalandsregionen
Department Name
Department of Hematology
Contact Person Name
Lina Wide
Contact Person Email
lina.wide@vgregion.se
Site Name
Region Halland
Department Name
Department of Medicine
Contact Person Name
Nevzeta Kuric
Contact Person Email
nevzeta.kuric@regionhalland.se
Site Name
Lund University Hospital
Department Name
Department of Oncology
Contact Person Name
Mats Jerkeman
Contact Person Email
mats.jerkeman@med.lu.se
Site Name
Uppsala University Hospital
Department Name
Department of Oncology
Contact Person Name
Ingrid Glimelius
Contact Person Email
ingrid.glimelius@igp.uu.se
Site Name
Laenssjukhuset I Kalmar Region Kalmar Laen
Department Name
Department of Internal Medicine
Contact Person Name
Fredrik Ellin
Contact Person Email
fredrik.ellin@regionkalmar.se
Site Name
Region Norrbotten
Department Name
Department of Medicine
Contact Person Name
Lena Brandefors
Contact Person Email
lena.brandefors@norbotten.se
Site Name
Sahlgrenska University Hospital-Vaestra Goetalandsregionen
Department Name
Department of Hematology and Coagulation
Contact Person Name
Martin Stenson
Contact Person Email
martin.stenson@vgregion.se
Site Name
Karolinska University Hospital
Department Name
Center of Hematology
Contact Person Name
Kristina Sonnevi
Site Name
Region Vaesterbotten
Department Name
Cancercentrum
Contact Person Name
Karin Papworth

Norway

Earliest CTIS Part Ii Submission Date
22-08-2024
Latest Decision Or Authorization Date
12-09-2024
Processing Time Days
21
Number Of Sites
4
Number Of Participants
16

Sites

Site Name
Helse Stavanger HF
Department Name
Department of Oncology
Contact Person Name
Idun Bakke Bø
Contact Person Email
idun.bakke.bo@sus.no
Site Name
Helse Bergen HF
Department Name
Department of Oncology
Contact Person Name
Anne Turid Bjørnevik
Site Name
Oslo University Hospital HF
Department Name
Department of Oncology
Contact Person Name
Jon Riise
Contact Person Email
jonrii@ous-hf.no
Site Name
St. Olavs Hospital HF
Department Name
Department of Oncology
Contact Person Name
Karin Fahl Wader

Sponsor

Primary sponsor

Full Name
Region Skane
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Sweden

Third parties

  • {"country":"Finland","full_name":"Oulu University Hospital","duties_or_roles":"sponsorDuties code: 1","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Finland","full_name":"HUS-Yhtymae","duties_or_roles":"sponsorDuties code: 1","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Norway","full_name":"Oslo University Hospital HF","duties_or_roles":"sponsorDuties code: 1","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Norway","full_name":"Helse Bergen HF","duties_or_roles":"sponsorDuties code: 1","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Norway","full_name":"St. Olavs Hospital HF","duties_or_roles":"sponsorDuties code: 1","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Denmark","full_name":"Odense University Hospital","duties_or_roles":"sponsorDuties code: 1","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Sweden","full_name":"Croak AB","duties_or_roles":"sponsorDuties code: 1","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
ACALABRUTINIB
Active Substance
ACALABRUTINIB
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Maximum Dose
200 mg per day
Combination Treatment
Yes

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