Clinical Trials /

Study of LOXO-305 Versus Investigator's Choice (IdelaR or BR) in Patients With CLL or SLL

NCT04666038

Description:

This is a study for patients with chronic lymphocytic leukemia (CLL) or small lymphocytic leukemia (SLL) who have previously received treatment with at least a BTK inhibitor. The main purpose is to compare LOXO-305 to idelalisib plus rituximab or bendamustine plus rituximab. Participation could last up to four years, and possibly longer, if the disease does not progress.

Related Conditions:
  • Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Recruiting Status:

Recruiting

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: Study of LOXO-305 Versus Investigator's Choice (IdelaR or BR) in Patients With CLL or SLL
  • Official Title: A Phase 3 Open-Label, Randomized Study of LOXO-305 Versus Investigator's Choice of Idelalisib Plus Rituximab or Bendamustine Plus Rituximab in BTK Inhibitor Pretreated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (BRUIN CLL-321)

Clinical Trial IDs

  • ORG STUDY ID: LOXO-BTK-20020
  • NCT ID: NCT04666038

Conditions

  • Chronic Lymphocytic Leukemia
  • Small Lymphocytic Lymphoma

Interventions

DrugSynonymsArms
LOXO-305PirtobrutinibArm A (LOXO-305)
IdelalisibZydeligArm B (Idelalisib plus rituximab [IdelaR] or bendamustine plus rituximab [BR])
BendamustineTreanda, Treakisym, Ribomustin, LevactArm B (Idelalisib plus rituximab [IdelaR] or bendamustine plus rituximab [BR])
RituximabRituxan, MabThera, TruximaArm B (Idelalisib plus rituximab [IdelaR] or bendamustine plus rituximab [BR])

Purpose

This is a study for patients with chronic lymphocytic leukemia (CLL) or small lymphocytic leukemia (SLL) who have previously received treatment with at least a BTK inhibitor. The main purpose is to compare LOXO-305 to idelalisib plus rituximab or bendamustine plus rituximab. Participation could last up to four years, and possibly longer, if the disease does not progress.

Detailed Description

      This is a Phase 3 global, randomized, open-label study comparing LOXO-305 (Arm A) to
      investigator's choice of either idelalisib plus rituximab or bendamustine plus rituximab (Arm
      B) in CLL/SLL patients who have been treated with at least a covalent BTK inhibitor (BTKi).
      Patients may have discontinued the prior covalent BTKi due to disease progression (PD) or
      intolerance. Patients who have received venetoclax are eligible for the study. Eligible
      patients will be randomized in 1:1 to Arm A and Arm B.
    

Trial Arms

NameTypeDescriptionInterventions
Arm A (LOXO-305)ExperimentalOrally
  • LOXO-305
Arm B (Idelalisib plus rituximab [IdelaR] or bendamustine plus rituximab [BR])Active ComparatorInvestigator's choice of idelalisib plus rituximab (IdelaR) or bendamustine plus rituximab (BR).
  • Idelalisib
  • Bendamustine
  • Rituximab

Eligibility Criteria

        Inclusion Criteria:

          -  Confirmed diagnosis of CLL/SLL requiring therapy as defined by iwCLL 2018 criteria

          -  Previously treated with a covalent BTK inhibitor

          -  Eastern Cooperative Oncology Group (ECOG) 0-2

          -  Absolute neutrophil count ≥ 0.75 × 109/L without granulocyte-colony stimulating factor
             support

          -  Hemoglobin ≥ 8 g/dL not requiring transfusion support or growth factors within 14 days
             of Cycle 1 Day 1

          -  Platelets ≥ 50 × 109/L not requiring transfusion support or growth factors within 14
             days of C1D1. If an investigator has chosen bendamustine/rituximab as the Arm B
             treatment, platelets must be ≥ (75 × 109/L).

          -  AST and ALT ≤ 3.0 x upper limit of normal (ULN).

          -  Total bilirubin ≤ 1.5 x ULN.

          -  Estimated creatinine clearance of ≥ 30 mL/min.

        Exclusion Criteria:

          -  Known or suspected Richter's transformation at any time preceding enrollment.

          -  Known or suspected history of central nervous system (CNS) involvement by CLL/SLL

          -  Ongoing drug-induced liver injury

          -  Active uncontrolled auto-immune cytopenia

          -  Significant cardiovascular disease

          -  History of allogeneic or stem cell transplantation (SCT) or chimeric antigen
             receptor-modified T cells (CAR-T) therapy within the past 60 days

          -  Active hepatitis B or hepatitis C

          -  Known active cytomegalovirus (CMV) infection.

          -  Active uncontrolled systemic bacterial, viral, fungal or parasitic infection.

          -  Known Human Immunodeficiency Virus (HIV) infection, regardless of CD4 count.

          -  Clinically significant active malabsorption syndrome or inflammatory bowel disease

          -  Prior exposure to non-covalent (reversible) BTK inhibitor.

          -  Patients requiring therapeutic anticoagulation with warfarin or another Vitamin K
             antagonist.

          -  Current treatment with strong cytochrome P450 (CYP) 3A4 (CYP3A4) inhibitors or
             inducers and/or strong P-glycoprotein (P-gp) inhibitors

          -  Vaccination with a live vaccine within 28 days prior to randomization

          -  Patients with the following hypersensitivity:

               1. Known hypersensitivity, including anaphylaxis, to any component or excipient of
                  LOXO-305, idelalisib, and bendamustine

               2. Prior significant hypersensitivity to rituximab
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:To evaluate progression-free survival (PFS) of LOXO-305 monotherapy (Arm A) compared to investigator's choice of idelalisib plus rituximab (IdelaR) or bendamustine plus rituximab (BR) (Arm B)
Time Frame:Up to approximately 36 months
Safety Issue:
Description:Assessed per iwCLL 2018

Secondary Outcome Measures

Measure:To evaluate the effectiveness of Arm A compared to Arm B based on Overall Response Rate (ORR)
Time Frame:Up to approximately 36 months
Safety Issue:
Description:Assessed per iwCLL 2018
Measure:To evaluate the effectiveness of Arm A compared to Arm B based on Overall Survival (OS)
Time Frame:Up to approximately 36 months
Safety Issue:
Description:Assessed by survival
Measure:To evaluate the effectiveness of Arm A compared to Arm B based on Time to Next Treatment (TTNT)
Time Frame:Up to approximately 36 months
Safety Issue:
Description:Defined as time from randomization to next systemic anticancer therapy for CLL/SLL
Measure:Time to worsening (TTW) of CLL/SLL related symptoms
Time Frame:Up to approximately 36 months
Safety Issue:
Description:Using symptom questions identified from the EORTC item library. The range of raw scores for these items could be from 0 to 52 with highest score being worse symptoms
Measure:Time to worsening (TTW) of physical function
Time Frame:Up to approximately 36 months
Safety Issue:
Description:Using the 5 physical function items identified from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) questionnaire (also known as the EORTC IL 19 questionnaire), physical function will be measured. The range of raw scores for these items could be from 0-20 with the highest score indicating worst function.

Details

Phase:Phase 3
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Loxo Oncology, Inc.

Trial Keywords

  • Hematologic Disease
  • Lymphoma, non-Hodgkin's
  • Lymphoma, B-cell
  • Lymphoma
  • Bruton's tyrosine kinase inhibitor
  • Ibrutinib
  • Acalabrutinib
  • Zanubrutinib
  • Pirtobrutinib

Last Updated

June 28, 2021