Pirtobrutinib Maintenance After CAR-T Therapy in Relapsed or Refractory B-Cell Lymphoma
A Single-Arm, Open-Label, Multicenter Clinical Study to Evaluate the Efficacy and Safety of Pirtobrutinib as Maintenance Therapy for Relapsed or Refractory B-Cell Lymphoma After CAR-T Cell Therapy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Guangdong
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Guangzhou, Guangdong, China, 510060
- Sun yat-sen University Cancer Center
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Contact:
- Principal investigator
- Phone Number: 0086-20-87342823
- Email: caiqq@sysucc.org.cn
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Able to understand and voluntarily sign the informed consent form.
- Age 18 years or older, male or female.
- Histologically confirmed large B-cell lymphoma, including diffuse large B-cell lymphoma, primary mediastinal large B-cell lymphoma, high-grade B-cell lymphoma, or transformed follicular lymphoma (tFL).
- Eastern Cooperative Oncology Group performance status of 0 to 2.
- Has received commercial anti-CD19 CAR-T cell therapy, with informed consent obtained before Day 28 after CAR-T cell infusion.
- Prior anti-lymphoma therapy-related adverse events, especially CAR-T-related adverse events, have stabilized and recovered to Grade 1 or lower, except for clinically insignificant toxicities.
Exclusion Criteria:
- History of other malignancies, except non-melanoma skin cancer without recurrence for more than 3 years, carcinoma in situ, such as cervical, bladder, or breast carcinoma, or follicular lymphoma.
- Prior autologous or allogeneic hematopoietic stem cell transplantation.
- Active or suspected uncontrolled fungal, bacterial, viral, or other infection requiring intravenous treatment. Patients with uncomplicated urinary tract infection or uncomplicated bacterial pharyngitis may be enrolled if responding to active treatment.
- History of immunodeficiency, including human immunodeficiency virus infection; positive treponema pallidum antibody; active hepatitis B virus infection; or active hepatitis C virus infection.
- Current or prior history of benign central nervous system disease, such as seizure, cerebrovascular ischemia or hemorrhage, dementia, cerebellar disease, or any central nervous system-related autoimmune disease.
- Lymphoma involvement of the atrium or ventricle.
- Autoimmune disease requiring systemic immunosuppressive or immunomodulatory therapy within 2 years.
- History of symptomatic deep vein thrombosis or pulmonary embolism within 6 months before enrollment.
- Any comorbidity that may affect or interfere with safety or efficacy assessment.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Pirtobrutinib Maintenance After CAR-T Cell Therapy
Patients will receive pirtobrutinib 200 mg orally once daily starting on Day 30 after commercial anti-CD19 CAR-T cell infusion.
Pirtobrutinib maintenance therapy will be continued for 6 months unless disease progression, unacceptable toxicity, withdrawal of consent, or other protocol-defined discontinuation criteria occur.
Patients who do not achieve complete response after 6 months of maintenance therapy, or who achieve complete response with detectable ctDNA, may receive a second infusion of commercial CAR-T cells at the investigator's discretion.
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Pirtobrutinib will be administered orally at a dose of 200 mg once daily for 6 months, beginning on Day 30 after commercial anti-CD19 CAR-T cell infusion.
Dose interruption, dose reduction, or treatment discontinuation will be performed according to protocol-specified toxicity management rules.
A second infusion of commercial anti-CD19 CAR-T cells may be administered after completion of 6 months of pirtobrutinib maintenance therapy in selected patients who do not achieve complete response, or who achieve complete response but remain ctDNA-positive, based on investigator assessment and protocol-defined criteria.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Complete response rate (CRR)
Time Frame: At 6 months after initiation of pirtobrutinib maintenance therapy
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CRR is defined as the proportion of patients who achieve complete response according to the Lugano 2014 criteria at 6 months after initiation of pirtobrutinib maintenance therapy.
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At 6 months after initiation of pirtobrutinib maintenance therapy
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall survival (OS)
Time Frame: Up to 24 months
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OS is defined as the time from enrollment to death from any cause.
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Up to 24 months
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Best complete response rate (bCRR)
Time Frame: Up to 24 months
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bCRR is defined as the proportion of patients whose best response is complete response according to the Lugano 2014 criteria.
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Up to 24 months
|
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Best objective response rate (bORR)
Time Frame: Up to 24 months
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bORR is defined as the proportion of patients whose best response is complete response or partial response according to the Lugano 2014 criteria.
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Up to 24 months
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Objective response rate (ORR)
Time Frame: At 6 months after initiation of pirtobrutinib maintenance therapy
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ORR is defined as the proportion of patients who achieve complete response or partial response according to the Lugano 2014 criteria at 6 months after initiation of pirtobrutinib maintenance therapy.
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At 6 months after initiation of pirtobrutinib maintenance therapy
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Duration of complete response (DoCR)
Time Frame: Up to 24 months
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DoCR is defined as the time from the first documented complete response to disease progression or death from any cause, whichever occurs first.
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Up to 24 months
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Duration of response (DOR)
Time Frame: Up to 24 months
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DOR is defined as the time from the first documented response to disease progression or death from any cause, whichever occurs first.
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Up to 24 months
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Progression-free survival (PFS)
Time Frame: Up to 24 months
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PFS is defined as the time from enrollment to disease progression or death from any cause, whichever occurs first.
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Up to 24 months
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Incidence of adverse events (AEs) and serious adverse events (SAEs)
Time Frame: Up to 30 days after the last dose of pirtobrutinib
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The incidence and severity of adverse events will be assessed and graded according to the National Cancer In Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.
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Up to 30 days after the last dose of pirtobrutinib
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms
- Disease Attributes
- Immune System Diseases
- Neoplasms by Histologic Type
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Lymphoma
- Pathological Conditions, Signs and Symptoms
- Hemic and Lymphatic Diseases
- Recurrence
- Lymphoma, B-Cell
- pirtobrutinib
Other Study ID Numbers
Other Study ID Numbers
- T2026-006
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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