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Study of Zanubrutinib in Older Patients With Previously Untreated Chronic Lymphocytic Leukemia (CLL) (ZEN-CLL)

9 settembre 2026 aggiornato da: The Lymphoma Academic Research Organisation

ZEN-CLL - A Phase II Trial Evaluating Zanubrutinib in Elderly, Treatment-Naïve, CLL Patients

This phase II, open-label, multicenter study evaluates zanubrutinib in patients aged 80 years and older with previously untreated chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who require treatment.

CLL and SLL are slow-growing blood cancers that mainly affect older adults. Although zanubrutinib is an effective treatment, taking it continuously at the full dose may increase the risk of side effects over time, particularly in elderly patients. The study aims to assess whether a planned reduction in the dose of zanubrutinib after an initial period of treatment can maintain disease control while improving long-term tolerability.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

The ZEN-CLL study is evaluating a treatment strategy based on zanubrutinib in previously untreated elderly patients with CLL or small lymphocytic lymphoma (SLL). Approximately 95 participants will be enrolled in 17 LYSA centers in France.

All participants will receive zanubrutinib 160 mg twice daily for the first 18 months of treatment. After Month 18, the dose will be reduced according to the dose received at that time and the participant's tolerability. Treatment will continue until permanent treatment discontinuation or the end of study participation.

The study aims to determine whether this dose reduction strategy can maintain disease control while improving long-term tolerability in this elderly population.

Tipo di studio

Interventistico

Iscrizione (Stimato)

95

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

  • Nome: Project management
  • Numero di telefono: +33 4 72 66 93 33
  • Email: zen-cll@lysarc.org

Luoghi di studio

  • Francia
      • Argenteuil, Francia, 95107
      • Avignon, Francia, 84000
        • Ch D'Avignon - Hopital Henri Duffaut
        • Contatto:
        • Investigatore principale:
          • Safia CHEBREK, doctor
      • Bayonne, Francia, 64109
        • CH de la Côte Basque
        • Contatto:
        • Investigatore principale:
          • Nathan MOTTAL, doctor
      • Bordeaux, Francia, 33076
      • Cergy-Pontoise, Francia, 95303
      • Corbeil-Essonnes, Francia, 91106
        • Ch Sud Francilien
        • Contatto:
        • Investigatore principale:
          • Laurence SIMON, doctor
      • Estaing, Francia, - SITE ESTAING
      • Grenoble, Francia, 38700
        • CHU de GRENOBLE
        • Contatto:
        • Investigatore principale:
          • Lysiane MOLINA, doctor
      • Le Chesnay, Francia, 78157
        • Ch de Versailles - Hopital Andre Mignot
        • Contatto:
        • Investigatore principale:
          • Fatiha MERABET, doctor
      • Le Mans, Francia, 72000
        • Ch Du Mans-Centre de Cancerologie de La Sarthe
        • Contatto:
        • Investigatore principale:
          • Kamel LARIBI, doctor
      • Lille, Francia, 59020
        • Hopital Saint Vincent-de-Paul
        • Contatto:
        • Investigatore principale:
          • Bénédicte HIVERT, doctor
      • Lyon, Francia, 69373
      • Orléans, Francia, 45067
      • Rouen, Francia, 76038
      • Toulouse, Francia, 31059
      • Vandœuvre-lès-Nancy, Francia, 54511
        • CHRU Nancy - hôpital Brabois
        • Contatto:
        • Investigatore principale:
          • Pierre FEUGIER, professor
    • Pierre Bénite
      • Lyon, Pierre Bénite, Francia, 69310

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Participant who understands and voluntarily signs and dates an informed consent form prior to any studyspecific assessments/procedures being conducted, including consent for specific biology analysis
  • Must be able to adhere to the trial visit schedule and other protocol requirements
  • ≥ 80 years at the time of signing the informed consent form (ICF) with no upper age limit
  • Previously untreated and documented CLL or small lymphocytic lymphoma (SLL), with a Royal Marsden Hospital (RMH) or Matutes Score of 4 or 5. For SLL a detectable clone with a CLL phenotype in the peripheral blood is a prerequisite for trial participation.
  • Participant requiring treatment according to 2018 IWCLL guidelines
  • ECOG performance status 0 to 2
  • Life expectancy > 6 months

  • Adequate hematopoietic function within 7 days before the participant's enrollment

    • ANC ≥ 0.75 G/L
    • And Platelets ≥ 50 G/L Note: Platelets transfusions may be administered during screening to meet this requirement
  • Hemoglobin level > 9g/dL, regardless of transfusion
  • Adequate renal function defined by a Creatinine Clearance ≥ 30 ml/min calculated according to MDRD or CKD-EPI or Cockcroft-Gault (using actual body weight).
  • Adequate liver function, as indicated by a total bilirubin <1.5 x ULN, AST and ALT <3 x ULN value, unless directly attributed to the participant's CLL/SLL or to Gilbert's Syndrome (the ULN is based on institutionalvalues)
  • Participant covered by any social security system
  • Participant who understands and speaks the country official language unless local regulation authorizes independent translator

Exclusion Criteria:

  • Any prior CLL or SLL-specific therapies, even including rituximab used for autoimmune cytopenias.

  • Clinically significant cardiovascular disease including the following:

    1. Myocardial infarction within 6 months prior to ICF signature
    2. Unstable angina within 3 months prior to ICF signature
    3. NYHA class III or IV heart failure
    4. Uncontrolled hypertension
    5. History of clinically significant arrhythmias (including sustained ventricular tachycardia, ventricular fibrillation, or torsades de pointes).
    6. History of Mobitz II second- or third-degree heart block without permanent pacemaker
    7. Known LVEF <50% as determined by echocardiography or multiple uptake gated acquisition (MUGA) scan
  • Child-Pugh liver cirrhosis
  • Clinical evidence for Central Nervous System involvement by CLL
  • Severe chronic obstructive lung disease with hypoxemia
  • Severe diabetes mellitus
  • Disease significantly affecting gastrointestinal function (malabsorption syndrome, stomach or small bowel resection)
  • Active or non-active autoimmune hemolytic anemia (AIHA) (isolated positive DAT is not an exclusion criterion, but reticulocytes/haptoglobin levels must be in lab normal ranges) or idiopathic thrombocytopenic purpura (ITP), requiring steroid therapy with > 20 mg daily of prednisone dose or equivalent.
  • Any prior history of Richter transformation or DLBCL
  • Any evidence or suspicion of Richter transformation or DLBCL during screening
  • Active malignancy other than the one treated in this trial. Prior history of malignancies unless the participant has been free of the disease for ≥ 2 years.

However, participants with the following history /conditions that have been treated with a curative intent are allowed:

  1. Non-invasive basal cell or epidermoid carcinoma (non melanoma)
  2. In situ carcinoma of the cervix
  3. In situ carcinoma of the breast
  4. Incidental histologic finding of prostate cancer (T1a or T1b) using the tumor, nodes, metastasis [TNM] clinical staging system

  5. Woman with adjuvant endocrine therapy (I.e., hormonotherapy) after breast cancer treatment can be enrolled if hormonotherapy was started for ≥ 2 years

    • History of stroke or intracranial hemorrhage within 6 months prior to ICF signature.
    • Major surgery 28 days before the ICF signature
    • History or known bleeding disorders (e.g hemophilia or von Willebrand disease)
    • Active Hepatitis C Virus (HCV) infection (RNA PCR-positive). Participants who received treatment for HCV infection that was intended to eradicate the virus may participate if hepatitis C RNA levels are undetectable
    • Active Hepatitis B Virus (HBV) infection (DNA PCR-positive). Participants with evidence of prior HBV infection but who are PCR-negative are permitted in the trial but should receive prophylactic antiviral therapy during the entire treatment with active monitoring of viral load in the blood
    • Patient with a positive HIV test before enrollment are eligible provided that they are stable on antiretroviral therapy for at least 4 weeks, have a CD4 count ≥ 200/uL, have an undetectable viral load, and have not had a history of opportunistic infection attributable to AIDS within the last 12 months.Known or suspected hypersensitivity or anaphylaxis to trial intervention including active substance or to any of the excipients.
    • Requires or receiving anticoagulation with warfarin or dual antiplatelets therapy equivalent vitamin K antagonists (other anticoagulants allowed: novel oral anticoagulant alone, aspirin alone, heparin alone).
    • Requires treatment with a strong/moderate cytochrome CYP3A4 inhibitor/inducer.
    • Participation in another clinical study who would compromise the participation to the current study.
    • Vaccinated with live, attenuated vaccines within 6 months of ICF
    • Use of any standard or experimental anti-cancer drug therapy within 28 days before the start (Day 1) of study treatment
    • Corticosteroid use > 20 mg per day within 1 week before the first dose of trial intervention, except as indicated for other medical conditions, such as inhaled steroid for asthma, topical steroid use, or as premedication for administration of trial intervention or contrast.
    • Any significant medical conditions, or laboratory abnormality or psychiatric illness likely to interfere with participation in this clinical trial or affect interpretation of trial outcomes (according to the investigator's decision)
    • Any uncontrolled and/or active significant infection (eg, bacterial, viral, or fungal; including participants with positive cytomegalovirus PCR).
    • Participant deprived of their liberty by a judicial or administrative decision
    • Participant hospitalized without consent
    • Adult participant under legal protection

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Zanubrutinib
Participants will receive oral zanubrutinib followed by a predefined dose reduction strategy. Treatment will continue until disease progression, permanent treatment discontinuation, withdrawal of consent, loss to follow-up, or the end of study participation.
Droga: Zanubrutinib
Zanubrutinib is a Bruton tyrosine kinase (BTK) inhibitor administered orally.
Altri nomi:
  • BRUKINSA

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Progression-Free Survival (PFS)
Lasso di tempo: 30 months and 5 years
The primary endpoint is the Progression-Free Survival (PFS).
30 months and 5 years

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Permanent Treatment Discontinuation (PTD) Rate
Lasso di tempo: 18 months
The key secondary endpoint is the rate of permanent treatment discontinuation (PTD).
18 months
Overall Survival (OS)
Lasso di tempo: At 30 months and at 5 years
The secondary efficacy endpoint 1 is the Overall Survival (OS).
At 30 months and at 5 years
Time to Next Anti-Leukemia Treatment
Lasso di tempo: At 30 months and at 5 years
The secondary efficacy endpoint 2 is the Time to Next Anti-Leukemia Treatment (TTNLT).
At 30 months and at 5 years
Overall Response Rate
Lasso di tempo: At 18 months and at 30 months
The secondary efficacy endpoints 3 and 4 are Overall Response Rate (ORR) at 18 months and at 30 months, respectively.
At 18 months and at 30 months
Change From Baseline in Geriatric Assessment Scores
Lasso di tempo: at baseline, at 18 months, at 30 months and at 42 months
Geriatric condition will be evaluated using minimal nurse-delivered scales recommended by the SIOG.
at baseline, at 18 months, at 30 months and at 42 months
Health-Related Quality of Life
Lasso di tempo: At baseline, every 3 months for the first 2 years, and every 6 months thereafter for 3 years.
Health-Related Quality of Life as assessed by Questionnaire
At baseline, every 3 months for the first 2 years, and every 6 months thereafter for 3 years.
Frailty Assessment Score
Lasso di tempo: At baseline, every 3 months for the first 2 years, and every 6 months thereafter for 3 years.
Frailty status will be assessed using a validated frailty scale.
At baseline, every 3 months for the first 2 years, and every 6 months thereafter for 3 years.
Patient-Reported Treatment Side Effect Burden
Lasso di tempo: Baseline, every 3 months for the first 2 years, and every 6 months thereafter for 3 years.
Treatment side effect burden will be assessed using a patient-reported questionnaire.
Baseline, every 3 months for the first 2 years, and every 6 months thereafter for 3 years.
Incidence and Severity of Adverse Events (AEs), Serious Adverse Events (SAEs), and Adverse Events of Special Interest (AESIs)
Lasso di tempo: From first dose of study treatment until the end of study participation (up to 5 years).
Safety will be assessed by the incidence, severity, and seriousness of adverse events, including serious adverse events and adverse events of special interest.
From first dose of study treatment until the end of study participation (up to 5 years).

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

The Lymphoma Academic Research Organisation

Collaboratori

Lymphoma Study Association
BeOne Medicines

Investigatori

  • Investigatore principale: Loïc YSEBAERT, Professor, IUCT Oncopole
  • Investigatore principale: Emmanuelle FERRANT, Doctor, Hospices Civils de Lyon

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 dicembre 2026

Completamento primario (Stimato)

1 aprile 2029

Completamento dello studio (Stimato)

1 dicembre 2032

Date di iscrizione allo studio

Primo inviato

28 luglio 2026

Primo inviato che soddisfa i criteri di controllo qualità

28 luglio 2026

Primo Inserito (Effettivo)

31 luglio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

14 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

9 settembre 2026

Ultimo verificato

1 luglio 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • ZEN-CLL
  • 2025 (Sovvenzione/contratto NIH degli Stati Uniti: Faculty of Social Sciences Scientific Grant at the University of Gdańsk)
  • 2025-525080-32-00 (Ctis)

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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