RecruitingPhase 2

Zanubrutinib and Venetoclax in CLL (ZANU-VEN)

A Phase 2 Trial of Zanubrutinib and Venetoclax in Previously Treated CLL/SLL Patients

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
18 Years and older
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

  • Time periods mentioned: 15 months, 36 months

Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.

Show the study's own words
  • "Participants will receive study treatment for 15 months initially."
  • "Participants will be followed for 36 months after they discontinue the study drugs."
Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests how well zanubrutinib and venetoclax work together. It is for adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), two blood cancers, that have come back after treatment.

This study is being done to test the effectiveness of zanubrutinib in combination with venetoclax in participants with previously treated chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Be age 18 or older, have confirmed CLL or SLL, and need treatment after the cancer has returned.
  • Group A: Never treated with covalent BTK inhibitors or BCL-2 inhibitors, types of targeted cancer drugs.
  • Group B: Previously treated with a BTK inhibitor or a BCL-2 inhibitor, but not both. Cancer must not have worsened while taking that treatment.
  • Group C: Cancer worsened during treatment with a covalent BTK inhibitor other than zanubrutinib.
  • Be able to care for yourself and be up and about for at least half of your waking hours.
  • Meet study blood count, liver, and kidney test limits.
  • Agree to use birth control as required. Men must continue for 4 months after their last study drug dose.
  • Be able to understand and sign the consent form, and swallow and keep down medicine.

Who can't join

  • Have a known BTK C481X gene change, cancer in the brain or spinal cord, or a past blood stem cell transplant from a donor.
  • Have had cancer treatment within 2 weeks before starting, with some exceptions, or be taking another experimental drug. Some other cancers also rule out joining.
  • Have an uncontrolled infection, recent IV antibiotics, or a live vaccine within 4 weeks before starting. A known history of HIV, active hepatitis C, or hepatitis B also rules out joining.
  • Have a bleeding disorder; a stroke, brain bleed, or major bleed within 6 months; or an ongoing immune attack on red blood cells or platelets, which help blood clot.
  • Need warfarin, similar blood thinners, or certain medicines that change how the study drugs are broken down. Have an allergy to drugs similar to the study drugs.
  • Be pregnant. Breastfeeding must stop during treatment.
  • Have major gut problems that affect digestion or medicine absorption, certain stomach or bowel surgeries, active bowel inflammation with symptoms, or a blocked bowel.
  • Have serious active heart disease or a heart attack or unstable chest pain within 6 months. Other serious illnesses or mental health or social issues may rule out joining if they affect safety or following study rules.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria * Confirmed diagnosis of CLL or SLL as per 2018 International Workshop on CLL (IWCLL) criteria. * Participants must have relapsed after at least one prior line of therapy and must currently require therapy by 2019 IWCLL criteria. * For enrollment to Cohort A: Participants must be covalent BTK and BCL-2 inhibitor naïve. Participants who have received prior therapy with a covalent BTK or BCL-2 inhibitor are not eligible, including but not limited to prior treatment with ibrutinib or acalabrutinib. * For enrollment to Cohort B: Participants must have had prior treatment with a BTK inhibitor or a BCL-2 inhibitor, but not both, and must not have experienced disease progression as defined by iwCLL criteria while receiving therapy. * For enrollment to Cohort C: participants must have a disease that progressed during therapy with a covalent BTK inhibitor, not including zanubrutinib. * Age ≥ 18 years. Because no dosing or adverse event data are currently available on the use of zanubrutinib and venetoclax in participants \< 18 years of age and CLL/SLL is extremely rare in this population, children are excluded from this study. * ECOG performance status ≤ 2 (Karnofsky ≥ 60%, see Appendix A). * Participants must have adequate organ function as defined below: * Platelet count ≥ 20,000/mcL * Total bilirubin ≤ 2 × institutional upper limit of normal (ULN) (unless due to controlled hemolysis, Gilbert's disease, or is of non-hepatic origin) * AST (SGOT) and ALT (SGPT) ≤ 4 × institutional ULN * Serum Creatinine ≤ 1.5 × institutional ULN, OR * Calculated creatinine clearance ≥ 50 mL/min (as calculated by the Cockcroft-Gault formula) * The effects of zanubrutinib or venetoclax on the developing human fetus are unknown. For this reason and because anti-cancer agents are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 4 months after completion of study agent administration. * Ability to understand and the willingness to sign a written informed consent document. * Ability to swallow and retain oral medication. Exclusion Criteria: * Known BTK C481X mutation. * For enrollment to Cohort B: participants who have received prior treatment with both a BTK inhibitor and BCL-2 inhibitor. * Participants who have had previous anti-cancer therapy (e.g., chemotherapy, radiotherapy, immunotherapy, biologic therapy, hormonal therapy, surgery, investigational agents, and/or tumor embolization) within 2 weeks of Cycle 1 Day 1 with the following exceptions: * Hormonal therapy given in the adjuvant setting * Corticosteroid therapy (prednisone or equivalent ≤ 20 mg daily) is allowed as clinically warranted as long as the dose is stabilized at least for 7 days prior to initial dosing. Topical, inhaled, intra-articular, or ophthalmologic corticosteroids are permitted * Participants enrolling to Cohort C may remain on prior BTK inhibitor therapy up until 2 days prior to Cycle 1 Day 1 * History of a prior allogeneic hematologic stem cell transplant. * Participants with known central nervous system (CNS) involvement, because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. Participants with no known history of CNS involvement are not required to undergo CT scan or lumbar puncture (LP) for trial eligibility unless the participant is symptomatic as judged by the treating investigator. * Participants who are receiving any other investigational agents at the time of study entry. * History of other malignancies, with the following exceptions: * Malignancy treated with curative intent and with no known active disease present for ≥ 2 years before the first dose of study drug and felt to be at low risk for recurrence by treating physician * Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease * Adequately treated carcinoma in situ without evidence of disease * Low-risk prostate cancer on active surveillance * Participants who have been vaccinated with live, attenuated vaccines \< 4 weeks prior to Cycle 1 Day 1. * Recent infection requiring intravenous antibiotics completed ≤ 7 days before the first dose of study drug, or any uncontrolled active systemic infection. * Known bleeding disorders (e.g. von Willebrand's disease) or hemophilia. * History of stroke, intracranial hemorrhage, or recent major bleed within 6 months prior to study entry. * Participants who require warfarin or other vitamin K antagonists for anticoagulation (other anticoagulants are allowed with approval from the overall principal investigator). * Participants who are known at the time of study entry to require concomitant treatment with any medications or substances that are moderate or strong CYP3A inhibitors or inducers. Because the lists of these agents are constantly changing, it is important to regularly consult a frequently-updated medical reference. As part of the enrollment/informed consent procedures, the participant will be counseled on the risk of interactions with other agents, and what to do if new medications need to be prescribed or if the participant is considering a new over-the-counter medicine or herbal product. * Known history of human immunodeficiency virus (HIV), active hepatitis C virus (HCV), or hepatitis B virus (HBV). * History of allergic reactions attributed to compounds of similar chemical or biologic composition to zanubrutinib or venetoclax. * Participants with psychiatric illness/social situations that would limit compliance with study requirements. * Pregnant women are excluded from this study because zanubrutinib and venetoclax are anti-cancer agents with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with zanubrutinib or venetoclax, breastfeeding should be discontinued if the mother is treated with zanubrutinib or venetoclax. * Participants with malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel, symptomatic inflammatory bowel disease or ulcerative colitis, or partial or complete bowel obstruction. * Currently active, clinically significant cardiovascular disease, such as uncontrolled arrhythmia or Class 3 or 4 congestive heart failure as defined by the New York Heart Association Functional Classification; or a history of myocardial infarction, unstable angina, or acute coronary syndrome within 6 months prior to study entry. * Any life-threatening illness, medical condition, or organ system dysfunction that, in the treating investigator's opinion, could compromise the participant's safety or the integrity of the trial. * Active and/or ongoing autoimmune anemia and/or autoimmune thrombocytopenia.

Study sites (4)

MA

ME