Not yet recruitingPhase 1 / Phase 2

Roginolisib Plus Obinutuzumab + Venetoclax in R/R CLL

A Phase 1b and 2 Study of Roginolisib (IOA-244) Combined With Obinutuzumab Followed by Venetoclax in Patients With Refractory/Relapsed Chronic Lymphocytic Leukemia (CLL) After Progression on Prior Bruton Tyrosine Kinase (BTK) Inhibitors

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: 6 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 receive obinutuzumab and roginolisib for 6 months, followed by venetoclax and roginolisib for an additional 6 months."
  • "Up to 40 patients will be enrolled over 36 months."
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 roginolisib with obinutuzumab, followed by venetoclax, for chronic lymphocytic leukemia (CLL), a blood cancer. It is for adults whose CLL came back or did not respond to treatment and got worse after a BTK inhibitor. Researchers will check safety, find a safe dose, and see whether very small amounts of cancer can no longer be found.

This is a Phase 1b and 2, open-label, single-arm study evaluating the safety, tolerability, and efficacy of roginolisib (IOA-244) in combination with obinutuzumab followed by venetoclax in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who have progressed after prior Bruton Tyrosine Kinase (BTK) inhibitor therapy. The study aims to determine the maximum tolerated dose of roginolisib in combination with obinutuzumab, and to assess the rate of undetectable minimal residual disease (uMRD) after sequential therapy with roginolisib, obinutuzumab, and venetoclax.

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, understand the study, and agree in writing to take part.
  • Have CLL that came back or did not respond to treatment, needs treatment, and can be measured.
  • Have had at least one CLL treatment that included a covalent BTK inhibitor, a drug that blocks signals cancer cells use to grow.
  • Be able to care for yourself and be out of bed or a chair for more than half of your waking hours.
  • Meet the study’s blood count, liver, and kidney test limits.
  • Agree to CT scans and bone marrow biopsies before and during treatment. A biopsy takes a small sample from inside a bone.
  • Be able to receive medicines to prevent infections and other supportive care. Brain or spinal cord disease may be allowed if inactive or treated; symptoms need extra tests.
  • Follow the study’s birth control rules during and after treatment. Those who could become pregnant must have negative blood pregnancy tests.

Who can't join

  • Venetoclax or PI3K inhibitor treatment in the past 6 months, other CLL treatment too close to the study start, or another experimental treatment for CLL.
  • A live vaccine within 30 days before study treatment, or ongoing high-dose medicines that weaken the immune system, including more than 20 mg of prednisone daily or an equal dose of another steroid.
  • CLL that changed into a more aggressive cancer, or another cancer whose treatment or course could interfere with this study.
  • Lasting side effects from earlier cancer treatment that are more than mild, except hair loss or tiredness. Immune-related side effects must be fully gone for at least 2 weeks.
  • Certain allergic reactions to similar drugs or ingredients, or medicines that interfere with how the study drugs are broken down. Some medicines may be allowed with a lower venetoclax dose.
  • Pregnancy. Breastfeeding must stop during treatment with roginolisib or venetoclax.
  • Trouble swallowing food or taking medicines by mouth, or heart or blood vessel disease that the study doctor thinks could affect participation.
  • Treatment for tuberculosis in the past 2 years, or an active infection needing antibiotics, antifungal drugs, or antiviral drugs through a vein.

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

Official eligibility criteria

Inclusion Criteria: * Participants with relapsed/refractory CLL who meet iwCLL criteria for requiring treatment (Hallek et al. 2018). * Participants with measurable disease as defined by at least one of: circulating lymphocytosis \> 5000 B cells/microliter, bone marrow involvement \> 30%, palpable splenomegaly or lymph nodes \> 1.5 cm. Computer tomography (CT) at screening must be performed and followed every 2 cycles (1 cycle = 28 days) * Participants must have received at least one prior therapy for CLL including systemic therapy containing a covalent BTK inhibitor. * Participants willing to undergo a pre-treatment and on treatment bone marrow biopsy. Age ≥18 years, at the time of signing the IRB approved informed consent. Because no dosing or adverse event data are currently available on the use of venetoclax in combination with roginolisib in participants \<18 years of age, children are excluded from this study, but will be eligible for future pediatric trials. Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2. -Participants must meet the following organ and marrow function as defined below: * Platelet count ≥50 x 109/L\^\^\^ * Total bilirubin ≤ 1.5 ×institutional upper limit of normal (ULN)\* * AST(SGOT)/ALT(SGPT) ≤3.0 × institutional ULN * Creatinine clearance ≥ 50 mL/min\*\* Thrombocytopenia due to marrow involvement of CLL: \> 30 x 109/L * unless increase attributed to leukemic organ involvement, hemolysis or Gilbert's syndrome. Participants who are \< 75 years may have bilirubin of ≤ 3.0 × ULN \*\* calculated by the Cockcroft Gault formula or measured by 24 hours urine collection Participants with clinically inactive CNS disease or treated CNS disease that is no longer symptomatic, or who need corticosteroids or anticonvulsants may be enrolled in the study. For participants who have symptoms present, imaging and lumbar puncture must be performed to exclude a CNS condition that may impact the study conduct. Willingness to undergo a pre-treatment and on-treatment bone marrow biopsy to evaluate MRD. Willingness to use adequate contraception prior to study entry and for the duration of study participation. * The effects of roginolisib on the developing human fetus are unknown. * Venetoclax may cause embryo fetal harm when administered to pregnant women. Anti-CD20 targeting agents are likely to cause fetal B-cell depletion. For this reason 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. Women of child-bearing potential will be required to have a negative serum pregnancy test during screening and a negative serum pregnancy test on Cycle 1 Day 1. 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 roginolisib or venetoclax administration. Contraception must be conducted up to 12 months after taking the last rituximab dose. Ability to understand and the willingness to sign a written informed consent document, which includes compliance with the requirements of this protocol. Eligible to receive infection prophylaxis and supportive care as per institutional guidelines. Exclusion Criteria: * Participants who have received prior treatment with venetoclax or PI3K inhibitors in the last 6 months. Participants must not have had any CLL-directed anticancer therapy within 5 half-lives of the therapy prior to Cycle 1 Day 1. Participants who have received a live vaccine within 30 days of planned start of study therapy. With regards to other type of vaccines, including SARS-Co2 vaccines, these are allowed -Participants requiring ongoing treatment with chronic high dose immunosuppressants (e.g., cyclosporine) or systemic steroids \> 20 mg prednisone (or equivalent) QD. For example, participants with uncontrolled autoimmune haemolytic anaemia (AIHA) or idiopathic thrombocytopenia purpura (ITP), which requires \> 20 mg once daily (QD) of prednisone (or equivalent) to maintain haemoglobin levels of \>8.0 g/dL or platelets \> 10,000 mL without transfusion support. History of transformation of CLL to aggressive non-Hodgkin lymphoma (Richter´s transformation or pro-lymphocytic leukaemia) which may otherwise interfere with the interpretation of the outcome of the study (including biomarker evaluation). * Participants who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities \> Grade 1) with the exception of alopecia or fatigue. Any irAEs from prior immunotherapy must have complete resolution and must have resolved at least 2 weeks before Cycle1 Day1. * Participants who are receiving any other investigational agents for this condition History of allergic reactions attributed to compounds of similar chemical or biologic composition to roginolisib or venetoclax or their formulation components or prior anti-CD20 targeting agents more than 6 months before initiating study treatments. * Participants receiving any medications or substances that are strong inhibitors or inducers of CYP3A are ineligible. Moderate CYP3A inhibitors and P-gp inhibitors can be administered when venetoclax dose is reduced to 50%. Otherwise, venetoclax is contraindicated in participants requiring strong or moderate CYP3A inducers. Because of ongoing research, regularly consulting medical reference databases is recommended. One such reference is the Website of the US-FDA: (Drug Interactions \| Relevant Regulatory Guidance and Policy Documents \| FDA) 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. Pregnant women are excluded from this study because venetoclax has the potential to cause embryo-fetal harm, and the potential for teratogenic or abortifacient effects with roginolisib is currently unknown. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with roginolisib or venetoclax breastfeeding should be discontinued if the mother is treated with these agents. Participants with a history of other primary malignancy are excluded when they require therapy that will interfere with the investigational treatments. Exceptions are if the natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen. For example: * Malignancies surgically treated with curative intent and with no known active disease present * Adequately treated nonmelanoma skin cancer or lentigo maligna without evidence of disease * Adequately treated cervical carcinoma in situ without evidence of disease. * Surgically/adequately treated low-grade, early-stage, localized prostate cancer without evidence of disease or low risk localized prostate cancer on observation. * Inability to swallow food or any condition of the upper gastrointestinal tract that precludes administration of oral medications. * History or presence of cardiovascular disease, which in the Investigator's opinion may impact the clinical trial participation. * History of tuberculosis treatment within the preceding two years. Ongoing systemic bacterial, fungal, or viral infections (including also hepatitis viral infection) at the time of initiation of study treatment (defined as requiring intravenous \[IV\] antimicrobial, antifungal or antiviral agents). Subjects on antimicrobial, antifungal or antiviral prophylaxis are not specifically excluded if all other inclusion/exclusion criteria are met, there is no evidence of active infection at enrollment, and ongoing treatment does not have a significant risk of drug-drug interaction with venetoclax. Known Human immunodeficiency virus (HIV) infection which is treated with agents that can interfere with venetoclax due to potential drug-drug interactions or increased risk of myelotoxicity. Any serious or uncontrolled medical disorder or active infection that, in the opinion of the Investigator, may increase the risk associated with study participation, study drug administration, or would impair the ability of the participant to receive protocol therapy. Known alcohol or substance abuse.

Study sites (2)

MA