Study of Acalabrutinib and Rituximab in Untreated Elderly and/or Frail Patients With DLBCL (ACRUE)

AstraZeneca

Status and phase: Enrolling; Phase 2

Conditions: Diffuse Large B-Cell Lymphoma

Treatments: Drug: Acalabrutinib; Biological: Rituximab

Study type: Interventional

Funder types: Industry

Identifiers

NCT05952024

D8227C00002

Details and patient eligibility

About

The study will measure the safety, tolerability, and efficacy with acalabrutinib in combination with rituximab in treatment-naïve elderly and/or frail patients with diffuse large B-cell lymphoma (DLBCL), who are otherwise unsuitable for standard front line chemoimmunotherapy treatments.

Full description

Treatment-naïve elderly and/or frail patients with DLBCL will be treated with acalabrutinib in combination with rituximab in a single arm.

Study details include the following:

• The study duration will be up to 108 weeks for each patient, including up to 28 days for screening and 104 weeks of treatment and follow-up.
• The treatment duration will be up to 8 cycles for rituximab and 28 cycles for acalabrutinib both beginning at cycle 1.

Enrollment: 80 estimated patients

Sex: All

Ages: 65 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ≥ 80 years of age at the time of screening, or
• ≥ 65 to 79 years of age at the time of screening and considered ineligible for chemoimmunotherapy
• Histologically documented DLBCL
• No prior treatment for DLBCL
• Stage II, III, or IV disease by the Ann Arbor Classification .
• Eastern Cooperative Oncology Group performance status of 0, 1, or 2 with no deterioration over the previous 2 weeks prior to baseline or day of the first dosing except when due to underlying lymphoma.
• At least 1 lesion that can be accurately measured at baseline as ≥ 10 mm in the longest diameter with computed tomography or magnetic resonance imaging and is suitable for accurate repeated measurements.
• Adequate organ and marrow function independent of growth factor or transfusion support within 1 week of Screening.

Exclusion criteria

• Any evidence of diseases (such as severe or uncontrolled systemic diseases, including uncontrolled hypertension, renal transplant, and active bleeding diseases), that would make the study undesirable for the patient or that would impact compliance with the protocol.
• History of prior or current malignancy, that would affect compliance with the protocol or interpretation of the results.
• Serologic status reflecting active hepatitis B or C infection.
• Serological positivity or known infection with HIV.
• Active central nervous system involvement by lymphoma, leptomeningeal disease, or spinal cord compression.
• Any comorbidity or organ system impairment rated with a single Cumulative Illness Rating Scale-Geriatric score (CIRS-G) of 4 or a total CIRS-G score of > 17.
• History of or ongoing confirmed Progressive Multifocal Leukoencephalopathy.
• Known active significant infection.
• History of stroke or intracranial haemorrhage within 6 months before the first dose of study drug.
• History of bleeding diathesis (eg, haemophilia, von Willebrand disease).
• Major surgical procedure within 30 days of first dose of study intervention or anticipated major surgery during the study timeframe.
• Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists.
• Received a live virus vaccination within 28 days of the first dose of study drug.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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80 participants in 1 patient group

Acalabrutinib and Rituximab

Experimental group

Description:

Patients will receive Dose A of acalabrutinib orally in X dosing schedule beginning on Cycle 1 Day 1 for a maximum of 28 cycles or until 2014 Lugano Classification for Non-Hodgkin's Lymphoma (NHL)-defined disease progression or another discontinuation criterion is met. Patients will also receive an intravenous (IV) infusion of Dose B rituximab on Cycle 1 Day 15 and Dose C of rituximab as an subcutaneous (SC) injection on Day 1 of Cycle 2 through Cycle 8.

Treatment:

Biological: Rituximab

Drug: Acalabrutinib