RECRUITING

Acalabrutinib Maintenance for the Treatment of Patients With Large B-cell Lymphoma

Conditions

Diffuse Large B-Cell Lymphoma High-grade B-cell Lymphoma Transformed Lymphoma Secondary Central Nervous System Lymphoma

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase Ib/II trial studies the side effects and efficacy of maintenance acalabrutinib following cellular therapy in treating patients with large B-cell lymphoma at very high risk of the cancer coming back. Acalabrutinib is a small molecular inhibitor that may interfere with the ability of cancer cells to grow and spread.

Official Title

Acalabrutinib Maintenance Following Cellular Therapy for Large B-Cell Lymphoma Patients at Very High Risk for Relapse

Quick Facts

Study Start:2023-01-23

Study Completion:2026-10-01

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT05256641

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years to 70 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Ages 18-70 years * One of the following: * Patients undergoing autologous stem cell transplantation (ASCT) or any Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy product for: * High grade B-cell lymphoma (double or triple hit) with rearrangements in bcl-2 and/or bcl-6, and rearrangement in myc * Large B-cell lymphoma with a history of secondary CNS involvement * Histologic transformation of indolent lymphoma to large B-cell lymphoma, including marginal zone lymphoma, follicular lymphoma, chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), lymphoplasmacytic leukemia, or Waldenstrom macroglobulinemia * High risk international prognostic index (IPI) score 4 or 5, at diagnosis or prior to CAR T-cell leukapheresis * Patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) for large B-cell lymphoma * Eastern Cooperative Oncology Group (ECOG) 0-2 * Requirements for post-ASCT and post-alloHCT participants: * Disease status of partial response (PR) or complete response (CR) prior to transplantation * Receive reduced-intensity conditioning regimen * Enrollment no later than day +90 * Requirements for post-CAR T-cell therapy participants: * Disease status of PR or CR after post-CAR T-cell therapy positron emission tomography (PET)-computed tomography (CT) at 1-3 months * Enrollment no later than day +104 * Ability to give full informed consent * Female subjects who are sexually active and can bear children must agree to use highly effective forms of contraception while on the study and for 2 days after the last dose of acalabrutinib * Willing and able to participate in all required evaluations and procedures in this study protocol, including swallowing capsules and tablets without difficulty * Absolute neutrophil count (ANC) \> 500/uL (microliters) * Platelets \> 50,000/uL independent of transfusions * Hemoglobin \> 8 g/dL independent of transfusions * Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 3 x upper limit of normal (ULN) * Total bilirubin =\< 1.5 x ULN, unless directly attributable to Gilbert's syndrome * Creatinine clearance \>= 60 mL/min based on Cockcroft-Gault glomerular filtration rate (GFR) and serum creatinine (Cr) =\< 1.8 mg/dL	* Cord blood as donor source in alloHCT * New York Heart Association Class III or IV * Left ventricular ejection fraction \< 50% * Estimated glomerular filtration rate \< 30 mL/min * Concurrent long-term use of posaconazole or other strong CYP3A4 inhibitors and unable to replace with equivalent medication * Acute or chronic graft-versus-host disease (GvHD) \>= stage 3 at time of enrollment * Received packed red blood cells (pRBC) transfusion within the past 2 weeks * Received platelet transfusion within the past 1 week * Active invasive fungal infection * Active bacterial or viral infection until resolution of the infection * History of or ongoing confirmed progressive multifocal leukoencephalopathy (PML) * Received any investigational drug within 30 days or 5 half-lives (whichever is shorter) before first dose of study drug * Major surgical procedure within 30 days before the first dose of study drug. Note: If a subject had major surgery, they must have recovered adequately from any toxicity and/or complications from the intervention before the first dose of study drug * Refractory nausea and vomiting, inability to swallow the formulated product, or malabsorption syndrome; chronic gastrointestinal disease, gastric restrictions, or bariatric surgery such as gastric bypass; partial or complete bowel obstruction, or previous significant bowel resection that would preclude adequate absorption, distribution, metabolism, or excretion of study treatment * Received a live virus vaccination within 28 days of first dose of study drug * Known history of infection with human immunodeficiency virus (HIV) * History of bleeding diathesis (e.g., hemophilia, von Willebrand disease) * Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists * Requires treatment with a strong cytochrome P450 3A (CYP3A) inhibitor or inducer. The use of strong CYP3A inhibitors within 1 week or strong CYP3A inducers within 3 weeks of the first dose of study drug is prohibited * Breastfeeding or pregnant * Concurrent participation in another therapeutic clinical trial

Inclusion Criteria

Exclusion Criteria

* Ages 18-70 years
* One of the following:
* Patients undergoing autologous stem cell transplantation (ASCT) or any Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy product for:
* High grade B-cell lymphoma (double or triple hit) with rearrangements in bcl-2 and/or bcl-6, and rearrangement in myc
* Large B-cell lymphoma with a history of secondary CNS involvement
* Histologic transformation of indolent lymphoma to large B-cell lymphoma, including marginal zone lymphoma, follicular lymphoma, chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), lymphoplasmacytic leukemia, or Waldenstrom macroglobulinemia
* High risk international prognostic index (IPI) score 4 or 5, at diagnosis or prior to CAR T-cell leukapheresis
* Patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) for large B-cell lymphoma
* Eastern Cooperative Oncology Group (ECOG) 0-2
* Requirements for post-ASCT and post-alloHCT participants:
* Disease status of partial response (PR) or complete response (CR) prior to transplantation
* Receive reduced-intensity conditioning regimen
* Enrollment no later than day +90
* Requirements for post-CAR T-cell therapy participants:
* Disease status of PR or CR after post-CAR T-cell therapy positron emission tomography (PET)-computed tomography (CT) at 1-3 months
* Enrollment no later than day +104
* Ability to give full informed consent
* Female subjects who are sexually active and can bear children must agree to use highly effective forms of contraception while on the study and for 2 days after the last dose of acalabrutinib
* Willing and able to participate in all required evaluations and procedures in this study protocol, including swallowing capsules and tablets without difficulty
* Absolute neutrophil count (ANC) \> 500/uL (microliters)
* Platelets \> 50,000/uL independent of transfusions
* Hemoglobin \> 8 g/dL independent of transfusions
* Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 3 x upper limit of normal (ULN)
* Total bilirubin =\< 1.5 x ULN, unless directly attributable to Gilbert's syndrome
* Creatinine clearance \>= 60 mL/min based on Cockcroft-Gault glomerular filtration rate (GFR) and serum creatinine (Cr) =\< 1.8 mg/dL

* Cord blood as donor source in alloHCT
* New York Heart Association Class III or IV
* Left ventricular ejection fraction \< 50%
* Estimated glomerular filtration rate \< 30 mL/min
* Concurrent long-term use of posaconazole or other strong CYP3A4 inhibitors and unable to replace with equivalent medication
* Acute or chronic graft-versus-host disease (GvHD) \>= stage 3 at time of enrollment
* Received packed red blood cells (pRBC) transfusion within the past 2 weeks
* Received platelet transfusion within the past 1 week
* Active invasive fungal infection
* Active bacterial or viral infection until resolution of the infection
* History of or ongoing confirmed progressive multifocal leukoencephalopathy (PML)
* Received any investigational drug within 30 days or 5 half-lives (whichever is shorter) before first dose of study drug
* Major surgical procedure within 30 days before the first dose of study drug. Note: If a subject had major surgery, they must have recovered adequately from any toxicity and/or complications from the intervention before the first dose of study drug
* Refractory nausea and vomiting, inability to swallow the formulated product, or malabsorption syndrome; chronic gastrointestinal disease, gastric restrictions, or bariatric surgery such as gastric bypass; partial or complete bowel obstruction, or previous significant bowel resection that would preclude adequate absorption, distribution, metabolism, or excretion of study treatment
* Received a live virus vaccination within 28 days of first dose of study drug
* Known history of infection with human immunodeficiency virus (HIV)
* History of bleeding diathesis (e.g., hemophilia, von Willebrand disease)
* Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists
* Requires treatment with a strong cytochrome P450 3A (CYP3A) inhibitor or inducer. The use of strong CYP3A inhibitors within 1 week or strong CYP3A inducers within 3 weeks of the first dose of study drug is prohibited
* Breastfeeding or pregnant
* Concurrent participation in another therapeutic clinical trial

Contacts and Locations

Study Contact

Vlad Kustanovitch

CONTACT

310-206-5756

VKustanovich@mednet.ucla.edu

Principal Investigator

Caspian Oliai, MD

PRINCIPAL_INVESTIGATOR

UCLA / Jonsson Comprehensive Cancer Center

Study Locations (Sites)

UCLA / Jonsson Comprehensive Cancer Center

Los Angeles, California, 90095

United States

University of California Davis Comprehensive Cancer Center

Sacramento, California, 95817

United States

University of Oklahoma

Oklahoma City, Oklahoma, 73190

United States

Collaborators and Investigators

Sponsor: Jonsson Comprehensive Cancer Center

Caspian Oliai, MD, PRINCIPAL_INVESTIGATOR, UCLA / Jonsson Comprehensive Cancer Center

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2023-01-23

Study Completion Date2026-10-01

Study Record Updates

Study Start Date2023-01-23

Study Completion Date2026-10-01

Terms related to this study

Additional Relevant MeSH Terms

Diffuse Large B-Cell Lymphoma
High-grade B-cell Lymphoma
Transformed Lymphoma
Secondary Central Nervous System Lymphoma