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Ublituximab + TGR-1202 Compared to Obinutuzumab + Chlorambucil in Participants With Untreated and Previously Treated Chronic Lymphocytic Leukemia

Phase 3, Randomized Study to Assess the Efficacy and Safety of Ublituximab in Combination With TGR-1202 (Umbralisib) Compared to Obinutuzumab in Combination With Chlorambucil in Patients With Chronic Lymphocytic Leukemia (CLL)

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02612311
Acronym
UNITY-CLL
Enrollment
603
Registered
2015-11-23
Start date
2015-11-19
Completion date
2023-02-22
Last updated
2024-12-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic Lymphocytic Leukemia

Brief summary

This study evaluates the combination of ublituximab, a novel monoclonal antibody, and TGR-1202, a novel PI3K delta inhibitor compared to obinutuzumab and chlorambucil, and compared to ublituximab or TGR-1202 alone in Chronic Lymphocytic Leukemia (CLL) participants.

Interventions

BIOLOGICALObinutuzumab

Obinutuzumab: IV infusion

BIOLOGICALUblituximab

Ublituximab: IV infusion

TGR-1202: Oral daily dose

DRUGChlorambucil

Chlorambucil: Oral dose

Sponsors

TG Therapeutics, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Treatment naïve or previously treated Chronic Lymphocytic Leukemia (CLL) requiring treatment * Eastern Cooperative Oncology Group (ECOG) score of 0 to 2

Exclusion criteria

* Any major surgery, chemotherapy or immunotherapy within the last 21 days * Evidence of hepatitis B virus, hepatitis C virus or known HIV infection * Autologous hematologic stem cell transplant within 3 months of study entry. Prior Allogeneic hematologic stem cell transplant is excluded * Transformation of CLL to aggressive Non-Hodgkin's Lymphoma (NHL) (Richter's transformation) * Prior therapy with obinutuzumab and/or chlorambucil or a PI3K delta inhibitor

Design outcomes

Primary

MeasureTime frameDescription
Progression-Free Survival (PFS) Per International Workshop on Chronic Lymphocytic Leukemia (iwCLL) CriteriaFrom enrolment to the earlier of the first documentation of definitive disease progression (PD) or death (Up to 87 months)PFS was defined as the interval from enrollment to the earlier of the first documentation of definitive disease progression (PD) or death from any cause. PD was appearance of new nodes \>1.5 centimetres (cm) in the longest diameter (LD) and \>1.0 in longest perpendicular diameter (LPD), new or recurrent hepatomegaly or splenomegaly, new or reappearance of an unequivocal extra-nodal lesion, ≥50% increase from the nadir in the sum of products of diameters (SPD) of target lesions, ≥50% increase in the LD of an individual node or extra-nodal mass, splenic/hepatic enlargement of ≥50% from nadir, unequivocal increase in the size of non-target disease, transformation to a more aggressive histology, decrease in platelet count or Hgb, \>50% decrease from the highest on-study platelet count, \>20 grams per Liter (g/L) decrease from the highest on-study hemoglobin (Hgb).

Secondary

MeasureTime frameDescription
Overall Response Rate (ORR) Per iwCLL CriteriaUp to 87 monthsORR=percent of participants who achieve complete response (CR), complete response with incomplete marrow recovery (CRi), partial response (PR) or nodular partial response (nPR).CR: No evidence of new disease; Absolute lymphocyte count(ALC)\<4x10\^9/liter(L);Regression of all target nodal masses to ≤1.5cm in LD;Normal spleen,liver size;Regression to normal of all nodal non-target disease and disappearance of all detectable;Non-nodal,non-target disease;Morphologically negative bone marrow;No lymphoid nodules;ANC \>1.5x10\^9/L,platelets≥100x10\^9/L,Hgb≥110 g/L.PR:No evidence of new disease; Response in 2 of following if abnormal at baseline: ALC\<4x10\^9/L or ≥50% decrease from baseline in sum of products of target nodal lesions;splenomegaly; hepatomegaly;≥50% decrease from baseline in CLL marrow infiltrate/B-lymphoid nodules;response in any 1: ANC\>1.5x10\^9/L, platelets\>100x10\^9/L,Hgb\>110g/L or ≥50% increase over baseline in any of these.CRi:for CR except with ANC\<1000/µL and/or platelets\<100.
Complete Response (CR) RateUp to 87 monthsThe CR rate is defined as the percentage of participants with a best overall response of complete response (CR) or complete response with incomplete marrow recovery (CRi). CR: No evidence of new disease; Absolute lymphocyte count(ALC)\<4x10\^9/L; Regression of all target nodal masses to ≤1.5 cm in LD; Normal spleen,liver size; Regression to normal of all nodal non-target disease and disappearance of all detectable; Non-nodal, non-target disease; Morphologically negative bone marrow; No lymphoid nodules; ANC\>1.5x10\^9/L,platelets≥100x10\^9/L,hemoglobin (Hgb)≥110 g/L. CRi was as for CR except with ANC \<1000/µL and/or platelets \<100,000/µL.
Minimal Residual Disease (MRD) Negativity RateFrom Cycle 6 until Cycle 15 (cycle length=28 days) up to approximately 81.5 monthsMRD negativity rate is defined as the percentage of participants who are MRD negative. If a participant was determined to be MRD negative by peripheral blood, a bone marrow aspirate was obtained to assess MRD in the bone marrow.
Duration of Response (DOR)From first documentation of response to study treatment till disease progression/death (up to approximately 87 months)DOR is defined as the interval from the first documentation of CR, CRi, PR, or nPR to the earlier of the first documentation of definitive disease progression or death from any cause.
Number of Participants Experiencing at Least One Treatment-Emergent Adverse Event (TEAE)From first dose of study treatment up to end of study (up to approximately 87 months)An adverse event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product. An AE does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAE is any AE that occur after first dosing of study medication and through the end of the study or through 30 days after the last dose of study treatment, or is considered treatment-related regardless of the start date of the event, or is present before first dosing of study medication but worsens in intensity or the investigator subsequently considers treatment-related.

Countries

Israel, Italy, Poland, Russia, Spain, United Kingdom, United States

Participant flow

Recruitment details

Participants took part in the study at multiple investigative sites in the United States, Israel, Italy, Poland, Russian Federation, Spain and the United Kingdom from 19 November 2015 to 22 February 2023.

Participants by arm

ArmCount
Experimental: Arm A: Ublituximab + Umbralisib
Participants received ublituximab, 150 milligrams (mg), intravenously (IV), on Day 1, 750 mg on Day 2, followed by 900 mg on Days 8 and 15 of Cycle 1 (cycle length=28 days), Day 1 of Cycles 2-6, and once every 3 cycles thereafter, along with umbralisib, 800 mg, orally, once daily during each cycle until disease progression, lack of tolerability, or until the treatment is commercially available or up to 87 months.
210
Active Comparator: Arm B: Obinutuzumab + Chlorambucil
Participants received obinutuzumab 100 mg, IV on Day 1, 900 mg on Day 2, followed by 1000 mg on Days 8 and 5 of cycle 1 (cycle length = 28 days), Day 1 of Cycle 2-6 along with chlorambucil 0.5 milligrams per kilogram (mg/kg) tablet orally on Days 1 and 15 once daily during each cycle until disease progression, lack of tolerability, or until the treatment is commercially available or up to 87 months.
211
Experimental: Arm C: Ublituximab
Participants received ublituximab, 150 mg, IV, on Day 1, 750 mg on Day 2, followed by 900 mg on Days 8 and 15 of Cycle 1 (cycle length=28 days), Day 1 of Cycles 2-6, and once every 3 cycles thereafter, until disease progression, lack of tolerability, or until the treatment is commercially available or up to 87 months.
91
Experimental: Arm D: Umbralisib
Participants received umbralisib, 800 mg tablets, orally, once daily during each cycle (cycle length= 28 days) until removal from study or up to 87 months.
91
Total603

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyAdverse Event1612713
Overall StudyDeath29101111
Overall StudyInitiation of Non-protocol Intervention5300
Overall StudyInvestigator's Decision111566
Overall StudyLack of Efficacy0011
Overall StudyLost to Follow-up2212
Overall StudyNon-Compliance with Study1000
Overall StudyProgressive Disease Confirmed by Central Radiology751133843
Overall StudyReason Not Specified3745
Overall StudySite Terminated by Sponsor2912135
Overall StudyUnknown/Missing101340
Overall StudyWithdrawal by Subject of Consent or to Discontinue Treatment292465

Baseline characteristics

CharacteristicExperimental: Arm A: Ublituximab + UmbralisibTotalExperimental: Arm D: UmbralisibExperimental: Arm C: UblituximabActive Comparator: Arm B: Obinutuzumab + Chlorambucil
Age, Continuous66.2 years66.8 years66.3 years67.6 years67.1 years
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants13 Participants3 Participants2 Participants5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
193 Participants556 Participants83 Participants86 Participants194 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
14 Participants34 Participants5 Participants3 Participants12 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants1 Participants0 Participants0 Participants1 Participants
Race/Ethnicity, Customized
Asian
0 Participants3 Participants1 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Black or African American
9 Participants25 Participants5 Participants5 Participants6 Participants
Race/Ethnicity, Customized
Multiple
2 Participants2 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants1 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Not Reported
8 Participants18 Participants1 Participants2 Participants7 Participants
Race/Ethnicity, Customized
Other
1 Participants4 Participants2 Participants0 Participants1 Participants
Race/Ethnicity, Customized
White
189 Participants549 Participants82 Participants83 Participants195 Participants
Sex: Female, Male
Female
75 Participants195 Participants30 Participants23 Participants67 Participants
Sex: Female, Male
Male
135 Participants408 Participants61 Participants68 Participants144 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
82 / 20640 / 20025 / 9129 / 86
other
Total, other adverse events
205 / 206189 / 20084 / 9184 / 86
serious
Total, serious adverse events
118 / 20647 / 20033 / 9134 / 86

Outcome results

Primary

Progression-Free Survival (PFS) Per International Workshop on Chronic Lymphocytic Leukemia (iwCLL) Criteria

PFS was defined as the interval from enrollment to the earlier of the first documentation of definitive disease progression (PD) or death from any cause. PD was appearance of new nodes \>1.5 centimetres (cm) in the longest diameter (LD) and \>1.0 in longest perpendicular diameter (LPD), new or recurrent hepatomegaly or splenomegaly, new or reappearance of an unequivocal extra-nodal lesion, ≥50% increase from the nadir in the sum of products of diameters (SPD) of target lesions, ≥50% increase in the LD of an individual node or extra-nodal mass, splenic/hepatic enlargement of ≥50% from nadir, unequivocal increase in the size of non-target disease, transformation to a more aggressive histology, decrease in platelet count or Hgb, \>50% decrease from the highest on-study platelet count, \>20 grams per Liter (g/L) decrease from the highest on-study hemoglobin (Hgb).

Time frame: From enrolment to the earlier of the first documentation of definitive disease progression (PD) or death (Up to 87 months)

Population: The ITT population included all randomized participants, regardless of administration of study treatment (ublituximab, TGR-1202, obinutuzumab + chlorambucil, or ublituximab + TGR-1202).

ArmMeasureValue (MEDIAN)
Experimental: Arm A: Ublituximab + UmbralisibProgression-Free Survival (PFS) Per International Workshop on Chronic Lymphocytic Leukemia (iwCLL) Criteria33.2 Months
Active Comparator: Arm B: Obinutuzumab + ChlorambucilProgression-Free Survival (PFS) Per International Workshop on Chronic Lymphocytic Leukemia (iwCLL) Criteria17.5 Months
Experimental: Arm C: UblituximabProgression-Free Survival (PFS) Per International Workshop on Chronic Lymphocytic Leukemia (iwCLL) Criteria32.9 Months
Experimental: Arm D: UmbralisibProgression-Free Survival (PFS) Per International Workshop on Chronic Lymphocytic Leukemia (iwCLL) Criteria22.4 Months
Secondary

Complete Response (CR) Rate

The CR rate is defined as the percentage of participants with a best overall response of complete response (CR) or complete response with incomplete marrow recovery (CRi). CR: No evidence of new disease; Absolute lymphocyte count(ALC)\<4x10\^9/L; Regression of all target nodal masses to ≤1.5 cm in LD; Normal spleen,liver size; Regression to normal of all nodal non-target disease and disappearance of all detectable; Non-nodal, non-target disease; Morphologically negative bone marrow; No lymphoid nodules; ANC\>1.5x10\^9/L,platelets≥100x10\^9/L,hemoglobin (Hgb)≥110 g/L. CRi was as for CR except with ANC \<1000/µL and/or platelets \<100,000/µL.

Time frame: Up to 87 months

Population: The ITT population included all randomized participants, regardless of administration of study treatment (ublituximab, TGR-1202, obinutuzumab + chlorambucil, or ublituximab + TGR-1202). Percentages are rounded off to the nearest decimal point.

ArmMeasureValue (NUMBER)
Experimental: Arm A: Ublituximab + UmbralisibComplete Response (CR) Rate5.7 percentage of participants
Active Comparator: Arm B: Obinutuzumab + ChlorambucilComplete Response (CR) Rate1.4 percentage of participants
Experimental: Arm C: UblituximabComplete Response (CR) Rate3.3 percentage of participants
Experimental: Arm D: UmbralisibComplete Response (CR) Rate0 percentage of participants
Secondary

Duration of Response (DOR)

DOR is defined as the interval from the first documentation of CR, CRi, PR, or nPR to the earlier of the first documentation of definitive disease progression or death from any cause.

Time frame: From first documentation of response to study treatment till disease progression/death (up to approximately 87 months)

Population: The ITT population included all randomized participants, regardless of administration of study treatment (ublituximab, TGR-1202, obinutuzumab + chlorambucil, or ublituximab + TGR-1202). Overall Number of Participants Analyzed is the number of participants with data available for analysis.

ArmMeasureValue (MEDIAN)
Experimental: Arm A: Ublituximab + UmbralisibDuration of Response (DOR)32.9 months
Active Comparator: Arm B: Obinutuzumab + ChlorambucilDuration of Response (DOR)21.9 months
Experimental: Arm C: UblituximabDuration of Response (DOR)47.5 months
Experimental: Arm D: UmbralisibDuration of Response (DOR)29.3 months
Secondary

Minimal Residual Disease (MRD) Negativity Rate

MRD negativity rate is defined as the percentage of participants who are MRD negative. If a participant was determined to be MRD negative by peripheral blood, a bone marrow aspirate was obtained to assess MRD in the bone marrow.

Time frame: From Cycle 6 until Cycle 15 (cycle length=28 days) up to approximately 81.5 months

Population: The ITT population included all randomized participants, regardless of administration of study treatment (ublituximab, TGR-1202, obinutuzumab + chlorambucil, or ublituximab + TGR-1202). Percentages are rounded off to the nearest decimal point.

ArmMeasureValue (NUMBER)
Experimental: Arm A: Ublituximab + UmbralisibMinimal Residual Disease (MRD) Negativity Rate29.0 percentage of participants
Active Comparator: Arm B: Obinutuzumab + ChlorambucilMinimal Residual Disease (MRD) Negativity Rate34.6 percentage of participants
Experimental: Arm C: UblituximabMinimal Residual Disease (MRD) Negativity Rate36.3 percentage of participants
Experimental: Arm D: UmbralisibMinimal Residual Disease (MRD) Negativity Rate5.5 percentage of participants
Secondary

Number of Participants Experiencing at Least One Treatment-Emergent Adverse Event (TEAE)

An adverse event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product. An AE does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAE is any AE that occur after first dosing of study medication and through the end of the study or through 30 days after the last dose of study treatment, or is considered treatment-related regardless of the start date of the event, or is present before first dosing of study medication but worsens in intensity or the investigator subsequently considers treatment-related.

Time frame: From first dose of study treatment up to end of study (up to approximately 87 months)

Population: The safety population included all randomized participants who had received at least one dose of study treatment (ublituximab, TGR-1202, obinutuzumab + chlorambucil, or ublituximab + TGR-1202

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Experimental: Arm A: Ublituximab + UmbralisibNumber of Participants Experiencing at Least One Treatment-Emergent Adverse Event (TEAE)205 Participants
Active Comparator: Arm B: Obinutuzumab + ChlorambucilNumber of Participants Experiencing at Least One Treatment-Emergent Adverse Event (TEAE)195 Participants
Experimental: Arm C: UblituximabNumber of Participants Experiencing at Least One Treatment-Emergent Adverse Event (TEAE)88 Participants
Experimental: Arm D: UmbralisibNumber of Participants Experiencing at Least One Treatment-Emergent Adverse Event (TEAE)86 Participants
Secondary

Overall Response Rate (ORR) Per iwCLL Criteria

ORR=percent of participants who achieve complete response (CR), complete response with incomplete marrow recovery (CRi), partial response (PR) or nodular partial response (nPR).CR: No evidence of new disease; Absolute lymphocyte count(ALC)\<4x10\^9/liter(L);Regression of all target nodal masses to ≤1.5cm in LD;Normal spleen,liver size;Regression to normal of all nodal non-target disease and disappearance of all detectable;Non-nodal,non-target disease;Morphologically negative bone marrow;No lymphoid nodules;ANC \>1.5x10\^9/L,platelets≥100x10\^9/L,Hgb≥110 g/L.PR:No evidence of new disease; Response in 2 of following if abnormal at baseline: ALC\<4x10\^9/L or ≥50% decrease from baseline in sum of products of target nodal lesions;splenomegaly; hepatomegaly;≥50% decrease from baseline in CLL marrow infiltrate/B-lymphoid nodules;response in any 1: ANC\>1.5x10\^9/L, platelets\>100x10\^9/L,Hgb\>110g/L or ≥50% increase over baseline in any of these.CRi:for CR except with ANC\<1000/µL and/or platelets\<100.

Time frame: Up to 87 months

Population: The ITT population included all randomized participants, regardless of administration of study treatment (ublituximab, TGR-1202, obinutuzumab + chlorambucil, or ublituximab + TGR-1202). Percentages are rounded off to the nearest decimal point.

ArmMeasureValue (NUMBER)
Experimental: Arm A: Ublituximab + UmbralisibOverall Response Rate (ORR) Per iwCLL Criteria83.3 percentage of participants
Active Comparator: Arm B: Obinutuzumab + ChlorambucilOverall Response Rate (ORR) Per iwCLL Criteria68.7 percentage of participants
Experimental: Arm C: UblituximabOverall Response Rate (ORR) Per iwCLL Criteria42.9 percentage of participants
Experimental: Arm D: UmbralisibOverall Response Rate (ORR) Per iwCLL Criteria61.5 percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 28, 2026