Diffuse Large B-Cell Lymphoma
Conditions
Brief summary
This study will treat patients with diffuse large B-cell lymphoma (DLBCL). It will assess the anti-tumor efficacy and safety of DZD8586 combination therapy by using objective response rate and the incidence and severity of adverse events. It will also measure the levels of DZD8586 in the body when combined with immunochemotherapy regimens.
Interventions
DRUGDZD8586+R-CHOP
DZD8586 at the protocol defined dose level (50 mg or 75 mg, po, qd) with R-CHOP (Rituximab: 375 mg/m2, IV, d1; Cyclophosphamide: 750 mg/m2, IV, d1; Doxorubicin: 50 mg/m2, IV, d1; Vincristine: 1.4 mg/m2, IV, d1; Prednisone: 100 mg, po, d1-5) in a 21-day cycle for 6 cycles. DZD8586 (pre-defined dose level, po, qd) as maintenance therapy for CR/PR patients.
DRUGDZD8586+R-GemOx
DZD8586 at the protocol defined dose level (50 mg or 75 mg, po, qd) with R-GemOx (Rituximab: 375 mg/m2, IV, d1; Gemcitabine: 1000 mg/m2, IV, d1; Oxaliplatin: 100 mg/m2, IV, d1) in a 21-day cycle for 8 cycles. DZD8586 (pre-defined dose level, po, qd) as maintenance therapy for CR/PR patients.
DRUGDZD8586+BR
DZD8586 at the protocol defined dose level (50 mg or 75 mg, po, qd) with BR (Bendamustine: 90 mg/m2, IV, d1-d2; Rituximab: 375 mg/m2, IV, d1) in a 21-day cycle for 6 cycles. DZD8586 (pre-defined dose level, po, qd) as maintenance therapy for CR/PR patients.
Sponsors
Dizal Pharmaceuticals
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Cohort 1: 1. Patients with pathologically confirmed DLBCL who have not received prior anti-lymphoma therapy. 2. Disease stage II to IV by Ann Arbor Classification. 3. Life expectancy ≥ 12 months. * Cohort 2, 3: 1. Pathologically confirmed DLBCL patients who have received adequate first-line treatment containing CD20 monoclonal antibody and anthracyclines (such as R-CHOP-like regimen). 2. Relapsed or refractory to first-line R-CHOP-like regimen. 3. For patients who have received only one line of therapy, if the patient has not received autologous stem cell transplantation, the investigator needs to assess as unsuitable or the patient refuses intensive chemotherapy and hematopoietic stem cell transplantation. 4. Life expectancy ≥ 6 months. * Patients must also meet all of the following criteria to be included in this study: 1. All patients must provide a signed and dated written informed consent prior to any study-specific procedure, sampling, and analysis. 2. Patients must be ≥ 18 years of age at the time of informed consent. 3. ECOG status score of 0 to 2. 4. Presence of at least one radiologically measurable lesion in 2 perpendicular directions as assessed by CT or MRI and a positive lesion on PET/CT scan consistent with a tumor site identified by CT or MRI. 5. Adequate bone marrow hematopoietic reserve and organ function. 6. No uncontrolled medical complications. 7. Patients should be able to follow the relevant requirements of this study for medication and follow-up. 8. Willing to comply with contraceptive restrictions.
Exclusion criteria
* Cohort 2, 3: a. Hematopoietic stem cell transplantation, cell therapy, or gene therapy within 90 days prior to first dose. Radiation therapy within 14 days prior to first dose. Chemotherapy and small-molecule targeted therapy were not terminated within 5 half-lives before the first dose; macromolecule drug therapy (such as antibody therapy) was not terminated within 28 days before the first dose. * All patients should not be included in this study if they have any of the following conditions: 1. Indolent lymphoma-transformed DLBCL, primary mediastinal lymphoma, lymphoma involving the central nervous system, or DLBCL with MYC and BCL2 rearrangements. 2. Prior use of BTK inhibitors. 3. Vaccination with live attenuated vaccines or viral vector vaccines within 4 weeks prior to enrollment. 4. Currently taking vitamin K antagonists, taking 2 or more antiplatelet/anticoagulant drugs at the same time, drugs/herbs or supplements known to potently induce or inhibit CYP3A enzyme activity, proton pump inhibitor drugs, anti-tumor traditional Chinese medicine or failing to meet the protocol-specified withdrawal time before administration in this study. 5. Major surgery within 4 weeks or anticipated surgery after the start of this study. Or insufficiently recovered from any toxicity and/or complications of previous intervention. 6. Clinically significant cardiac disorders. History of thrombotic diseases, stroke or intracranial hemorrhage within 6 months. 7. Active infectious diseases. 8. Intractable nausea and vomiting that cannot be well controlled by supportive treatment, chronic gastrointestinal diseases, dysphagia, or previous surgical resection of the intestinal segment may affect the adequate absorption of the drug. 9. The patient has been diagnosed with other malignant diseases other than B-cell lymphoma within the past 2 years. 10. Patients with hypersensitivity to DZD8586 drug excipients or other chemical analogues. 11. Patients with severe or uncontrolled systemic diseases, including poorly controlled hypertension and active bleeding constitution. 12. Serious medical or psychiatric illness that could affect participation in the study or could compromise the ability to consent 13. Women who are pregnant or breastfeeding.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Part A: Incidence and severity of adverse events | Approximately 5 years |
| Part B: Objective response rate (ORR) | Approximately 5 years |
Secondary
| Measure | Time frame |
|---|---|
| Part A: Objective response rate (ORR) | Approximately 5 years |
| Part A: Complete response rate (CRR) | Approximately 5 years |
| Part A: Time to response (TTR) | Approximately 5 years |
| Part A: Duration of Response (DoR) | Approximately 5 years |
| Part A: Progression-Free Survival (PFS) | Approximately 5 years |
| Part A: Overall Survival (OS) | Approximately 5 years |
| Part B: Incidence and severity of adverse events | Approximately 5 years |
| Part B: Complete response rate (CRR) | Approximately 5 years |
| Part B: Time to response (TTR) | Approximately 5 years |
| Part B: Duration of Response (DoR) | Approximately 5 years |
| Part B: Progression-Free Survival (PFS) | Approximately 5 years |
| Part B: Overall Survival (OS) | Approximately 5 years |
| Part A: Peak plasma concentration (Cmax) of DZD8586 and metabolite (DZ4581) | Up to 24 hours post dose |
| Part A: Area under the plasma concentration versus time curve (AUC) of DZD8586 and metabolite (DZ4581) | Up to 24 hours post dose |
| Part A: Time to peak concentration (Tmax) of DZD8586 and metabolite (DZ4581) | Up to 24 hours post dose |
| Part A: Metabolite (DZ4581) to parent (DZD8586) ratio based on area under the plasma concentration versus time curve (MRAUC) | Up to 24 hours post dose |
| Part A: Trough concentration at steady state (Css, min) of DZD8586 and metabolite (DZ4581) | Up to 24 hours post dose |
| Part A: Apparent clearance at steady state (CLss/F) of DZD8586 | Up to 24 hours post dose |
| Part A: Accumulation index in area under the plasma concentration versus time curve (RACAUC) of DZD8586 and metabolite (DZ4581) | Up to 24 hours post dose |
| Part A: Accumulation index in peak plasma concentration (RACCmax) of DZD8586 and metabolite (DZ4581) | Up to 24 hours post dose |
Countries
China
Contacts
CONTACTMengling Zhong
PRINCIPAL_INVESTIGATORHuang
Sun Yat-Sen University Cancer Center
Outcome results
None listed