Relapsed and Refractory DLBCL
Conditions
Brief summary
This is a prospective, single arm trial in patients with ≥ 18 years with relapsed and refractory DLBCL. Aim of this study is to evaluate the efficacy and safety of pirtobrutinib in combination with rituximab, gemcitabine, and oxaliplatin with or without polatuzumab vedotin (Pirto-R-GemOx±pola) in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) previously treated with covalent BTK inhibitors.
Interventions
DRUGPirtobrutinib
Dose:200mg，d1-21
DRUGR-GemOx
Dose: Rituximab: 375mg/m2, d1; Gemcitabine: 1000mg/m2, d2; Oxaliplatin:100mg/m2, d2
DRUGPolatuzumab Vedotin
Dose: 1.8mg/kg，iv，d1 (For patient who is CD79b positive and has not previously received polatuzumab Vedotin)
Sponsors
Ruijin Hospital
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
* Histologically confirmed DLBCL (2016 WHO criteria) of MCD, BN2, N1 subtypes, double-expressor, intravascular large B-cell lymphoma, or other BTK-sensitive subtypes * Disease progression/relapse after covalent BTK inhibitor therapy * ≥1 measurable lesion (nodal \>15mm/extranodal \>10mm) on PET/CT within 28 days * Eastern Cooperative Oncology Group (ECOG) 0-2 * age ≥18 years * Adequate organ function: ANC ≥0.5×10⁹/L ；Platelets ≥50×10⁹/L (transfusion-independent)；Bilirubin ≤1.5×ULN; ALT/AST ≤2.5×ULN；Cr ≤1.5×ULN or CrCl ≥30mL/min；LVEF ≥50% (NYHA class \<III) * Life expectancy \>3 months * Sign the written ICF, and be able to comply with the visits and related procedures stipulated in the protocol; * Female subjects of childbearing potential or male subjects with female partners of childbearing potential must use effective contraception throughout the treatment period and for 90 days after the last treatment.
Exclusion criteria
* DLBCL with central nervous system (CNS) or meningeal involvement * Histologically transformed DLBCL * Contraindications or hypersensitivity to any drug in the combination regimen * Major surgery within 4 weeks prior to treatment (excluding vascular access placement or biopsy) * Any life-threatening illness, medical condition, or organ system dysfunction that, in the investigator's judgment, may compromise patient safety or compliance with study procedures * Poorly controlled cardiac clinical symptoms or diseases, including: i. NYHA Class II or higher heart failure ii. Unstable angina iii. Myocardial infarction within 1 year iv. Clinically significant supraventricular or ventricular arrhythmias requiring treatment/intervention * Active hemorrhage * Poorly controlled systemic bacterial, viral, fungal, or parasitic infections (excluding fungal nail infections), or other clinically significant active diseases that render patients unsuitable for trial participation per investigator assessment * Patients with:Active chronic hepatitis B or C.Positive HBsAg and/or HBcAb or HCV antibodies at screening must demonstrate HBV DNA ≤2,500 copies/mL (or 500 IU/mL) to exclude active HBV/HCV infection requiring treatment.HBsAg/HBcAb-positive patients must receive antiviral prophylaxis. HIV-infected patients and/or AIDS patients * Inability to swallow tablets, malabsorption syndrome, or any gastrointestinal disorder/ dysfunction that may impair drug absorption * Lactating or pregnant women * Psychiatric disorders or inability to provide informed consent * Any other condition deemed unsuitable for study participation by the investigator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| complete response rate(CRR) | Up to 6 cycles (each cycle is 21 days) | CRR after treated by pirto-R-GemOx±pola |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Objective response rate(ORR) | Up to 6 cycles (each cycle is 21 days) ± pola | ORR after treated by pirto-R-GemOx |
| Progression-free survival (PFS) | Up to 6 cycles (each cycle is 21 days) | PFS after treated by pirto-R-GemOx±pola |
| Overall Survival (OS) | up to 6 cycles(each cycle is 21 days) | OS after treated by pirto-R-GemOx±pola |
| undetectable MRD rate | Up to 6 cycles (each cycle is 21 days) ± pola | undetectable MRD rate after treated by pirto-R-GemOx |
Countries
China
Contacts
Primary ContactWeili Zhao, Professor
Outcome results
None listed