Small Lymphocytic Lymppho, Relapsed/Refractory Chronic Lymphocytic Leukemia
Conditions
Brief summary
To Evaluate the Efficacy and Safety of TQB3909 Tablets versus Investigator's Choice in the Treatment of Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL)
Interventions
DRUGTQB3909 Tablets
TQB3909 Tablets is a BCL-2 inhibitor.
Bendamustine A bifunctional alkylating agent with dual characteristics of both an alkylating agent and a purine analogue. It exerts its anti-tumor effects by forming DNA cross-links and inducing single-strand and double-strand DNA breaks, thereby blocking DNA replication and transcription in tumor cells and ultimately leading to apoptosis. It is not fully cross-resistant with other alkylating agents.
Rituximab A chimeric anti-CD20 monoclonal antibody. It targets the CD20 antigen on the surface of B lymphocytes and kills cells through three mechanisms: antibody-dependent cell-mediated cytotoxicity (ADCC), complement-dependent cytotoxicity (CDC), and direct induction of apoptosis. It primarily depletes B cells (including both normal and malignant B cells) and is effective against B-cell-derived lymphomas/leukemias such as CLL/SLL.
DRUGLenalidomide Capsules
Lenalidomide An immunomodulatory drug (IMiD) that binds to the E3 ubiquitin ligase substrate recognition protein cereblon, promoting the ubiquitination and degradation of transcription factors Ikaros and Aiolos. Its downstream effects include: enhancing the anti-tumor activity of NK cells and T cells, directly inducing tumor cell apoptosis, inhibiting tumor angiogenesis, and modulating the tumor microenvironment.
Sponsors
Chia Tai Tianqing Pharmaceutical Group Co., Ltd.
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
1. The subject voluntarily agrees to participate in this study, signs the informed consent form, and is expected to be compliant. 2. Age: ≥18 years; ECOG PS score: 0-2; expected survival \>3 months. 3. Subject population: 1. Patients with a confirmed diagnosis of CLL/SLL according to the diagnostic criteria of the revised 2018 iwCLL guidelines; 2. Meet at least one indication for treatment of CLL/SLL according to the revised 2018 iwCLL guidelines; 3. Have developed treatment intolerance during or after immunochemotherapy and BTK inhibitor therapy, or have failed to achieve PR or better response after adequate treatment, or have experienced disease progression. For patients assessed by the investigator as unfit for immunochemotherapy, they must have developed treatment intolerance during BTK inhibitor therapy, failed to achieve PR or better response after adequate treatment, or experienced disease progression after adequate treatment. 4. Adequate major organ function. 5. SLL patients must have measurable disease on CT/MRI. 6. Female subjects of childbearing potential must agree to use contraception (e.g., intrauterine device, contraceptive pills, or condoms) during the study and for 6 months after the last dose; serum pregnancy test must be negative within 7 days prior to enrollment, and must not be breastfeeding. Male subjects must agree to use contraception during the study and for 6 months after the last dose.
Exclusion criteria
1. Comorbidities and Medical History: 1. History of or concurrent other malignancies within 3 years prior to the first dose. The following two conditions are allowed: other malignancies treated with surgery alone and achieving continuous disease-free survival (DFS) of 5 years; cured cervical carcinoma in situ, non-melanoma skin cancer, and superficial bladder tumors \[Ta (non-invasive tumor), Tis (carcinoma in situ), and T1 (tumor invading lamina propria)\]; 2. History of Richter's transformation or prolymphocytic leukemia (PLL); 3. Known lymphoma/leukemia involvement of the central nervous system (CNS); 4. Prior allogeneic hematopoietic stem cell transplantation; 5. Autologous hematopoietic stem cell transplantation within 3 months prior to the first dose; 6. Multiple factors affecting oral drug administration (e.g., inability to swallow, chronic diarrhea, bowel obstruction, etc.); 7. Active or uncontrolled autoimmune cytopenia despite low-dose glucocorticoid therapy (equivalent to prednisone 20 mg), including autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP); 8. Toxicity from any prior treatment that has not recovered to ≤ Grade 1 per CTCAE, excluding alopecia, neutrophil count, and platelet count; 9. Major surgical treatment or significant traumatic injury within 28 days prior to the start of study treatment; 10. Severe arterial/venous thromboembolic events within 3 months prior to the first dose, such as cerebrovascular accidents (including transient ischemic attack, intracranial hemorrhage, cerebral infarction), deep vein thrombosis, and pulmonary embolism, etc.; 11. History of psychoactive substance abuse that cannot be discontinued, or psychiatric disorders; 12. Subjects with any severe and/or uncontrolled diseases, including: Myocardial ischemia or myocardial infarction ≥ Grade 2, arrhythmia (QTcF \>450 ms for males, QTcF \>470 ms for females), and ≥ Grade 2 congestive heart failure (New York Heart Association \[NYHA\] classification), or left ventricular ejection fraction (LVEF) \<50% by echocardiography within 6 months prior to the first dose; Active infection (≥ Grade 2 infection per CTCAE); Active hepatitis\*; Hepatitis B: HBV DNA ≥ lower limit of detection; Hepatitis C: HCV antibody positive and HCV viral titer \> lower limit of detection; History of immunodeficiency, including HIV positivity or other acquired or congenital immunodeficiency diseases, or history of organ transplantation; Epilepsy requiring treatment; 2. Tumor-Related Symptoms and Treatment: 1. Chemotherapy, monoclonal antibody therapy, or radiotherapy within 4 weeks prior to the first dose; immune checkpoint inhibitors or CAR-T therapy within 12 weeks prior to the first dose; other small-molecule anti-tumor therapies within 5 half-lives (calculated from the end date of the last treatment); 2. Corticosteroids administered for anti-tumor purposes; short-term (≤7 days) systemic corticosteroid therapy (≤20 mg prednisone equivalent) to control lymphoma-related symptoms or BTKi withdrawal symptoms prior to enrollment is permitted, but tapering to discontinuation within 5 days after study start is required; 3. Prior treatment with BCL-2 inhibitors; 4. Retreatment with bendamustine is allowed if the prior response to bendamustine lasted \>24 months; 3. Study Treatment-Related: Vaccination within 4 weeks prior to the first dose, or planned vaccination during the study; 4. Participation in other anti-tumor drug clinical trials within 4 weeks prior to the first dose; for small-molecule targeted drugs with defined targets such as BTK inhibitors, calculated as 5 half-lives; 5. Subjects with concomitant diseases that seriously endanger subject safety or affect study completion, or subjects considered unsuitable for enrollment for other reasons, as judged by the investigator; 6. Allergy to both allopurinol and benzbromarone.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression free survival (PFS) evaluated by an independent review committee (IRC) | Up to 4 years | Progression free survival (PFS) evaluated by an independent review committee (IRC) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) | Up to 4 years | the time interval from the start of first study treatment to death due to any cause. |
| Progression free survival (PFS) evaluated by researchers | Up to 4 years | The time from randomization to researcher evaluation of disease progression or death from any cause (whichever occurs first) is determined according to the 2014 Lugano criteria and LYRIC. |
| Objective response rate (ORR) | Up to 4 years | The percentage of complete (CR) or partial response (PR) subjects determined by IRC based on the 2014 Lugano criteria or by researchers based on the 2014 Lugano criteria and LYRIC, respectively |
| Duration of Response (DOR) per Independent Review Committee (IRC) and investigator assessment | Up to 4 years | defined as the time from the date of first documented Complete Response (CR) or Partial Response (PR) to the date of first documented disease progression, start of new anti-tumor therapy, or death. |
Countries
China
Contacts
CONTACTJian Yong Li, doctor
CONTACTKe Shu Zhou, doctor
Outcome results
None listed