Actively Recruiting

Phase 1
Age: 18Years +
All Genders
NCT06735664

Zanubrutinib in Combination With Odronextamab for the Treatment of Patients With Richter's Transformation

Led by City of Hope Medical Center · Updated on 2025-09-16

23

Participants Needed

1

Research Sites

121 weeks

Total Duration

On this page

Sponsors

C

City of Hope Medical Center

Lead Sponsor

N

National Cancer Institute (NCI)

Collaborating Sponsor

AI-Summary

What this Trial Is About

This phase I trial tests the safety and side effects of zanubrutinib in combination with odronextamab and how well it works in treating patients with Richter's transformation. Zanubrutinib, a tyrosine kinase inhibitor, blocks a protein called Bruton tyrosine kinase (BTK), which may help keep cancer cells from growing. Odronextamab is a bispecific monoclonal antibody that can bind to two different antigens at the same time. Odronextamab binds to CD20 found on B-cells (a type of white blood cell) and on many B-cell cancers and to CD3 on T-cells (also a type of white blood cell) and may interfere with the ability of cancer cells to grow and spread. Giving zanubrutinib in combination with odronextamab may be safe, tolerable and/or effective in treating patients with Richter's transformation.

CONDITIONS

Official Title

Zanubrutinib in Combination With Odronextamab for the Treatment of Patients With Richter's Transformation

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Signed informed consent from participant or legal representative
  • Age 18 years or older
  • ECOG performance status 0, 1, or 2
  • Histologically confirmed Richter transformation with diffuse large B-cell lymphoma subtype
  • Evidence of CD20 positivity at screening by immunohistochemistry or flow cytometry
  • Treatment naive or relapsed/refractory disease including prior CLL therapy
  • Measurable lymphadenopathy (≥ 1.5 cm), splenomegaly, or bone marrow involvement by DLBCL/RT
  • Fully recovered from acute toxic effects of prior anticancer therapy except alopecia (≤ grade 1)
  • Adequate neutrophil count (ANC ≥ 1,000/mm3 without bone marrow involvement or ≥ 500/mm3 with involvement)
  • Adequate platelet count (≥ 50,000/mm3 without bone marrow involvement or ≥ 25,000/mm3 with involvement)
  • Hemoglobin ≥ 7 g/dL if bone marrow involvement present
  • Total bilirubin ≤ 2 x ULN or ≤ 3 x ULN for Gilbert's disease or compensated hemolysis
  • AST ≤ 3 x ULN
  • ALT ≤ 3 x ULN
  • ALP ≤ 2.5 x ULN or ≤ 5 x ULN if due to liver lymphoma involvement
  • Serum creatinine ≤ 1.5 x ULN or creatinine clearance ≥ 50 mL/min
  • INR and PT within normal limits or therapeutic range if on anticoagulants
  • aPTT within normal limits or therapeutic range if on anticoagulants
  • Left ventricular ejection fraction ≥ 45% within 28 days prior to treatment
  • Seronegative for HCV, HBV, and no HIV history, or controlled infections as specified
  • Negative pregnancy test for women of childbearing potential
  • Agreement to use effective birth control or abstain during and 6 months after treatment
Not Eligible

You will not qualify if you...

  • Allogeneic bone marrow or organ transplant within past 6 months or active graft versus host disease
  • Prior CD20-targeted bispecific antibody therapy
  • Chronic systemic corticosteroid use > 10 mg/day prednisone equivalent within 72 hours before treatment
  • Recent therapeutic anticancer antibodies, radio- or toxin-immunoconjugates, live vaccines, investigational therapies, or radiotherapy within specified timeframes
  • Prior organ transplantation
  • Chemotherapy or targeted therapy within specified washout periods
  • Need for strong CYP3A4 inducers or inhibitors during treatment
  • Uncontrolled immune hemolysis or thrombocytopenia
  • Allergic reactions to study drug components or hypersensitivity to allopurinol and rasburicase
  • Unstable cardiac disease or recent serious cardiac events
  • Recent thrombotic or embolic events within 3 months
  • Active uncontrolled cardiac arrhythmia or unstable angina
  • History or current interstitial lung disease or severely impaired lung function
  • Central nervous system involvement within 6 months prior to treatment
  • Major surgery within 30 days before treatment
  • Clinically significant uncontrolled illness
  • Active infections requiring treatment or with risk of severe disease
  • Active COVID-19 infection
  • Uncontrolled HIV, HBV, or HCV infections
  • Detectable cytomegalovirus infection until controlled
  • Active malignancy except certain treated or stable cancers
  • Pregnant or breastfeeding females
  • Inability to swallow or retain oral medication
  • Any other condition deemed unsafe or interfering with study participation by investigator

AI-Screening

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Trial Site Locations

Total: 1 location

1

City of Hope Medical Center

Duarte, California, United States, 91010

Actively Recruiting

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How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NA

Model

SINGLE_GROUP

Primary Purpose

TREATMENT

Number of Arms

1

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