Flag of the European Union EU Clinical Trials Register Help

Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43873   clinical trials with a EudraCT protocol, of which   7292   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
    How to search [pdf]
    Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, Rare Diseases and Orphan Designation. For these items you should use the filters and not add them to your search terms in the text field.
    Advanced Search: Search tools
     

    < Back to search results

    Print Download

    Summary
    EudraCT Number:2015-004454-17
    Sponsor's Protocol Code Number:ACE-CL-309
    National Competent Authority:France - ANSM
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2016-11-30
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedFrance - ANSM
    A.2EudraCT number2015-004454-17
    A.3Full title of the trial
    A Randomized, Multicenter, Open-Label, Phase 3 Study of Acalabrutinib (ACP-196) Versus Investigator’s Choice of Either Idelalisib Plus Rituximab or Bendamustine Plus Rituximab in Subjects with Relapsed or Refractory Chronic Lymphocytic Leukemia
    Étude de phase 3 randomisée, multicentrique, en ouvert portant sur l’acalabrutinib (ACP-196) comparé au choix de traitement de l’investigateur, soit idélalisib plus rituximab ou bendamustine plus rituximab, chez des sujets atteints de leucémie lymphoïde chronique en rechute ou réfractaire
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Clinical trial to compare Acalabrutinib (ACP-196) versus investigator's choice standard treatment with Bendamustine/Rituximab or Idelalisib/Rituximab alone in patients with Relapsed or Refractory Chronic Lymphocytic Leukemia
    A.4.1Sponsor's protocol code numberACE-CL-309
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorAcerta Pharma BV
    B.1.3.4CountryNetherlands
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportAcerta Pharma
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAcerta Pharma
    B.5.2Functional name of contact pointMedical Director
    B.5.3 Address:
    B.5.3.1Street Address2200 Bridge Parkway, Suite 202
    B.5.3.2Town/ cityRedwood City, CA
    B.5.3.3Post code94065
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1650 787 4817
    B.5.5Fax number+1650 591 2816
    B.5.6E-mailp.patel@acerta-pharma.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameAcalabrutinib
    D.3.2Product code ACP-196
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNACALABRUTINIB
    D.3.9.1CAS number 1420477-60-6
    D.3.9.2Current sponsor codeACP-196
    D.3.9.4EV Substance CodeSUB182073
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Zydelig® (idelalisib) 100 mg
    D.2.1.1.2Name of the Marketing Authorisation holderGilead Sciences International Ltd
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameIdelalisib
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIDELALISIB
    D.3.9.1CAS number 870281-82-6
    D.3.9.4EV Substance CodeSUB126168
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Zydelig® (idelalisib) 150 mg
    D.2.1.1.2Name of the Marketing Authorisation holderGilead Sciences International Ltd
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameIdelalisib
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIDELALISIB
    D.3.9.1CAS number 870281-82-6
    D.3.9.4EV Substance CodeSUB126168
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name MabThera® (rituximab) 500 mg
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameRituximab
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRITUXIMAB
    D.3.9.1CAS number 174722-31-7
    D.3.9.4EV Substance CodeSUB12570MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 5
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Levact® (bendamustine hydrochloride), powder for concentrate for infusion
    D.2.1.1.2Name of the Marketing Authorisation holderAstellas Pharma GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBendamustine
    D.3.4Pharmaceutical form Powder for concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBENDAMUSTINE HYDROCHLORIDE
    D.3.9.1CAS number 3543-75-7
    D.3.9.4EV Substance CodeSUB00696MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 6
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Bendamustine hydrochloride Accord 2.5 mg/ml Powder for concentrate for solution for infusion
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBendamustine
    D.3.4Pharmaceutical form Powder for concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBENDAMUSTINE HYDROCHLORIDE
    D.3.9.1CAS number 3543-75-7
    D.3.9.4EV Substance CodeSUB00696MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Relapsed or Refractory Chronic Lymphocytic Leukemia
    Leucémie lymphoïde chronique en rechute ou réfractaire
    E.1.1.1Medical condition in easily understood language
    Chronic Leukemia
    Leucémie chronique
    E.1.1.2Therapeutic area Diseases [C] - Blood and lymphatic diseases [C15]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 19.0
    E.1.2Level LLT
    E.1.2Classification code 10008978
    E.1.2Term Chronic lymphocytic leukemia refractory
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the efficacy of acalabrutinib monotherapy (Arm A) compared with idelalisib/rituximab or bendamustine/rituximab (Arm B) based on Independent Review Committee (IRC) assessment of progression-free survival (PFS) per International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 criteria (Hallek 2008) with incorporation of the clarification for treatment-related lymphocytosis (Cheson 2012)—hereafter referred to as IWCLL 2008 criteria in subjects with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL).
    Évaluer l’efficacité de l’acalabrutinib en monothérapie (Bras A) par rapport à idélalisib/rituximab ou bendamustine/rituximab (Bras B) basée sur l’évaluation de la survie sans progression (SSP) par le Comité d’examen indépendant (CEI) selon les critères du comité de travail international sur la leucémie lymphoïde chronique (International Workshop on Chronic Lymphocytic Leukemia, IWCLL) de 2008 (Hallek 2008) avec incorporation de la clarification pour la lymphocytose liée au traitement (Cheson 2012) - ci-après appelés critères IWCLL 2008, chez des sujets atteints de leucémie lymphoïde chronique (LLC) en rechute/réfractaire (R/R).
    E.2.2Secondary objectives of the trial
    To evaluate Arm A (acalabrutinib) compared with Arm B (idelalisib/rituximab or bendamustine/rituximab) in terms of:
    • Investigator (INV)-assessed PFS per IWCLL 2008 criteria.
    • INV- and IRC-assessed objective response rate (ORR) per IWCLL 2008 criteria.
    • Overall survival (OS).
    • Patient-reported outcomes (PROs) by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT Fatigue).
    • INV- and IRC-assessed duration of response (DOR).
    • INV- and IRC-assessed time to next treatment (TTNT).
    Évaluer le Bras A (acalbrutinib) par rapport au Bras B (idelalisib/rituximab ou bendamustine/rituximab) en termes de :
    • SSP déterminée par l’investigateur (INV) selon les critères IWCLL 2008.
    • Taux de réponse objective (TRO) évalué par l’INV et le CEI selon les critères IWCLL 2008.
    • Survie globale (SG).
    • Résultats rapportés par les patients (RRP) au moyen du questionnaire d’évaluation fonctionnelle du traitement pour une maladie chronique, relatif à la fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue, FACIT-Fatigue).
    • Durée de réponse (DR) déterminée par l’INV et le CEI.
    • Temps jusqu’au prochain traitement (Time to next treatment, TTNT) déterminé par l’INV et le CEI.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Men and women ≥ 18 years of age.
    2. ECOG performance status of 0 to 2.
    3. Diagnosis of CLL that meets published diagnostic criteria (Hallek 2008):
    a. Monoclonal B-cells (either kappa or lambda light chain restricted) that are clonally co-expressing ≥ 1 B-cell marker (CD19, CD20, or CD23) and CD5.
    b. Prolymphocytes may comprise ≤ 55% of blood lymphocytes.
    c. Presence of ≥ 5 x 109 B lymphocytes/L (5000 µL) in the peripheral blood (at any point since diagnosis).
    4.Must have documented CD20-positive CLL.
    5.Active disease meeting ≥ 1 of the following IWCLL 2008 criteria for requiring treatment:
    a. Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia (hemoglobin < 10 g/dL) and/or thrombocytopenia (platelets < 100,000/μL).
    b. Massive (ie, ≥ 6 cm below the left costal margin), progressive, or symptomatic splenomegaly.
    c. Massive nodes (ie, ≥ 10 cm in the longest diameter), progressive, or symptomatic lymphadenopathy.
    d. Progressive lymphocytosis with an increase of > 50% over a 2-month period or a LDT of < 6 months. LDT may be obtained by linear regression extrapolation of ALC obtained at intervals of 2 weeks over an observation period of 2 to 3 months. In subjects with initial blood lymphocyte counts of < 30 x 109/L (30,000/μL), LDT should not be used as a single parameter to define indication for treatment. In addition, factors contributing to lymphocytosis or lymphadenopathy other than CLL (eg, infections) should be excluded.
    e. Autoimmune anemia and/or thrombocytopenia that is poorly responsive to standard therapy.
    f. Constitutional symptoms documented in the subject’s chart with supportive objective measures, as appropriate, defined as ≥ 1 of the following disease- related symptoms or signs:
    i. Unintentional weight loss ≥ 10% within the previous 6 months before screening.
    ii. Significant fatigue (ECOG performance score 2 or worse; inability to work or perform usual activities).
    iii. Fevers higher than 100.5°F or 38.0°C for ≥ 2 weeks before screening without evidence of infection.
    iv. Night sweats for > 1 month before screening without evidence of infection.
    6. Meet the following laboratory parameters:
    a. Absolute neutrophil count (ANC) ≥ 750 cells/μL (0.75 x 109/L), or ≥ 500 cells/μL (0.50 x 109/L) in subjects with documented bone marrow involvement, and independent of growth factor support 7 days before assessment.
    b. Platelet count ≥ 50,000 cells/μL (50 x 109/L), or ≥ 30,000 cells/μL
    (30 x 109/L) in subjects with documented bone marrow involvement, and without transfusion support 7 days before assessment. Subjects with transfusion-dependent thrombocytopenia are excluded. If an investigator has chosen bendamustine/rituximab as the Arm B treatment, platelets must be ≥ 75,000 cells/μL (75 x 109/L).
    c. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.0 x upper limit of normal (ULN).
    d. Total bilirubin ≤ 1.5 x ULN.
    e. Estimated creatinine clearance of ≥ 30 mL/min, calculated using the formula of Cockcroft and Gault [(140-Age) • Mass (kg)/(72 • creatinine mg/dL); multiply by 0.85 if female].
    7.Must have received ≥ 1 prior systemic therapies for CLL. Note: Single-agent steroids or localized radiation are not considered a prior line of therapy. If a single- agent anti-CD20 antibody was previously administered, subjects must have received ≥ 2 doses.
    8.Able to receive all outpatient treatment, all laboratory monitoring, and all radiologic evaluations at the institution that administers study drug for the entire study.
    9.Women who are sexually active and can bear children must agree to use highly effective forms of contraception while on the study and for 90 days after the last dose of acalabrutinib or idelalisib, 120 days after the last dose of bendamustine, or 12 months after the last dose of rituximab, whichever is longer. Highly effective forms of contraception are defined in Section 9.2.2.
    10. Men who are sexually active and can beget children must agree to use highly effective forms of contraception during the study and for 90 days after the last dose of acalabrutinib or idelalisib, 120 days after the last dose of bendamustine, or 12 months after the last dose of rituximab, whichever is longer. Highly effective forms of contraception are defined in Section 9.2.2.
    11.Men must agree to refrain from sperm donation during the study and for 90 days after the last dose of of acalabrutinib or idelalisib, 120 days after the last dose of bendamustine, or 12 months after the last dose of rituximab, whichever is longer.
    12.Willing and able to participate in all required evaluations and procedures in this study protocol, including swallowing capsules without difficulty.
    13.Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (in accordance with national and local patient privacy regulations).
    1. Hommes et femmes âgés de ≥ 18 ans.
    2. Indice de performance ECOG de 0 à 2.
    3. Diagnostic de LLC remplissant les critères diagnostiques publiés (Hallek 2008) :
    a. Cellules B monoclonales (limitées à une chaine légère kappa ou lambda) co-exprimant par clonage ≥ 1 marqueur de cellules B (CD19, CD20 ou CD23) et le CD5.
    b. Les prolymphocytes peuvent représenter ≤ 55 % des lymphocytes sanguins.
    c. Présence de ≥ 5 x 109 lymphocytes B/l (5 000 μl) dans le sang périphérique (à tout moment depuis le diagnostic).
    4. LLC CD20-positive documentée.
    5. Maladie active remplissant ≥ 1 des critères IWCLL 2008 suivants pour exiger un traitement :
    a. Signes d’insuffisance médullaire progressive se manifestant par le développement ou l’aggravation d’une anémie (hémoglobine < 10 g/dl) et/ou d’une thrombocytopénie (plaquettes < 100 000/μl).
    b. Splénomégalie massive (c.-à-d. ≥ 6 cm sous le rebord costal gauche), progressive ou symptomatique.
    c. Lymphadénopathie ganglionnaire massive (c.-à-d. ≥ 10 cm dans leur diamètre le plus long), progressive ou symptomatique.
    d. Lymphocytose progressive avec augmentation > 50 % sur une période de 2 mois, ou un temps de doublement du nombre de lymphocytes (lymphocyte doubling time, LDT) < 6 mois. Le LDT peut être obtenu par extrapolation de la régression linéaire de la numération absolue des lymphocytes (NAL) mesurée à des intervalles de 2 semaines sur une période d’observation de 2 à 3 mois. Chez les sujets présentant une numération initiale des lymphocytes sanguins < 30 x 109/l (30 000/μl), le LDT ne devra pas être le seul paramètre utilisé pour définir une indication de traitement. En outre, les facteurs contribuant à une lymphocytose ou à une lymphadénopathie autre que la LLC (par ex. les infections) doivent être exclus.
    e. Anémie auto-immune et/ou thrombocytopénie répondant mal à un traitement standard.
    f. Symptômes constitutionnels documentés dans le dossier médical du sujet et accompagnés de mesures objectives, le cas échéant, définis comme correspondant à ≥ 1 des symptômes ou signes liés à la maladie suivants :
    i. Perte de poids involontaire ≥ 10 % au cours des 6 mois précédant la sélection.
    ii. Fatigue significative (indice de performance ECOG de 2 ou plus ; impossibilité de travailler ou d’effectuer les activités habituelles).
    iii. Épisodes de fièvre supérieurs à 38,0 °C pendant ≥ 2 semaines avant la sélection sans signes d’infection.
    iv. iv. Sueurs nocturnes pendant > 1 mois avant la sélection sans signes d’infection.
    6. Remplir les paramètres de laboratoire suivants :
    a. Numération absolue des neutrophiles (NAN) ≥ 750 cellules/μl (0,75 x 109/l), ou ≥ 500 cellules/μl (0,50 x 109/l) chez les sujets présentant une atteinte médullaire documentée, indépendamment de l’apport de facteur de croissance 7 jours avant l’évaluation.
    b. Numération plaquettaire ≥ 50 000 cellules/μl (50 x 109/l), ou ≥ 30 000 cellules/μl (30 x 109/l) chez les sujets présentant une atteinte médullaire documentée et sans l’apport d’une transfusion 7 jours avant l’évaluation. Les sujets présentant une thrombocytopénie dépendant de transfusions sont exclus. Si un investigateur a choisi bendamustine/rituximab comme traitement pour le Bras B, les plaquettes doivent être ≥ 75 000 cellules/μl (75 x 109/l).
    c. Aspartate aminotransférase (ASAT) et alanine aminotransférase (ALAT) sériques ≤ 2,0 x la limite supérieure de la normale (LSN).
    d. Bilirubine totale ≤ 1,5 x LSN.
    e. Clairance de la créatinine estimée ≥ 30 ml/min, calculée à l’aide de la formule de Cockcroft et Gault [(140-Âge) • Poids (kg)/(72 • créatinine mg/dl) ; multiplié par 0,85 pour une femme].
    7. Doit avoir reçu ≥ 1 traitement systémique préalable pour la LLC. Remarque : les stéroïdes en monothérapie ou une irradiation localisée ne sont pas considérés comme une ligne de traitement préalable. Si un anticorps anti-CD20 en monothérapie a été préalablement administré, les sujets doivent en avoir reçu ≥ 2 doses.
    8. Capable de recevoir tout le traitement en ambulatoire, d’effectuer toute la surveillance clinique du laboratoire ainsi que toutes les évaluations radiologiques à l’établissement administrant le médicament de l’étude pour toute la durée de l’étude.
    9. Les femmes sexuellement actives et pouvant avoir des enfants doivent accepter d’utiliser des méthodes de contraception très efficaces pendant leur participation à l’étude et pendant 90 jours après la dernière dose d’acalabrutinib ou d’idélalisib, 120 jours après la dernière dose de bendamustine, ou 12 mois après la dernière dose de rituximab, selon la durée la plus longue. Les méthodes de contraception très efficaces sont définies à la Section 9.2.2.

    Se référer au résumé en français pour la suite des critères d'inclusion
    E.4Principal exclusion criteria
    1.Known CNS lymphoma or leukemia.
    2.Known prolymphocytic leukemia or history of, or currently suspected, Richter’s syndrome.
    3.Uncontrolled AIHA or ITP defined as declining hemoglobin or platelet count secondary to autoimmune destruction within the screening period or requirement for high doses of steroids (> 20 mg daily of prednisone daily or equivalent).
    4.Prior exposure to a BCL-2 inhibitor (eg, ABT-199) or a BCR inhibitor (eg, Btk inhibitors or PI3K inhibitors).
    5.Received any chemotherapy, external beam radiation therapy, anticancer antibodies, or investigational drug within 30 days before first dose of study drug.
    6.Corticosteroid use > 20 mg within 1 week before first dose of study drug, except as indicated for other medical conditions such as inhaled steroid for asthma, topical steroid use, or as premedication for administration of study drug or contrast. For example, subjects requiring steroids at daily doses > 20 mg prednisone equivalent systemic exposure daily, or those who are administered steroids for leukemia control or white blood cell count lowering are excluded.
    7.Prior radio- or toxin-conjugated antibody therapy.
    8.Prior allogeneic stem cell transplant or prior autologous transplant within 6 months of first dose of study drug(s) or presence of graft-vs-host disease or recieving treatment for
    graft-vs-host disease.
    9.Major surgical procedure within 30 days of first dose of study drug. Note: If a subject had major surgery, they must have recovered adequately from any toxicity and/or complications from the intervention before the first dose of study drug.
    10.History of prior malignancy except for the following:
    a. Malignancy treated with curative intent and with no evidence of active disease present for more than 2 years before screening and felt to be at low risk for recurrence by treating physician.
    b. Adequately treated lentigo maligna melanoma without current evidence of disease or adequately controlled nonmelanomatous skin cancer.
    c. Adequately treated carcinoma in situ without current evidence of disease.
    11.Significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of screening, or any Class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification, or QTc > 480 msec at screening.
    12.Malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel or gastric bypass, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction.
    13.Received a live virus vaccination within 28 days of first dose of study drug.
    14.Known history of infection with HIV or any uncontrolled active systemic infection (eg, bacterial, viral or fungal).
    15.Serologic status reflecting active hepatitis B or C infection. Subjects with anti-HBc who are surface antigen negative or who are hepatitis C antibody positive will need to have a negative PCR result before randomization. Those who are HbsAg-positive or hepatitis B PCR positive and those who are hepatitis C PCR positive will be excluded.
    16.Ongoing, drug-induced liver injury, alcoholic liver disease, non-alcoholic steatohepatitis, primary biliary cirrhosis, ongoing extrahepatic obstruction caused by cholelithiasis, cirrhosis of the liver, or portal hypertension.
    17.History of or ongoing drug-induced pneumonitis.
    18.History of serious allergic reactions including anaphylaxis and toxic epidermal necrolysis.
    19.History of stroke or intracranial hemorrhage within 6 months before first dose of study drug.
    20.History of bleeding diathesis (eg, hemophilia, von Willebrand disease).
    21.Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists (eg, phenprocoumon) within 7 days of first dose of study drug.
    22.Presence of a gastrointestinal ulcer diagnosed by endoscopy within 3 months before screening.
    23.Requires treatment with a strong CYP3A inhibitor/inducer.
    24.Requires treatment with proton-pump inhibitors (eg, omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, or pantoprazole). Subjects receiving proton-pump inhibitors who switch to H2-receptor antagonists or antacids are eligible for enrollment to this study.
    25.Breast feeding or pregnant.
    26.Concurrent participation in another therapeutic clinical trial.
    1. Leucémie ou lymphome du système nerveux central (SNC) connu(e).
    2. Leucémie prolymphocytaire connue ou antécédents/suspicion actuelle de syndrome de Richter.
    3. Anémie hémolytique auto-immune (AHAI) incontrôlée ou purpura thrombopénique idiopathique (PTI) défini comme une baisse de l’hémoglobine ou de la numération plaquettaire suite à une destruction auto-immune au cours de la période de sélection, ou traitement requis par des stéroïdes à haute dose (> 20 mg par jour de prednisone ou équivalent).
    4. Exposition préalable à un inhibiteur de BCL-2 (par ex., ABT-199) ou à un inhibiteur du récepteur des cellules B (B-cell receptor, BCR) (par ex., inhibiteurs de la tyrosine kinase de Bruton [Bruton tyrosine kinase, Btk] ou inhibiteurs de la phosphoinositide-3 kinase [PI3K]). Un retraitement par la bendamustine est autorisé si la réponse préalable à la bendamustine a duré > 24 mois.
    5. Administration de toute chimiothérapie, toute radiothérapie à rayons externes, tout anticorps anticancéreux ou tout médicament expérimental dans les 30 jours précédant la première dose du médicament de l’étude.
    6. Prise de corticoïdes à une dose > 20 mg au cours de la semaine précédant la première dose du médicament de l’étude, sauf si indiqué pour d’autres affections médicales, à savoir les stéroïdes inhalés contre l’asthme, les stéroïdes topiques ou en tant que prémédication lors de l’administration du médicament de l’étude ou d’un produit de contraste. Par exemple, sont exclus les sujets chez qui des doses quotidiennes de stéroïdes > 20 mg équivalent à une exposition systémique de prednisone par jour sont requises, ou ceux chez qui des stéroïdes sont administrés pour le contrôle d’une leucémie ou pour diminuer la numération des globules blancs.
    7. Traitement préalable par un anticorps radiomarqué ou conjugué à une toxine.
    8. Greffe allogénique de cellules souches ou greffe autologue préalable au cours des 6 mois précédant la première dose du ou des médicaments de l’étude, ou présence de maladie du greffon contre l’hôte ou administration d’un traitement pour la maladie du greffon contre l’hôte.
    9. Procédure chirurgicale majeure au cours des 30 jours précédant la première dose du médicament de l’étude. Remarque : si un sujet a eu une intervention chirurgicale majeure, il doit être correctement rétabli de toute toxicité et/ou complication éventuelle de l’intervention avant la première dose du médicament de l’étude.
    10. Antécédents de tumeur maligne préalable à l’exception des cas suivants :
    a. Tumeur maligne traitée dans un but curatif avec absence de signes de maladie active pendant plus de 2 ans avant la sélection, et jugée comme comportant un faible risque de récidive par le médecin traitant.
    b. Mélanome à lentigo malin correctement traité sans preuve actuelle de maladie ou cancer cutané non-mélanomateux contrôlé de manière adéquate.
    c. Carcinome in situ traité de manière adéquate sans preuve actuelle de maladie.
    11. Maladie cardiovasculaire significative telle qu’une arythmie non contrôlée ou symptomatique, une insuffisance cardiaque ou un infarctus du myocarde au cours des 6 mois précédant la sélection, ou toute maladie cardiaque de classe 3 ou 4 selon la classification fonctionnelle de la New York Heart Association, ou un intervalle QT corrigé (QTc) > 480 msec lors de la sélection.
    12. Syndrome de malabsorption, maladie affectant la fonction gastro-intestinale de manière significative, ou résection de l’estomac, de l’intestin grêle ou bypass gastrique, maladie de l’intestin inflammatoire symptomatique ou obstruction partielle ou complète des intestins.
    13. Administration d’une vaccination par un virus vivant au cours des 28 jours précédant la première dose du médicament de l’étude.
    14. Antécédents connus d’infection par le virus de l’immunodéficience humaine (VIH) ou toute infection systémique active non contrôlée (par ex., bactérienne, virale ou fongique).
    15. Statut sérologique reflétant une infection active par le virus de l’hépatite B ou C. Les sujets positifs pour les anticorps du noyau de l’hépatite B (anti-HBc) et négatifs pour l’antigène de surface, ou positifs pour les anticorps de l’hépatite C, devront obtenir un résultat négatif au test de la réaction en chaine par polymérase (polymerase chain reaction, PCR) avant la randomisation. Ceux qui sont positifs pour l’antigène de surface de l’hépatite B (HbsAg) ou qui présentent un test par PCR pour l’hépatite B ou l’hépatite C positif seront exclus.
    16. Lésions hépatiques induites par le médicament, maladies hépatiques dues à l’alcoolisme, stéatohépatite non alcoolique, cirrhose biliaire primaire, obstruction extrahépatique provoquée par une cholélithiase, cirrhose du foie ou hypertension portale actuelles.
    17. Antécédents de pneumonite induite par un médicament ou présence de cette affection.

    Se référer au résumé en français pour la suite des critères d'exclusion
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint of the study is PFS (defined as the time from randomization until disease progression or death from any cause) as assessed by the IRC per IWCLL 2008 criteria.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Estimated 48 months
    E.5.2Secondary end point(s)
    • INV-assessed PFS per IWCLL 2008 criteria.
    • INV-assessed ORR (defined as the proportion of patients who achieve a best response of complete remission [CR], complete remission with incomplete bone marrow recovery [CRi], nodal partial remission [nPR], or partial remission [PR]) per IWCLL 2008 criteria.
    • IRC-assessed ORR per IWCLL 2008 criteria.
    • OS (defined as the time from randomization to the date of death due to any cause)
    • PROs as measured by change in scores from baseline to each assessment in the FACIT-Fatigue.
    • INV- and IRC-assessed DOR (defined as the time from the first documentation of objective response to the earlier time of disease progression [assessed by the IRC per IWCLL 2008 criteria] or death from any cause)
    • INV- and IRC-assessed TTNT (defined as the time from randomization to institution of nonprotocol-specified treatment for CLL)
    E.5.2.1Timepoint(s) of evaluation of this end point
    Estimated 48 months
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over Yes
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned10
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA113
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Austria
    Belgium
    Bulgaria
    Canada
    Croatia
    Czech Republic
    Denmark
    France
    Germany
    Hong Kong
    Hungary
    Israel
    Italy
    Korea, Republic of
    New Zealand
    Poland
    Romania
    Russian Federation
    Singapore
    Slovakia
    Spain
    Sweden
    Taiwan
    Turkey
    Ukraine
    United Kingdom
    United States
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The maximum duration of the study is approximately 48 months from the first subject randomized. Therefore the end of trial will occur approximately 48 months after the first subject is randomized.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months3
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months3
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 92
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 214
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others Yes
    F.3.3.7.1Details of other specific vulnerable populations
    Elderly
    F.4 Planned number of subjects to be included
    F.4.1In the member state25
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 196
    F.4.2.2In the whole clinical trial 306
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Any subjects who have not progressed at the end of trial, defined as the point when the last subject on the study exits the study for any reason, and are tolerating study drug, may continue to receive their study treatment after discussion with the Medical Monitor. They will continue to have scheduled visits as outlined on the schedule of assessments. Otherwise, they will be treated according to current standard of care.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2016-11-23
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-12-14
    P. End of Trial
    P.End of Trial StatusCompleted
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

    European Medicines Agency © 1995-Tue May 07 02:55:49 CEST 2024 | Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
    EMA HMA