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    Summary
    EudraCT Number:2018-001366-42
    Sponsor's Protocol Code Number:BGB-3111-305
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2018-10-25
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2018-001366-42
    A.3Full title of the trial
    A Phase 3, Randomized Study of Zanubrutinib (BGB-3111) Compared with Ibrutinib in Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
    Estudio de fase 3 aleatorizado de zanubrutinib (BGB-3111) en comparación con ibrutinib en pacientes con leucemia linfocítica crónica o linfoma linfocítico de células pequeñas recidivante/resistente
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study of Zanubrutinib Compared with Ibrutinib in patients with Relapsed/Refractory Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
    Estudio de de zanubrutinib en comparación con ibrutinib en pacientes con leucemia linfocítica crónica o linfoma linfocítico de células pequeñas recidivante/resistente
    A.4.1Sponsor's protocol code numberBGB-3111-305
    A.5.4Other Identifiers
    Name:USANNumber:Zanubrutinib
    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 SponsorBeiGene, Ltd.
    B.1.3.4CountryUnited States
    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 supportBeiGene, Ltd.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBeiGene, Ltd.
    B.5.2Functional name of contact pointBeiGene Clinical Support
    B.5.3 Address:
    B.5.3.1Street AddressUSA
    B.5.3.2Town/ cityUSA
    B.5.3.3Post codeUSA
    B.5.3.4CountryUnited States
    B.5.4Telephone number34900834223
    B.5.6E-mailRegistroEspanolDeEstudiosClinicos@druginfo.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 nameZanubrutinib
    D.3.2Product code BGB-3111
    D.3.4Pharmaceutical form Capsule
    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 INNZanubrutinib
    D.3.9.1CAS number 1691249-45-2
    D.3.9.2Current sponsor codeBGB-3111
    D.3.9.3Other descriptive nameBGB-3111
    D.3.9.4EV Substance CodeSUB184615
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number80
    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 Imbruvica
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag International NV
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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.3.4Pharmaceutical 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 INNIbrutinib
    D.3.9.1CAS number 936563-96-1
    D.3.9.4EV Substance CodeSUB120863
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number140
    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
    Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
    Leucemia linfocítica crónica / Linfoma linfocítico de células pequeñas
    E.1.1.1Medical condition in easily understood language
    Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
    Leucemia linfocítica crónica / Linfoma linfocítico de células pequeñas
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10041152
    E.1.2Term Small lymphocytic lymphoma, consistent with CLL (Working Formulation)
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10008976
    E.1.2Term Chronic lymphocytic leukemia
    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 compare the efficacy of zanubrutinib versus ibrutinib as measured by overall response
    rate determined by independent central review
    Comparar la eficacia de zanubrutinib con la de ibrutinib determinada mediante la tasa de respuesta global según una revisión centralizada independiente.
    E.2.2Secondary objectives of the trial
    To compare the efficacy of zanubrutinib versus ibrutinib as measured by:
    - Progression-free survival determined by independent central review
    - Progression-free survival determined by investigator assessment
    - Duration of response as determined by independent central review
    - Duration of response as determined by investigator assessment
    - Time to treatment failure
    - Rate of partial response with lymphocytosis or higher determined by independent
    central review
    - Overall survival
    - Patient-reported outcomes

    To compare the safety of zanubrutinib versus ibrutinib
    Comparar la eficacia de zanubrutinib con la de ibrutinib determinada mediante:
    - Supervivencia libre de progresión según una revisión centralizada independiente.
    - Supervivencia libre de progresión según la evaluación del investigador.
    - Duración de la respuesta según una revisión centralizada independiente.
    - Duración de la respuesta según la evaluación del investigador.
    - Tiempo transcurrido hasta el fracaso del tratamiento.
    - Tasa de respuesta parcial con linfocitosis o superior según una revisión centralizada independiente.
    - Supervivencia global.
    - Resultados comunicados por los pacientes.

    Comparar la seguridad de zanubrutinib con la de ibrutinib.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Each patient eligible to participate in this study must meet ALL of the following criteria:
    1.Age 18 years or older
    2.Confirmed diagnosis of CLL or SLL that meets the IWCLL criteria
    3.CLL/SLL requiring treatment as defined by at least 1 of the following criteria:
    a.Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia and/or thrombocytopenia
    b.Massive (≥ 6 cm below left costal margin), progressive, or symptomatic splenomegaly
    c.Massive nodes (≥ 10 cm in longest diameter), or progressive or symptomatic lymphadenopathy
    d.Progressive lymphocytosis with an increase of > 50% over a 2 month period or lymphocyte doubling time of < 6 months. Lymphocyte doubling time may be obtained by linear regression extrapolation of absolute lymphocyte counts obtained at intervals of 2 weeks over an observation period of 2 to 3 months. In patients with initial blood lymphocyte counts of < 30 x 10 9/L (30,000/µL), lymphocyte doubling time should not be used as a single parameter to define treatment indication. In addition, factors contributing to lymphocytosis or lymphadenopathy other than CLL/SLL (eg, infection) should be excluded.
    e.Autoimmune anemia and/or thrombocytopenia that is poorly responsive to corticosteroids or other standard therapy
    f.Constitutional symptoms, defined as any 1 or more of the following disease-related symptoms or signs:
    i.Unintentional weight loss of ≥ 10% within the previous 6 months
    ii.Significant fatigue (ie, inability to work or perform usual activities)
    iii.Fevers > 100.5ºF or 38ºC for ≥ 2 weeks without other evidence of infection
    iv.Night sweats for > 1 month without evidence of infection

    4.Relapsed or refractory to at least 1 prior systemic therapy for CLL/SLL. A line of therapy is defined as completing at least 2 cycles of treatment of standard regimen according to current guidelines or of an investigational regimen on a clinical trial
    5.Measurable disease by CT/magnetic resonance imaging (MRI). Measurable disease is defined as ≥ 1 lymph node > 1.5 cm in longest diameter and measurable in 2 perpendicular diameters
    6.Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
    7.Life expectancy ≥ 6 months
    8.Adequate bone marrow function as defined by:
    a.Absolute neutrophil count (ANC) ≥ 1000/mm3 (growth factor use is allowed), except for patients with bone marrow involvement in which case ANC must be ≥ 750/mm3
    b.Platelet ≥ 75,000/mm3 (may be post-transfusion), except for patients with bone marrow involvement by CLL in which case the platelet count must be ≥ 50,000/mm3
    9.Patient must have adequate organ function defined as:
    a.Creatinine clearance ≥ 30 mL/min (as estimated by the Cockcroft-Gault equation or the Modification of Diet in Renal Disease [MDRD] equation, or as measured by nuclear medicine scan or 24 hour urine collection)
    b.Aspartate aminotransferase/serum glutamic oxaloacetic transaminase, and alanine aminotransferase (ALT)/serum glutamic pyruvic transaminase ≤ 2.5 × upper limit of normal unless due to CLL/SLL
    c.Serum total bilirubin < 3.0 × upper limit of normal (unless documented Gilbert’s syndrome)
    10.Female patients of childbearing potential must practice highly effective methods (Section 5.1.2) of contraception initiated prior to first dose of study drug, for the duration of the study, and for ≥ 90 days after the last dose of zanubrutinib or ibrutinib
    11.Male patients are eligible if vasectomized or if they agree to the use of barrier contraception with other highly effective methods described in Section 5.1.2 during the study treatment period and for ≥ 90 days after the last dose of zanubrutinib or ibrutinib
    12.Ability to provide written informed consent and can understand and comply with the requirements of the study.
    Para poder participar en este estudio, un paciente elegible deberá cumplir TODOS los siguientes criterios:
    -Edad mínima de 18 años.
    -Diagnóstico confirmado de LLC o LLCP que cumpla los criterios del IWCLL
    - LLC/LLCP con necesidad de tratamiento, definida como la presencia de al menos una de las circunstancias siguientes:
    a.Datos de insuficiencia medular progresiva, manifestada mediante la aparición, o el empeoramiento, de anemia o trombocitopenia.
    b.Esplenomegalia masiva (>= 6 cm por debajo del reborde costal izquierdo), progresiva o sintomática.
    c.Adenopatías masivas (>= 10 cm de diámetro mayor), progresivas o sintomáticas.
    d.Linfocitosis progresiva con aumento de más del 50 % durante un período de dos meses o tiempo de duplicación de los linfocitos inferior a 6 meses. El tiempo de duplicación de los linfocitos puede obtenerse mediante extrapolación de regresión lineal de los recuentos absolutos de linfocitos obtenidos a intervalos de dos semanas durante un período de observación de 2 a 3 meses. En los pacientes con recuentos iniciales de linfocitos en sangre < 30 x 109/l (30.000/l), el tiempo de duplicación de los linfocitos no podrá utilizarse como único parámetro para definir la indicación del tratamiento. Además, han de descartarse factores que pudieran contribuir a la presencia de linfocitosis o adenopatías aparte de la LLC/LLCP (por ejemplo, infecciones).
    e.Anemia o trombocitopenia autoinmunitaria con respuesta escasa a los corticoides o a otro tratamiento habitual.
    f.Síntomas constitucionales, definidos como uno o más de los siguientes síntomas o signos relacionados con la enfermedad:
    i.Pérdida de peso involuntaria >= 10% en los 6 meses anteriores.
    ii.Astenia significativa (incapacidad para trabajar o realizar las actividades habituales).
    iii.Fiebre > 38,0 °C durante al menos dos semanas sin otros signos de infección.
    iv.Sudores nocturnos durante más de un mes sin signos de infección.

    -Recidiva o resistencia a al menos un tratamiento sistémico previo contra la LLC/LLCP. Una línea de tratamiento se define como la finalización de al menos dos ciclos de tratamiento de una pauta de referencia según las directrices actuales o de una pauta experimental en un ensayo clínico.
    -Enfermedad mensurable mediante TC/resonancia magnética (RM). La enfermedad mensurable se define como ≥ 1 ganglio linfático con un diámetro mayor > 1,5 cm y mensurable en dos diámetros perpendiculares
    -Estado funcional del Eastern Cooperative Oncology Group (ECOG) de 0, 1 o 2.
    -Esperanza de vida de seis meses o más.
    -Función medular adecuada, definida como:
    a.Recuento absoluto de neutrófilos (RAN) >= 1000/mm3 (se permite el uso de factores de crecimiento), excepto en los pacientes con afectación de la médula ósea, en cuyo caso el RAN debe ser >= 750/mm3.
    b.Recuento de plaquetas >= 75.000/mm3 (puede ser después de una transfusión), excepto en los pacientes con afectación de la médula ósea por la LLC, en cuyo caso el recuento de plaquetas debe ser >= 50.000/mm3.
    -Función orgánica adecuada, definida como:
    a.Aclaramiento de creatinina >= 30 ml/min (calculado mediante la ecuación de Cockcroft-Gault o la ecuación MDRD o medido mediante un estudio de medicina nuclear o en una recogida de orina de 24 horas).
    b.Aspartato aminotransferasa/transaminasa glutamicooxaloacética sérica y alanina aminotransferasa (ALT)/transaminasa glutamicopirúvica sérica <= 2,5 veces el límite superior de la normalidad a menos que se deba a la LLC/LLCP.
    c.Bilirrubina sérica total < 3,0 veces el límite superior de la normalidad (a menos que exista un síndrome de Gilbert documentado).
    -Las mujeres con capacidad reproductiva deberán utilizar métodos anticonceptivos muy eficaces, iniciados antes de recibir la primera dosis del fármaco del estudio, durante todo el estudio y hasta, como mínimo, 90 días después de recibir la última dosis de zanubrutinib o ibrutinib.
    -Los varones podrán participar en caso de estar vasectomizados o de comprometerse a utilizar métodos anticonceptivos de barrera con otros métodos muy eficaces, según se describe en la Sección 5.1.2, durante el período de tratamiento del estudio y hasta, como mínimo, 90 días después de recibir la última dosis de zanubrutinib o ibrutinib.
    -Capacidad de otorgar el consentimiento informado por escrito y de comprender y cumplir los requisitos del estudio.
    E.4Principal exclusion criteria
    Each patient eligible to participate in this study must NOT meet any of the following exclusion criteria:
    1.Known prolymphocytic leukemia or history of, or currently suspected, Richter’s transformation (biopsy based on clinical suspicion may be needed to rule out transformation)
    2.Clinically significant cardiovascular disease including the following:
    a.Myocardial infarction within 6 months before screening
    b.Unstable angina within 3 months before screening
    c.New York Heart Association class III or IV congestive heart failure
    d.History of clinically significant arrhythmias (eg, sustained ventricular tachycardia, ventricular fibrillation, Torsades de Pointes)
    e.QTcF > 480 milliseconds based on Fridericia’s formula
    f.History of Mobitz II second-degree or third-degree heart block without a permanent pacemaker in place
    g.Uncontrolled hypertension as indicated by a minimum of 2 consecutive blood pressure measurements showing systolic blood pressure > 170 mmHg and diastolic blood pressure > 105 mmHg at screening
    3.Prior malignancy within the past 3 years, except for curatively treated basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix or breast
    4.History of severe bleeding disorder such as hemophilia A, hemophilia B, von Willebrand disease, or history of spontaneous bleeding requiring blood transfusion or other medical intervention
    5.History of stroke or intracranial hemorrhage within 180 days before first dose of study drug
    6.Severe or debilitating pulmonary disease
    7.Unable to swallow capsules or disease significantly affecting gastrointestinal function such as malabsorption syndrome, resection of the stomach or small bowel, bariatric surgery procedures, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction
    8.Active fungal, bacterial, and/or viral infection requiring systemic therapy
    9.Known central nervous system involvement by leukemia or lymphoma
    10.Underlying medical conditions that, in the investigator’s opinion, will render the administration of study drug hazardous or obscure the interpretation of toxicity or AEs
    11.Known infection with HIV or serologic status reflecting active viral hepatitis B or C infection as follows:
    a.Presence of hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb). Patients with presence of HBcAb, but absence of HBsAg, are eligible if hepatitis B virus (HBV) DNA is undetectable (< 20 IU), and if they are willing to undergo monitoring for HBV reactivation
    b.Presence of hepatitis C virus (HCV) antibody. Patients with presence of HCV antibody are eligible if HCV RNA is undetectable
    12.Moderate or severe hepatic impairment, ie, Child-Pugh class B or C
    13.Major surgery within 4 weeks of the first dose of study drug
    14.Prior treatment with a BTK inhibitor
    15.Last dose of prior therapy for CLL/SLL ≤ 14 days before randomization, with the following additional exclusion requirements:
    a.Treatment with monoclonal antibody-based therapy within 28 days of first dose of study drug
    b.Treatment with chimeric antigen receptor T-cell therapy within 180 days of first dose of study drug
    c.Treatment with Chinese herbal medicine with anticancer intent within 28 days of first dose of study drug
    d.Chemotherapy or radiation treatment within 21 days of first dose of study drug or hematopoietic stem cell transplantation within 90 days of first dose of study drug
    16.Prior steroid use
    •For prior corticosteroid use of 10mg/day or less, regardless of reason or duration of treatment, must stop steroid no later than day prior to first dose.
    •For prior corticosteroid use of 10mg/day or more, regardless of reason or duration of treatment, must stop steroid 4 weeks prior to date of randomization.
    17.Toxicity from prior anticancer therapy that has not recovered to ≤ Grade 1 (except for alopecia, ANC, and platelet count; for ANC and platelet count, see inclusion criterion 8)
    18.Pregnant or lactating women
    19.Vaccination with a live vaccine within 35 days prior to the first dose of study drug
    20.Ongoing alcohol or drug addiction
    21.Hypersensitivity to zanubrutinib, ibrutinib, or any of the other ingredients in either drug
    22.Patient requires treatment with warfarin or other vitamin K antagonists
    23.Requires ongoing treatment with a strong CYP3A inhibitor or inducer
    24.Concurrent participation in another therapeutic clinical trial.
    -Leucemia prolinfocítica conocida o antecedentes o sospecha presente de transformación de Richter (puede ser necesaria una biopsia basada en la sospecha clínica para descartar una transformación).
    -Enfermedad cardiovascular clínicamente significativa, como:
    Infarto de miocardio en los 6 meses previos a la selección.
    Angina de pecho inestable en los 3 meses previos a la selección.
    Insuficiencia cardíaca congestiva en clase III o IV según la NYHA. Antecedentes de arritmias clínicamente significativas (pej, taquicardia ventricular sostenida, fibrilación ventricular o taquicardia helicoidal).
    Intervalo QTcF > 480 ms según la fórmula de Fridericia.
    Antecedentes de bloqueo cardíaco de segundo grado de tipo Mobitz II o de tercer grado sin implantación de un marcapasos permanente.
    Hipertensión no controlada, indicada por un mínimo de dos determinaciones consecutivas de presión arterial que muestren una presión arterial sistólica > 170 mm Hg y una presión arterial diastólica > 105 mm Hg durante la fase de selección.

    -Neoplasia maligna en los 3 años previos, excepto cáncer basocelular o espinocelular de piel, cáncer superficial de vejiga o carcinoma in situ de cuello uterino o mama tratados con intención curativa.
    -Antecedentes de trastorno hemorrágico grave, como hemofilia A, hemofilia B o enfermedad de Von Willebrand, o antecedentes de hemorragia espontánea con necesidad de transfusión de sangre u otra intervención médica.
    -Antecedentes de ictus o hemorragia intracraneal en los 180 días previos a la primera dosis del fármaco del estudio.
    -Enfermedad pulmonar grave o debilitante.
    -Incapacidad para tragar cápsulas o enfermedad que afecte significativamente a la función gastrointestinal, como síndrome de malabsorción, resección del estómago o intestino delgado, intervenciones de cirugía bariátrica, enfermedad inflamatoria intestinal sintomática u obstrucción intestinal parcial o completa.
    -Infección micótica, bacteriana o vírica activa con necesidad de tratamiento sistémico.
    -Afectación conocida del sistema nervioso central por leucemia o linfoma.
    -Enfermedades subyacentes que, en opinión del investigador, hagan peligrosa la administración del fármaco del estudio o dificulten la interpretación de la toxicidad o los acontecimientos adversos.
    -Infección conocida por el VIH o estado serológico que refleje una infección activa por el virus de la hepatitis B o C de la manera siguiente:
    Presencia de HBsAg o anticuerpos anti-HBc. Los pacientes con presencia de anti-HBc, pero sin HBsAg, podrán participar si el ADN del virus VHB es indetectable (< 20 UI) y si están dispuestos a someterse a controles para detectar una reactivación del VHB.
    Presencia de anticuerpos contra el virus VHC. Los pacientes con presencia de anticuerpos contra el VHC podrán participar si el ARN del VHC es indetectable
    -Insuficiencia hepática moderada o grave, definida como una clase B o C de Child-Pugh.
    -Intervención de cirugía mayor en las 4 semanas previas a la primera dosis del fármaco del estudio.
    -Tratamiento previo con un inhibidor de BTK.
    -Última dosis del tratamiento previo contra la LLC/LLCP administrada <=14 días antes de la aleatorización, con los siguientes requisitos adicionales:
    Tratamiento con AcMos en los 28 días previos a la primera dosis del fármaco del estudio.
    Tratamiento con linfocitos T con receptores de antígenos quiméricos en los 180 días previos a la primera dosis del fármaco del estudio.
    Tratamiento con fitoterapia china con intención antineoplásica en los 28 días previos a la primera dosis del fármaco del estudio.
    Quimioterapia o radioterapia en los 21 días previos a la primera dosis del fármaco del estudio o trasplante de células madre hematopoyéticas en los 90 días previos a la primera dosis del fármaco del estudio.
    -Uso previo de esteroides.
    En caso de uso previo de corticosteroides equivalente a 10 mg/día o menos, con independencia del motivo o la duración del tratamiento, deberá suspenderse el uso de esteroides no más tarde del día previo a la primera dosis.
    En caso de uso previo de corticosteroides equivalente a 10 mg/día o más, con independencia del motivo o la duración del tratamiento, deberá suspenderse el uso de esteroides cuatro semanas antes de la fecha de aleatorización.
    -Toxicidad de un tratamiento antineoplásico previo que no se ha recuperado hasta un grado <= 1 (excepto alopecia, RAN y recuento de plaquetas; véase el criterio de inclusión n.º 8).
    -Mujeres embarazadas o en período de lactancia.
    -Vacunación con una vacuna de microorganismos vivos en los 35 días previos a la primera dosis del fármaco del estudio.
    -Alcoholismo o toxicomanía activos.
    -Hipersensibilidad a zanubrutinib, ibrutinib o cualquiera de los demás componentes de estos fármacos.
    -Necesidad de tratamiento con warfarina u otros antagonistas de la vitamina K.
    -Necesidad de tratamiento persistente con un inhibidor o inductor de la enzima CYP3A.
    -Participación simultánea en otro ensayo clínico terapéutico.
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint is ORR determined by independent central review using the “modified” 2008 IWCLL guidelines with modification for treatment-related lymphocytosis for patients with CLL and per Lugano Classification for non-Hodgkin lymphoma (NHL) for patients with SLL.
    El criterio principal de valoración es la determinación de la tasa de respuesta global según una revisión centralizada independiente conforme a las directrices del International Workshop on Chronic Lymphocytic Leukemia de 2008 “modificadas con modificación de la linfocitosis relacionada con el tratamiento en los pacientes con LLC y según la clasificación de Lugano del linfoma no hodgkin en los pacientes con LLCP.
    E.5.1.1Timepoint(s) of evaluation of this end point
    The final analysis will occur approximately 12 months after 400 patients have been randomized.
    El análisis final tendrá lugar unos 12 meses después de que se haya aleatorizado a 400 pacientes
    E.5.2Secondary end point(s)
    Key Secondary Endpoint:
    - PFS, defined as the time from randomization to the date of first documentation of disease progression or death, whichever occurs first, determined by independent central review
    Other Secondary Endpoints:
    - PFS determined by investigator assessment
    - Duration of response, defined as the time from the date that response criteria are first met to the date that disease progression is objectively documented or death, whichever occurs first, determined by independent central review
    - Duration of response by investigator assessment
    - Time to treatment failure, defined as time from randomization to discontinuation of study drug due to any reason
    - Rate of PR-L or higher, defined as the proportion of patients who achieve a CR/CRi + PR + nodular PR + PR-L determined by independent central review
    - Overall survival, defined as the time from randomization to the date of death due to any cause
    - PROs measured by the EQ-5D-5L and EORTC QLQ-C30 questionnaires
    - Safety parameters, including AEs, SAEs, clinical laboratory tests, physical exams, and vital signs
    Criterio de valoración secundario:
    Supervivencia libre de progresión (SLP), definida como el tiempo desde la aleatorización hasta la primera documentación de progresión de enfermedad o muerte, lo que ocurra primero, según una revisión centralizada independiente.
    Otros Criterios de valoración secundarios:
    Supervivencia libre de progresión según la evaluación del investigador.
    Duración de la respuesta, definida como el tiempo desde la aleatorización hasta la primera documentación de progresión de enfermedad o muerte, lo que ocurra primero, según una revisión centralizada independiente.
    Duración de la respuesta según la evaluación del investigador.
    Tiempo transcurrido hasta el fracaso del tratamiento, definido como el tiempo desde la aleatorización hasta la discontinuación del tratamiento por alguna razón.
    Tasa de respuesta correspondiente a respuesta parcial con linfocitosis definida como la proporción de pacientes que alcanzan una respuesta completa / respuesta completa con recuperación de médula ósea incompleta + respuesta parcial + respuesta parcial con linfocitosis, según una revisión centralizada independiente.
    Supervivencia global, definida como el tiempo desde la aleatorización hasta la fecha de muerte por cualquier causa
    Resultados comunicados por los pacientes: se resumirá la puntuación en el cuestionario EQ-5D-5L y QLQ-C30 de la EORTC
    Parámetros de seguridad, incluidos AAs, AAGs, pruebas de laboratorio, examenes físicos y constantes vitales
    E.5.2.1Timepoint(s) of evaluation of this end point
    The final analysis will occur approximately 12 months after 400 patients have been randomized.
    El análisis final tendrá lugar unos 12 meses después de que se haya aleatorizado a 400 pacientes
    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 Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    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 No
    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 concerned11
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA83
    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
    Belgium
    China
    Czech Republic
    France
    Germany
    Italy
    Netherlands
    New Zealand
    Poland
    Spain
    Sweden
    Turkey
    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
    LVLS
    Ultima Visita del Ultimo Paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years7
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years7
    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: 80
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 320
    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 No
    F.4 Planned number of subjects to be included
    F.4.1In the member state42
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 204
    F.4.2.2In the whole clinical trial 400
    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)
    Patients receiving zanubrutinib, who in the opinion of the investigator, continue to benefit from study treatment may continue treatment with zanubrutinib by enrolling on the Zanubrutinib Long Term Extension Study
    Los pacientes que reciben zanubrutinib, que en opinion del investigador, continuen beneficiándose del tratamiento del estudio ,pueden continuar con zanubrutinib siendo incluidos en el estudio de extensión de zanubrutinib a largo plazo
    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 Decision2019-01-15
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-12-14
    P. End of Trial
    P.End of Trial StatusOngoing
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