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Active, Not Recruiting

NCT Number: NCT03336333

A Study Comparing Zanubrutinib With Bendamustine Plus Rituximab in Participants With Previously Untreated CLL or SLL

To compare efficacy between zanubrutinib versus bendamustine and rituximab in patients with previously untreated CLL/SLL, as measured by progression free survival assess by Independent Central Review.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Concord Repatriation General Hospital, Concord, New South Wales, Australia

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About this study

This is a global phase 3, open label, randomized study of zanubrutinib versus bendamustine plus rituximab (B+R) in participants with previously untreated chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL), including participants without del(17p) [Cohort 1] and participants with del(17p) [Cohort 2 and Cohort 3]. Participants in Cohort 1 are randomized 1:1 to zanubrutinib (Arm A) or bendamustine plus rituximab (Arm B). Randomization will be stratified by age, Binet stage, immunoglobulin variable region heavy chain (IGHV) mutational status, and geographic region. Participants in Cohort 2 will receive treatment with zanubrutinib. Participants in Cohort 3 will receive treatment with zanubrutinib and venetoclax.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Key Inclusion Criteria:

  • Unsuitable for chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab (FCR)
  • Confirmed diagnosis of CD20-positive CLL or SLL, requiring treatment
  • Measurable disease by imaging
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
  • Life expectancy ≥ 6 months
  • Adequate bone marrow function
  • Adequate renal and hepatic function

Key Exclusion Criteria:

  • Previous systemic treatment for CLL/SLL
  • Requires ongoing need for corticosteroid treatment
  • Known prolymphocytic leukemia or history of or suspected Richter's transformation.
  • Clinically significant cardiovascular disease
  • Prior malignancy within the past 3 years, except for curatively treated basal or squamous cell skin cancer, non-muscle-invasive bladder cancer, carcinoma in situ of the cervix of breast, or localized Gleason score 6 prostate cancer
  • History of severe bleeding disorder
  • History of stroke or intracranial hemorrhage within 6 months before the first dose of study drug
  • Severe or debilitating pulmonary disease
  • Inability to swallow capsules or disease affecting gastrointestinal function
  • Active infection requiring systemic treatment
  • Known central nervous system involvement by leukemia or lymphoma
  • Underlying medical condition that will render the administration of study drug hazardous or obscure interpretation of toxicity or AEs
  • Known infection with human immunodeficiency virus (HIV) or active hepatitis B or C infection
  • Major surgery ≤ 4 weeks prior to start of study treatment
  • Pregnant or nursing females
  • Vaccination with live vaccine within 35 days prior to the first dose of study drug.
  • Ongoing alcohol or drug addiction
  • Known hypersensitivity to zanubrutinib, bendamustine, rituximab, or venetoclax (as applicable) or any other ingredients of the study drugs
  • Requires ongoing treatment with strong cytochrome P450 (CYP3A) inhibitor or inducer
  • Concurrent participation in another therapeutic clinical study

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Treatment and study plan

Zanubrutinib

Drug

Administered as two 80-milligram (mg) capsules by mouth twice a day (160 mg twice a day)

Other names: BGB-3111, BRUKINSA

Bendamustine

Drug

Administered intravenously (IV) at a dose of 90 mg/m^2/day on the first 2 days of each cycle for 6 cycles.

Other names: Treanda, Ribomustin, and Levact

Rituximab

Drug

Administered intravenously (IV) at a dose of 375 mg/m^2 on day 0 of cycle 1, and at a dose of 500 mg/m^2 on day 1 of cycles 2 to 6

Other names: Rituxan, MabThera

Venetoclax

Drug

400 mg tablets administered orally once daily.

Other names: Venclexta, Venclyxto

Primary outcomes

  1. Cohort 1: Progression-free Survival (PFS) as Determined by Independent Central Review (ICR)

    Time frame: Up to approximately 3 years and 7 months (as of cut-off date of 07MAY2021)

    PFS is defined as the time from randomization until first documentation of progression or death from any cause, whichever occurs first, as assessed by the ICR per 2008 International Workshop on Chronic Lymphocytic Leukemia (iwCLL) guidelines with modifications for treatment-related lymphocytosis in participants with CLL and the Revised Criteria for Response for Malignant Lymphoma in participants with small lymphocytic lymphoma (SLL).

Secondary outcomes

  1. Cohort 1: Overall Response Rate (ORR) Between Treatment Groups as Determined by ICR

    Time frame: Up to 5 years

    ORR in Cohort 1 is defined as the percentage of participants who achieve a complete response, complete response with incomplete bone marrow recovery, partial response, or partial response with lymphocytosis, determined by the ICR.

  2. Pooled Cohort 1/1a: Overall Response Rate (ORR) Between Treatment Groups

    Time frame: Up to 5 years

  3. Cohort 1: Overall Survival (OS) Between Treatment Groups as Determined by the ICR

    Time frame: Up to 5 years

    OS in Cohort 1 is defined as the time from randomization to the date of death due to any reason.

  4. Cohort 1: Duration of Response (DOR) Between Treatment Groups as Determined by the ICR

    Time frame: Up to 5 years

    Duration of response in Cohort 1 determined using the iwCLL criteria with modification for treatment related lymphocytosis (in participants with CLL) and the Lugano Classification for non-Hodgkin lymphoma (NHL; in participants with SLL), is defined as the time from the date that criteria for response (ie, partial response with lymphocytosis [PR-L] or better) are first met to the date that disease progression is objectively documented or death, whichever occurs first.

  5. Pooled Cohort 1/1a: Duration of Response (DOR) Between Treatment Groups

    Time frame: Up to 5 years

  6. Cohort 1: Progression-free Survival (PFS) Between Treatment Groups Determined by Investigator Assessment (IA)

    Time frame: Up to 5 years

    PFS is defined as the time from randomization until first documentation of progression or death from any cause, whichever occurs first, as assessed by the investigator per iwCLL guidelines with modifications for treatment-related lymphocytosis in participants with CLL and the Revised Criteria for Response for Malignant Lymphoma in participants with SLL.

  7. Pooled Cohort 1/1a: Progression-free Survival (PFS) Between Treatment Groups Determined by Investigator Assessment (IA)

    Time frame: Up to 5 years

  8. Cohort 1: Patient-reported Outcomes as Assessed by the (European Quality Of Life 5D 5L) EQ-5D-5L Questionnaire

    Time frame: Up to 5 years

  9. Cohort 1: Patient-reported Outcomes as Assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) Questionnaire.

    Time frame: Up to 5 years

  10. Cohort 2: Overall Response Rate (ORR)

    Time frame: Up to 5 years

  11. Cohort 2: Progression-free Survival (PFS)

    Time frame: Up to 5 years

  12. Cohort 2: Duration of Response (DOR)

    Time frame: Up to 5 years

  13. Cohort 3: Overall Response Rate (ORR)

    Time frame: Up to 5 years

  14. Cohort 3: Progression-free Survival (PFS)

    Time frame: Up to 5 years

  15. Cohort 3: Duration of Response (DOR)

    Time frame: Up to 5 years

  16. Cohort 3: Rate of Undetectable Minimal Residual Disease (MRD4)

    Time frame: Up to 5 years

  17. Number of Participants Experiencing Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Time frame: Up to 5 years

  18. Apparent Rate of Clearance of Zanubrutinib From Plasma (CL/F)CL/F

    Time frame: Predose up to 12 hours postdose

  19. Cohort 1 Zanubrutinib Only Arms: Area-Under-Curve From Time 0 to 12 Hours Postdose (AUC0-12)

    Time frame: Predose up to 12 hours postdose

  20. Cohort 3: Area-Under-Curve From Time 0 to 12 Hours Postdose (AUC0-12) of Zanubrutinib

    Time frame: Predose up to 12 hours postdose

Sponsors and collaborators

Lead sponsor

BeiGene

Industry

Registry information

Official study title

An International, Phase 3, Open-Label, Randomized Study of BGB-3111 Compared With Bendamustine Plus Rituximab in Patients With Previously Untreated Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma (CLL/SLL)

Acronym: SEQUOIA

Important dates

Study start
2017
Primary completion
2021
Study completion
2027
First posted
Nov 8, 2017
Registry last updated
Mar 9, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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