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Completed

NCT Number: NCT04062448

A Study of Ibrutinib in Combination With Rituximab, in Japanese Participants With Waldenstrom's Macroglobulinemia (WM)

The purpose of this study is to evaluate overall response rate (ORR) by Independent Review Committee (IRC) assessment, when combined with rituximab in Japanese participants with treatment naïve or relapsed/refractory Waldenstrom's Macroglobulinemia (WM).

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Key information

Age range

20 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Kameda Medical Center, Chiba, Japan

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Clinicopathological diagnosis of Waldenstrom's Macroglobulinemia (WM) in accordance with the consensus panel of the second International Workshop on Waldenstrom's Macroglobulinemia (IWWM)
  • Japanese participants with treatment naïve or relapsed/refractory WM
  • Measurable disease defined as serum monoclonal immunoglobulin M (IgM) greater than (>) 0.5 gram per deciliter (g/dL)
  • Symptomatic disease, requiring treatment
  • Eastern Cooperative Oncology Group (ECOG) performance status of less than or equal to (<=) 2
  • Hematology and biochemical values within protocol-defined limits
  • Female participants of childbearing potential must have a negative serum pregnancy test at screening and agree to use highly effective methods of contraception while taking study drug. Women of childbearing potential must be practicing a highly effective, preferably user independent method of birth control during treatment with any drug in this study and for up to 12 months after the last dose of rituximab, 1 month after last dose of ibrutinib. Male participants must use an effective barrier method of contraception during the study and after receiving the last dose of ibrutinib, and for up to 12 months after last dose of rituximab if sexually active with a female of childbearing potential
  • Must sign an informed consent form (ICF) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study. Participants must be willing and able to adhere to the prohibitions and restrictions specified in this protocol
  • Must be willing and able to adhere to the lifestyle restrictions specified in this protocol

Exclusion criteria

  • Involvement of the central nervous system by WM
  • Prior exposure to ibrutinib or other Bruton's Tyrosine Kinase (BTK) inhibitors
  • Rituximab treatment within the last 12 months before the first dose of study intervention
  • Received any WM-related therapy <=30 days prior to first administration of study treatment
  • Plasmapheresis less than (<) 35 days prior to the initiation of study drug, except when at least one serum IgM central assessment was performed during the screening period and was >35 days from the most recent plasmapheresis procedure
  • History of other malignancies
  • Vaccinated with live, attenuated vaccines within 4 weeks of first dose of study drug
  • Infection requiring systemic treatment that was completed <=14 days before the first dose of study drug
  • Currently active, clinically significant Child-Pugh Class B or C hepatic impairment
  • Inability or difficulty swallowing capsules, malabsorption syndrome, or any disease or medical condition significantly affecting gastrointestinal function
  • Stroke or intracranial hemorrhage within 12 months prior to enrollment
  • Currently active, clinically significant cardiovascular disease
  • Requires treatment with a strong cytochrome P450 (CYP) 3A inhibitor
  • Infection with human immunodeficiency virus (HIV) or active infection with hepatitis B or hepatitis C virus
  • Major surgery within 4 weeks of first dose of study drug
  • Lactating or pregnant
  • Male participants who plan to father a child while enrolled in this study or within 3 months after the last dose of ibrutinib, and within 12 months after last dose of rituximab
  • Any contraindication to ibrutinib or rituximab including hypersensitivity to the active substance or to any of the excipients of ibrutinib or rituximab per local prescribing information
  • Received an investigational intervention (including investigational vaccines) or used an invasive investigational medical device within 4 weeks before the planned first dose of study intervention or is currently enrolled in an investigational study
  • Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (eg [for example], compromise the wellbeing) or that could prevent, limit, or confound the protocol-specified assessments
  • Employee of the investigator or study site, with direct involvement in the proposed study or other studies under the direction of that investigator or study site, as well as family members of the employees or the investigator

Treatment and study plan

Ibrutinib

Drug

Ibrutinib 420 mg will be administered orally.

Other names: PCI-32765

Rituximab

Drug

Rituximab 375 mg/m^2 will be administered intravenously.

Primary outcomes

  1. Overall Response Rate (ORR) According to the Modified Sixth International Workshop on Waldenstrom's Macroglobulinemia (IWWM) Criteria

    Time frame: Up to 1 year 11 months

    ORR is defined as the percentage of participants achieving a best overall response of confirmed complete response (CR), very good partial response (VGPR) or partial response (PR) according to the modified sixth IWWM criteria (National Comprehensive Cancer Network [NCCN] version 2, 2019), as assessed by the Independent Review Committee (IRC). CR: Immunoglobulin M (IgM) in normal range, disappearance of monoclonal protein by immunofixation, no histologic evidence of bone marrow involvement, resolution of any adenopathy/organomegaly (if present at baseline) along with no signs or symptoms attributable to Waldenstrom's Macroglobulinemia (WM); VGPR and PR: greater than or equal to (>=) 90 percent (%) (for VGPR) and >=50% (for PR) reduction of serum IgM, decrease in adenopathy/organomegaly (if present at baseline) on physical examination or computerized tomography (CT) scan, no new symptoms or signs of active disease.

Secondary outcomes

  1. Progression Free Survival (PFS) Assessed by Independent Review Committee

    Time frame: From the date of initial dose up to 3 years and 5 months

    PFS was defined as duration from the date of initial dose of ibrutinib to the date of first documented evidence of disease progression or death, whichever occurred first regardless of the use of subsequent antineoplastic therapy prior to documented disease progression or death. Kaplan-Meier method was used for the analysis.

  2. Plasma Concentrations of Ibrutinib

    Time frame: Day 1 of Week 4: Predose, 1 hour, 2 hours, 4 hours, and 6 hours postdose

    Plasma concentrations of ibrutinib were reported.

  3. Plasma Concentrations of Metabolite PCI-45227

    Time frame: Day 1 of Week 4: Predose, 1 hour, 2 hours, 4 hours, and 6 hours postdose

    Plasma concentrations of metabolite PCI-45227 were reported.

  4. Number of Participants With Myeloid Differentiation Primary Response Gene 88 (MYD88) Biomarker Mutation

    Time frame: Day 1 of Week 1

    Number of participants with MYD88 biomarker mutations were reported. MYD88 was assessed using next generation sequencing to detect the somatic mutations in the bone marrow aspiration samples collected during the study.

  5. Number of Participants With C-X-C Chemokine Receptor Type 4 (CXCR-4) Biomarker Mutations

    Time frame: Day 1 of Week 1

    Number of participants with CXCR-4 biomarker mutations were reported. CXCR-4 was assessed using next generation sequencing to detect the somatic mutations in the bone marrow aspiration samples collected during the study.

  6. Number of Participants With Treatment- Emergent Adverse Events (TEAEs)

    Time frame: From first dose of study drug up to 30 days post last dose of study drug (that is, up to 40.6 months)

    An adverse event was defined as any untoward medical event that occurred in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. TEAEs were defined as any AE that occurred at or after the initial administration of study intervention through the day of last dose plus 30 days.

Sponsors and collaborators

Lead sponsor

Janssen Pharmaceutical K.K.

Industry

Registry information

Official study title

Phase 2 Study of Bruton's Tyrosine Kinase (BTK) Inhibitor, Ibrutinib (PCI-32765) in Combination With Rituximab, in Japanese Patients With Waldenstrom's Macroglobulinemia (WM)

Important dates

Study start
2019
Primary completion
2021
Study completion
2023
First posted
Aug 20, 2019
Registry last updated
May 25, 2025

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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