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NCT Number: NCT07574073

CD20 Monoclonal Antibody Combined With BTK Inhibitor for the Treatment of Refractory Immune-related Cytopenia

This study aims to utilize anti-CD20 monoclonal antibodies to eliminate peripheral B cells and reduce the mechanism of autoantibody production, as well as combine the mechanism of BTK inhibitors (BTKi) blocking the B cell receptor signaling pathway and inhibiting B cell activation and proliferation, for the treatment of refractory immune-related cytopenia. In this study, it includes the salvage treatment of immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA), expecting to achieve a synergistic and enhancing effect. This study aims to select Zuberitamab, a human-mouse chimeric anti-CD20 monoclonal antibody, and the BTKi Orelabrutinib as combination therapy options. The clinical efficacy of the Zuberitamab-Orelabrutinib combination therapy (overall response rate, duration of sustained remission) will be evaluated, along with its safety profile (including infections, bleeding, cardiac toxicity), to provide a theoretical basis for their combined use in treating refractory immune-related thrombocytopenia (ITP and AIHA).

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Key information

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Diagnosed with refractory immune-related cytopenia, including immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA);
  • Age ranging from 18 to 80 years old (inclusive of 18 and 80);
  • Expected survival time > 12 months;
  • Good function of major organs:
  • liver function: ALT/AST < 3 times the upper limit of normal;
  • kidney function: creatinine < 100 μmol/L;
  • lung function: indoor oxygen saturation ≥ 95%;
  • heart function: left ventricular ejection fraction (LVEF) ≥ 50%;
  • Peripheral superficial venous blood flow is unobstructed, capable of meeting the requirements for intravenous infusion;
  • Karnofsky score ≥ 60, ECOG ≤ 2 points.

Exclusion criteria

  • Women who are pregnant (with positive urine/blood pregnancy test results) or breastfeeding;
  • Those who have severe underlying heart diseases when participating in this study, including:
  • clinically significant atrial fibrillation (AF),
  • cardiac conduction block,
  • myocardial infarction (within 1 year),
  • congestive heart failure (CHF);
  • cardiac echocardiography LVEF < 50%;
  • New York Heart Association (NYHA) cardiac function classification of III-IV grade;
  • Those with active bleeding or bleeding tendencies, and those who need to take anticoagulant drugs;
  • Those with organ dysfunction or uncontrollable coexisting diseases;
  • History of malignant tumors;
  • Those with active chronic hepatitis B or active hepatitis C;
  • Known history of human immunodeficiency virus (HIV) infection and/or acquired immunodeficiency syndrome;
  • Those with uncontrollable infectious diseases;
  • As determined by the investigator, other unsuitable conditions exist.

Treatment and study plan

Anti-CD20 monoclonal antibody and the BTK inhibitor

Drug

This is a novel combination regimen of anti-CD20 monoclonal antibody plus BTKi, specifically designed for patients with refractory immune-related cytopenia.

Primary outcomes

  1. Evaluate the Median overall response rate at 6 months of anti-CD20 monoclonal antibody and BTKi combination therapy in refractory immune-related cytopenia

    Time frame: Six month after treatment initiation

    Median overall response rate at 6 months after treatment initiation

Secondary outcomes

  1. Evaluate the early overall response rate 3 months after the start of anti-CD20 monoclonal antibody and BTKi combination therapy in refractory immune-related cytopenia

    Time frame: Three month after therapy

    The early overall response rate 3 months after the start of treatment

  2. Evaluate the sustained remission rate that lasts for 6 months after achieving remission following anti-CD20 monoclonal antibody and BTKi combination therapy in refractory immune-related cytopenia

    Time frame: Six month after achieving remission

    The sustained remission rate that lasts for 6 months after achieving remission

  3. Evaluate the Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability) of anti-CD20 monoclonal antibody and BTKi combination therapy in refractory immune-related cytopenia

    Time frame: Up to three month after therapy

    The incidence and severity of therapy related toxic reactions (including infections, bleeding, cardiac toxicity)

Sponsors and collaborators

Lead sponsor

Qi deng

Other

Registry information

Official study title

Clinical Study on the Treatment of Refractory Immune-related Cytopenia With CD20 Monoclonal Antibody Combined With BTK Inhibitor (BTKi)

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
May 7, 2026
Registry last updated
May 22, 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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