NCT05256641 · Jonsson Comprehensive Cancer Center
Acalabrutinib Maintenance for the Treatment of Patients With Large B-cell Lymphoma
What this study is about
This phase Ib/II trial studies the side effects and effectiveness of maintenance acalabrutinib following cellular therapy in treating patients with large B-cell lymphoma at very high risk of the cancer coming back. Acalabrutinib is a small molecular inhibitor that may interfere with the ability of cancer cells to grow and spread.
View original scientific description
This phase Ib/II trial studies the side effects and efficacy of maintenance acalabrutinib following cellular therapy in treating patients with large B-cell lymphoma at very high risk of the cancer coming back. Acalabrutinib is a small molecular inhibitor that may interfere with the ability of cancer cells to grow and spread.
Interventions
DRUG
Acalabrutinib
Given PO
Primary outcome measures
Permanent discontinuation of acalabrutinib
Time frame: Up to 12 months from cellular therapy
Tolerability will be determined by the number of patients who permanently discontinue acalabrutinib within 12 months from cellular therapy due to intolerance. The proportion of patients with acalabrutinib discontinuation will be reported along with 95% and 90% confidence intervals.
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- Ages 18-70 years
- One of the following:
- Patients undergoing autologous stem cell transplantation (ASCT) or any Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy product for:
- High grade B-cell lymphoma (double or triple hit) with rearrangements in bcl-2 and/or bcl-6, and rearrangement in myc
- Large B-cell lymphoma with a history of secondary CNS involvement
- Histologic transformation of indolent lymphoma to large B-cell lymphoma, including marginal zone lymphoma, follicular lymphoma, chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), lymphoplasmacytic leukemia, or Waldenstrom macroglobulinemia
- High risk international prognostic index (IPI) score 4 or 5, at diagnosis or prior to CAR T-cell leukapheresis
- Patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) for large B-cell lymphoma
- Eastern Cooperative Oncology Group (ECOG) 0-2
- Requirements for post-ASCT and post-alloHCT participants:
- Disease status of partial response (PR) or complete response (CR) prior to transplantation
- Receive reduced-intensity conditioning regimen
- Enrollment no later than day +90
- Requirements for post-CAR T-cell therapy participants:
- Disease status of PR or CR after post-CAR T-cell therapy positron emission tomography (PET)-computed tomography (CT) at 1-3 months
- Enrollment no later than day +104
- Ability to give full informed consent
- Female subjects who are sexually active and can bear children must agree to use highly effective forms of contraception while on the study and for 2 days after the last dose of acalabrutinib
- Willing and able to participate in all required evaluations and procedures in this study protocol, including swallowing capsules and tablets without difficulty
- Absolute neutrophil count (ANC) \> 500/uL (microliters)
- Platelets \> 50,000/uL independent of transfusions
- Hemoglobin \> 8 g/dL independent of transfusions
- Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 3 x upper limit of normal (ULN)
- Total bilirubin =\< 1.5 x ULN, unless directly attributable to Gilbert's syndrome
- Creatinine clearance \>= 60 mL/min based on Cockcroft-Gault glomerular filtration rate (GFR) and serum creatinine (Cr) =\< 1.8 mg/dL
Exclusion criteria
- Cord blood as donor source in alloHCT
- New York Heart Association Class III or IV
- Left ventricular ejection fraction \< 50%
- Estimated glomerular filtration rate \< 30 mL/min
- Concurrent long-term use of posaconazole or other strong CYP3A4 inhibitors and unable to replace with equivalent medication
- Acute or chronic graft-versus-host disease (GvHD) \>= stage 3 at time of enrollment
- Received packed red blood cells (pRBC) transfusion within the past 2 weeks
- Received platelet transfusion within the past 1 week
- Active invasive fungal infection
- Active bacterial or viral infection until resolution of the infection
- History of or ongoing confirmed progressive multifocal leukoencephalopathy (PML)
- Received any investigational drug within 30 days or 5 half-lives (whichever is shorter) before first dose of study drug
- Major surgical procedure within 30 days before the 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
- Refractory nausea and vomiting, inability to swallow the formulated product, or malabsorption syndrome; chronic gastrointestinal disease, gastric restrictions, or bariatric surgery such as gastric bypass; partial or complete bowel obstruction, or previous significant bowel resection that would preclude adequate absorption, distribution, metabolism, or excretion of study treatment
- Received a live virus vaccination within 28 days of first dose of study drug
- Known history of infection with human immunodeficiency virus (HIV)
- History of bleeding diathesis (e.g., hemophilia, von Willebrand disease)
- Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists
- Requires treatment with a strong cytochrome P450 3A (CYP3A) inhibitor or inducer. The use of strong CYP3A inhibitors within 1 week or strong CYP3A inducers within 3 weeks of the first dose of study drug is prohibited
- Breastfeeding or pregnant
- Concurrent participation in another therapeutic clinical trial
Where
- Los Angeles, California
- Sacramento, California
- Oklahoma City, Oklahoma
Collaborators
AstraZeneca
Related conditions & keywords
Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced Mar 10, 2026 · Source of record for eligibility and locations