Can a targeted drug outperform chemo for a common blood cancer?

NCT ID NCT02475681

Disease control Sponsor: Acerta Pharma BV Source: ClinicalTrials.gov ↗

First seen Aug 25, 2026 · Last updated Aug 26, 2026 · Updated 1 time

Summary

This phase 3 trial compares three treatment approaches for people with previously untreated chronic lymphocytic leukemia (CLL): a standard chemo-immunotherapy (obinutuzumab plus chlorambucil), a newer targeted drug (acalabrutinib) combined with obinutuzumab, and acalabrutinib alone. The main goal is to see whether the acalabrutinib-containing regimens delay disease progression better than the standard. The study enrolls adults with CLL who are older or have other health conditions that make standard chemo less suitable.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance: acalabrutinib (a targeted cancer drug) alone or combined with obinutuzumab (an antibody therapy), compared with obinutuzumab plus chlorambucil (standard chemo-immunotherapy)
What this could lead to: If acalabrutinib-based regimens prove superior, they could become a new first-line standard for CLL, offering better disease control and longer remission without chemotherapy.
What could go wrong: This is a phase 3 trial, but results may not show a clear benefit over existing treatment. Acalabrutinib can cause side effects like bleeding, infections, and heart rhythm issues.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Phase 3

Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.

Participants

535 people

The number who actually took part.

Started

Jun 2015

Expected to finish

Sep 2026

An estimate. End dates often move.

Lead sponsor

A company

The lead sponsor is a pharmaceutical, biotech, or medical-device company.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria 1. Men and women: a. ≥ 65 years of age OR b. \> 18 and \< 65 years of age, provided that they meet at least one of the following criteria: i. Creatinine clearance 30 to 69 mL/min using the Cockcroft-Gault equation ii. A score higher than 6 on the CIRS-G (Appendix L). 2. ECOG performance status of 0, 1, or 2. 3. Diagnosis of CD20+ CLL that meets published diagnostic criteria (Hallek 2008): 1. Monoclonal B cells (either kappa or lambda light chain restricted) that are clonally co-expressing ≥ 1 B-cell marker (CD19, CD20, or CD23) and CD5. 2. Prolymphocytes may comprise ≤ 55% of blood lymphocytes. 3. Presence of ≥ 5 x 109 B lymphocytes/L (5000 μL) in the peripheral blood (at any point since diagnosis) 4. Active disease meeting ≥ 1 of the following IWCLL 2008 criteria for requiring treatment: 1. Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia (hemoglobin \< 10 g/dL) and/or thrombocytopenia (platelets \< 100,000/μL). 2. Massive (i.e., ≥ 6 cm below the left costal margin), progressive, or symptomatic splenomegaly. 3. Massive nodes (i.e., ≥ 10 cm in the longest diameter), progressive, or symptomatic lymphadenopathy. 4. Progressive lymphocytosis with an increase of \> 50% over a 2-month period or a LDT of \< 6 months. LDT may be obtained by linear regression extrapolation of ALC obtained at intervals of 2 weeks over an observation period of 2 to 3 months. In subjects with initial blood lymphocyte counts of \< 30 x 109/L (30,000/μL), LDT should not be used as a single parameter to define indication for treatment. In addition, factors contributing to lymphocytosis or lymphadenopathy other than CLL (e.g., infections) should be excluded. 5. Autoimmune anemia and/or thrombocytopenia that is poorly responsive to standard therapy. 6. Constitutional symptoms documented in the subject's chart with supportive objective measures, as appropriate, defined as ≥ 1 of the following disease-related symptoms or signs: i. Unintentional weight loss ≥ 10% within the previous 6 months before Screening. ii. Significant fatigue (i.e., ECOG performance status 2; inability to work or perform usual activities). iii. Fevers higher than 100.5°F or 38.0°C for 2 or more weeks before Screening without evidence of infection. iv. Night sweats for \> 1 month before Screening without evidence of infection. 5. This criterion was deleted as of Protocol Amendment 3. 6. Meet the following laboratory parameters: 1. ANC ≥ 750 cells/μL (0.75 x 109/L), or ≥ 500 cells/μL (0.50 x 109/L) in subjects with documented bone marrow involvement, and independent of growth factor support 7 days before assessment. 2. Platelet count ≥ 50,000 cells/μL (50 x 109/L), or ≥ 30,000 cells/μL (30 x 109/L) in subjects with documented bone marrow involvement, and without transfusion support 7 days before assessment. Subjects with transfusion-dependent thrombocytopenia are excluded. 3. Serum AST and ALT/SGPT ≤ 3.0 x ULN. 4. Total bilirubin ≤ 1.5 x ULN. 5. Estimated creatinine clearance (i.e., eGFR using Cockcroft-Gault) ≥ 30 mL/min 7. Able to receive all outpatient treatment, all laboratory monitoring, and all radiologic evaluations. 8. Women 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 or 18 months after the last dose of obinutuzumab in combination with chlorambucil, whichever is longer. Highly effective forms of contraception are defined in Section 6.4.4. 9. Men who are sexually active and can beget children must agree to use highly effective forms of contraception during the study and for 90 days after the last dose of obinutuzumab or chlorambucil, whichever is later. Highly effective forms of contraception are defined in Section 6.4.4. 10. Men must agree to refrain from sperm donation during the study and for 90 days after the last dose of obinutuzumab or chlorambucil, whichever is later. 11. Must be willing and able to adhere to the study visit schedule, understand and comply with other protocol requirements, and provide written informed consent and authorization to use protected health information (in accordance with national and local subject privacy regulations). Note vulnerable subjects, as defined in International Conference on Harmonisation (ICH) GCP, are not allowed on this protocol (e.g., prisoners or institutionalized subjects). Exclusion Criteria: 1. Any prior systemic treatment for CLL (note: Prior localized radiotherapy is allowed). 2. Known CNS lymphoma or leukemia. 3. Known prolymphocytic leukemia or history of, or currently suspected, Richter's syndrome. 4. Missing or incomplete documentation of FISH results reflecting the presence or absence of 17p del and the percentage of cells with the deletion in subject records before randomization. 5. Uncontrolled AIHA or ITP defined as declining hemoglobin or platelet count secondary to autoimmune destruction within the screening period or requirement for high doses of steroids (\> 20 mg daily of prednisone daily or equivalent). 6. Corticosteroid use \> 20 mg within 1 week before first dose of study drug, except as indicated for other medical conditions such as inhaled steroid for asthma, topical steroid use, or as premedication for administration of study drug or contrast. For example, subjects requiring steroids at daily doses \> 20 mg prednisone equivalent systemic exposure daily, or those who are administered steroids for leukemia control or WBC count lowering are excluded. 7. Major surgery within 4 weeks before first dose of study drug. 8. History of prior malignancy except for the following: 1. Malignancy treated with curative intent and with no evidence of active disease present for more than 3 years before Screening and felt to be at low risk for recurrence by treating physician. 2. Adequately treated lentigo maligna melanoma without current evidence of disease or adequately controlled non-melanomatous skin cancer. 3. Adequately treated cervical carcinoma in situ without current evidence of disease. 9. Significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of screening, or any Class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification, or QTc \> 480 msec at screening. 10. Unable to swallow capsules or malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel or gastric bypass, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction. 11. Uncontrolled active systemic fungal, bacterial, viral, or other infection (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment) or ongoing intravenous anti-infective treatment. 12. Known history of infection with HIV. 13. Vaccinated with live, attenuated vaccines within 4 weeks of first dose of study drug. 14\. Serologic status reflecting active hepatitis B or C infection. Subjects with hepatitis B core antibody positive who are surface antigen negative or who are hepatitis C antibody positive will need to have a negative PCR result before randomization. Those who are hepatitis B surface antigen positive or hepatitis B PCR positive and those who are hepatitis C PCR positive will be excluded. 15\. History of stroke or intracranial hemorrhage within 6 months before randomization. 16\. Known history of a bleeding diathesis (e.g., hemophilia, von Willebrand disease). 17\. Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists (e.g., phenprocoumon) within 7 days of first dose of study drug. 18\. Requires treatment with proton-pump inhibitors (e.g., omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, or pantoprazole). 19\. Breast feeding or pregnant. 20. Current life-threatening illness, medical condition, or organ system dysfunction which, in the Investigator's opinion, could compromise the subject's safety or put the study at risk. 21\. Concurrent participation in another therapeutic clinical trial. 22. Requires treatment with a strong CYP3A inhibitor/inducer. 23. Presence of a gastrointestinal ulcer diagnosed by endoscopy within 3 months before screening.

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Conditions

The condition(s) this trial relates to.

B-cell chronic lymphocytic leukemia

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Chronic lymphocytic leukemia

Contacts and locations

Locations

Research Site

Goodyear, Arizona, 85395, United States
Research Site

Phoenix, Arizona, 85016, United States
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Anaheim, California, 92801, United States
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Los Angeles, California, 90017, United States
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Los Angeles, California, 90033, United States
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Los Angeles, California, 90095, United States
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Oxnard, California, 93030, United States
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Palo Alto, California, 94304, United States
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Aurora, Colorado, 80045, United States
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Lone Tree, Colorado, 80124, United States
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Washington D.C., District of Columbia, 20007, United States
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Fort Myers, Florida, 33901-8101, United States
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Jacksonville, Florida, 32224, United States
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Tallahassee, Florida, 32308-5304, United States
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Tallahassee, Florida, 32308, United States
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Tampa, Florida, 33612, United States
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Niles, Illinois, 60714, United States
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Lafayette, Indiana, 47904, United States
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Wichita, Kansas, 67214, United States
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Louisville, Kentucky, 40207, United States
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New Orleans, Louisiana, 70112, United States
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COL, Maryland, 21044, United States
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Rochester, Minnesota, 55905, United States
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Saint Cloud, Minnesota, 56303, United States
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Billings, Montana, 59102, United States
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Brick, New Jersey, 08724, United States
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Hackensack, New Jersey, ?07601, United States
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Lake Success, New York, 11042, United States
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New York, New York, 10029, United States
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Blue Ash, Ohio, 45242, United States
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Canton, Ohio, 44719, United States
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Columbus, Ohio, 43210, United States
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Nashville, Tennessee, 37203, United States
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Austin, Texas, 78705, United States
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Bedford, Texas, 76022, United States
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Dallas, Texas, 75230, United States
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Fort Sam Houston, Texas, 78234, United States
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Houston, Texas, 77030, United States
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New Braunfels, Texas, 78130, United States
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Round Rock, Texas, 76508, United States
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San Antonio, Texas, 78258, United States
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Texas City, Texas, 77591, United States
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Tyler, Texas, 75702, United States
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Salt Lake City, Utah, 84112, United States
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Roanoke, Virginia, 24014, United States
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Seattle, Washington, 98109, United States
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Seattle, Washington, 98122, United States
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Spokane, Washington, 99208, United States
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Tacoma, Washington, 98405, United States
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Yakima, Washington, 98902, United States
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Northwest WA, Wisconsin, 20007, United States
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Darlinghurst, 2010, Australia
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Frankston, 3199, Australia
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Geelong, 3220, Australia
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South Brisbane, QLD 4101, Australia
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Waratah NSW, 2298, Australia
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Wollongong, 2500, Australia
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Woodville, 5011, Australia
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Bruges, 8000, Belgium
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Brussels, 1090, Belgium
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Brussels, 1200, Belgium
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Ghent, 9000, Belgium
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Kortrijk, 8500, Belgium
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Leuven, 3000, Belgium
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Roeselare, 8900, Belgium
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Wilrijk, 2610, Belgium
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Yvoir, 5530, Belgium
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Barretos, 14784-400, Brazil
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Florianópolis, 88034-000, Brazil
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Passo Fundo, 99010-260, Brazil
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Porto Alegre, 90035-903, Brazil
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Porto Alegre, 90470-340, Brazil
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São Paulo, 155, Brazil
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Vancouver, British Columbia, V5Z 4E6, Canada
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Halifax, Nova Scotia, B3H2Y9, Canada
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Québec, G1J 1Z4, Canada
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Saint John, E2L 4L2, Canada
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Winnipeg, R3E 0V9, Canada
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Santiago, 8380455, Chile
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Temuco, 4810469, Chile
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Medellín, 050034, Colombia
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Montería, 110221, Colombia
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Bobigny, 93000, France
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Dijon, 21000, France
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Pierre-Bénite, 69310, France
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Strasbourg, 67098, France
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Villejuif, 94800, France
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Aschaffenburg, 63739, Germany
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Bielefeld, 33604, Germany
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Erlangen, 91052, Germany
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Heilbronn, 74078, Germany
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Warzburg, 97080, Germany
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Budapest, 1085, Hungary
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Budapest, 1122, Hungary
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Debrecen, 4032, Hungary
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Kaposvár, 7400, Hungary
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Szolnok, 5004, Hungary
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Ashkelon, 7830604, Israel
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Beersheba, 84101, Israel
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Haifa, 31000, Israel
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Haifa, 31096, Israel
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Haifa, 34362, Israel
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Jerusalem, 9103102, Israel
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Nahariya, 22100, Israel
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Petah Tikvah, 49100, Israel
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Petah Tikvah, 49102, Israel
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Rehovot, 76100, Israel
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Tel Aviv, 64239, Israel
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Tel Litwinsky, 52621, Israel
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Tiberias, 15208, Israel
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Alessandria, 15100, Italy
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Aviano, 33081, Italy
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Brescia, 25123, Italy
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Florence, 50134, Italy
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Meldola, 47014, Italy
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Milan, 20132, Italy
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Parma, Italy
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Ravenna, 48121, Italy
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Rimini, 47900, Italy
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Rome, 168, Italy
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Rozzano, 20089, Italy
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Kaunas, LT-50009, Lithuania
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Klaipėda, LT-92288, Lithuania
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Vilnius, LT-08661, Lithuania
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Auckland, ?0620, New Zealand
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Otahuhu, 2025, New Zealand
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Tauranga, 3112, New Zealand
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Bydgoszcz, 85-168, Poland
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Gdansk, 80-129, Poland
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Gdynia, 81-519, Poland
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Krakow, 30-727, Poland
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Lodz, 93-510, Poland
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Lublin, 20-081, Poland
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Olsztyn, 10-228, Poland
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Opole, 46-020, Poland
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Słupsk, 76-200, Poland
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Barcelona, ?08041, Spain
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Madrid, 28006, Spain
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Madrid, 28031, Spain
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Madrid, 28041, Spain
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Majadahonda, 28222, Spain
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Santander, 39008, Spain
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Gothenburg, 41345, Sweden
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Linköping, 58185, Sweden
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Lund, SE-22185, Sweden
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Örebro, 701 85, Sweden
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Bournemouth, BH7 7DW, United Kingdom
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Cambridge, CB2 0QQ, United Kingdom
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Leeds, LS9 7TF, United Kingdom
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Leicester, LE1 7RH, United Kingdom
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London, SE5 9RS, United Kingdom
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Plymouth, PL6 8DH, United Kingdom
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Southampton, SO16 6YD, United Kingdom
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Truro, TR1 3LJ, United Kingdom
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Wolverhampton, WV10 0QP, United Kingdom

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