Can a targeted drug boost the fight against an aggressive blood cancer?

NCT ID NCT03899337

Ongoing Disease control Sponsor: University of Birmingham Source: ClinicalTrials.gov ↗

First seen Aug 07, 2026 · Last updated Aug 07, 2026

Summary

This trial is testing whether adding the targeted drug acalabrutinib to the standard CHOP-R chemotherapy regimen can improve outcomes for people newly diagnosed with Richter's syndrome, an aggressive lymphoma that can develop from chronic lymphocytic leukemia (CLL). Richter's syndrome is hard to treat and life expectancy is often short, so better first-line options are needed. The study will compare CHOP-R plus acalabrutinib against CHOP-R alone, and will also serve as a platform to test other promising new drugs for this disease. Participants will receive standard CHOP-R treatment in the hospital, with half also taking acalabrutinib capsules twice daily.

What this could mean

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

Active substance: Acalabrutinib combined with standard chemotherapy (CHOP-R: cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab)
What this could lead to: If adding acalabrutinib to standard chemoimmunotherapy works, it could extend the time people with Richter's syndrome live without their cancer progressing, offering a more effective first-line treatment.
What could go wrong: This is a phase II trial with a relatively small number of participants, so results may not be definitive. Acalabrutinib can cause side effects like bleeding, infections, and heart rhythm problems, and the combination may not prove more effective than standard care.

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Conditions

The condition(s) this trial relates to.

diffuse large B-cell lymphoma Leukemia, B-Cell non-Hodgkin lymphoma Richter transformation

As listed by the trial registrant

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

RICHTER SYNDROME

Contacts and locations

Locations

Beatson West of Scotland Cancer Centre

Glasgow, United Kingdom
Belfast City Hospital

Belfast, United Kingdom
Christie Hospital

Manchester, United Kingdom
Churchill Hospital

Oxford, United Kingdom
Derriford Hospital

Plymouth, United Kingdom
King's College Hospital

London, United Kingdom
Leicester Royal Infirmary

Leicester, United Kingdom
Norfolk and Norwich University Hospital

Norwich, United Kingdom
Nottingham City Hospital

Nottingham, United Kingdom
Royal Bournemouth Hospital

Bournemouth, United Kingdom
Royal Hallamshire Hospital

Sheffield, United Kingdom
Royal Marsden Hospital

Sutton, United Kingdom
Southampton General Hospital

Southampton, United Kingdom
St Bartholomew's Hospital

London, United Kingdom
St James's University Hospital

Leeds, United Kingdom
University College London Hospital

London, United Kingdom
University Hospital of Wales

Cardiff, United Kingdom

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