New daily pill shows promise in controlling leukemia

NCT ID NCT04008706

Disease control Sponsor: AstraZeneca Source: ClinicalTrials.gov ↗

First seen Jun 27, 2026 · Last updated Sep 02, 2026 · Updated 2 times

Summary

This study tested a daily medication called acalabrutinib in 552 adults with chronic lymphocytic leukemia (CLL), a type of blood cancer. Participants included those newly diagnosed, those whose cancer returned, and those who had previously taken a similar drug. The goal was to see if the drug is safe and helps control the cancer, but patients must keep taking it long-term to manage the disease.

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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

552 people

The number who actually took part.

Started

Sep 2019

Finished

Nov 2025

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 to 130 years

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 ≥18 years of age (or the legal age of consent in the jurisdiction in which the study is taking place) 2. Diagnosis of CLL that meets all published diagnostic criteria (Hallek et al. 2018): 1. Monoclonal B-cells (either kappa or lambda light chain restricted) that are clonally co-expressing ≥1 B-cell marker (CD19, CD20, and CD23) and CD5 during screening 2. Prolymphocytes may comprise \<55% of blood lymphocytes during screening 3. Presence of ≥5 × 10\^9 B lymphocytes/L (5000/μL) in the peripheral blood (at any point since the initial diagnosis) 3. Active disease per at least 1 of the following iwCLL 2018 criteria 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 lymphocyte doubling time (LDT) of \<6 months. LDT may be obtained by linear regression extrapolation of absolute lymphocyte count obtained at intervals of 2 weeks over an observation period of 2 to 3 months. In participants with initial blood lymphocyte counts of \<30x10\^9/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. B-symptoms documented in the participant's chart with supportive objective measures, as appropriate, defined as ≥1 of the following disease-related symptoms or signs: o- Unintentional weight loss ≥10% within the previous 6 months before screening o- Significant fatigue (Eastern Cooperative Oncology Group \[ECOG\] performance status ≥2; inability to work or perform usual activities) o- Fevers higher than 100.5°F or 38.0°C for ≥2 weeks o- Night sweats for ≥1 month before screening without evidence of infection 4. Must meet one of the following criteria: a. Have received no prior therapy for treatment of CLL and meets one of the following criteria (for this study, participants in the UK will be enrolled ONLY in the R/R or the prior ibrutinib cohort): i. A score of \>6 on the Cumulative Illness Rating Scale (CIRS) ii. Creatinine clearance of 30 to 69 mL/min using the Cockcroft-Gault equation b. Have previously received therapy for CLL and have either refractory or relapsed CLL c. Have received prior ibrutinib therapy (i.e., defined as a participant who discontinued a ibrutinib for any reason prior to disease progression) for CLL (participants in the US will not be enrolled into the prior ibrutinib therapy cohort) 5. ECOG performance status of ≤2 6. Female participants of childbearing potential (i.e., not surgically sterile or postmenopausal) who are sexually active with a non-sterilized male partner must use ≥1 highly effective method of contraception from the time of screening and must agree to continue using such precautions for 2 days after the last dose of study intervention. Contraception measures and restrictions on sperm donation are not required for male participants. 7. Fluorescence in situ hybridization (FISH) for which the next-generation sequencing (NGS) method is preferred) within 60 days during screening up to before the first dose reflecting the presence or absence of del(17p), del(13q), del(11q), and trisomy of chromosome 12 along with the percentage of cells with the deletion, along with TP53 sequencing. Participants must also have molecular analysis to detect IGHV mutation status (NGS is the preferred method) at screening if not done at any time point before that since diagnosis. 8. Each participant (or legally authorized representative if allowed per local regulations) 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. Exclusion Criteria: 1. Participants who have had disease progression while on a BTKi for any malignant or nonmalignant condition 2. Prior malignancy (other than CLL), except for adequately treated basal cell or squamous cell skin cancer, in situ cancer, early stage prostate cancer, or other cancer from which the participant has been disease-free for ≥2 years 3. History of confirmed progressive multifocal leukoencephalopathy 4. Significant cardiovascular disease such as symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months before screening, or any Class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification, or corrected QT interval using Fridericia's formula (QTcF) \>480 msec at screening. Note: Participants with rate-controlled, asymptomatic atrial fibrillation are allowed to enroll in the study (For prior ibrutinib therapy cohort only, except in Finland and the Republic of South Korea, where this is applicable to all 3 cohorts; also, the prior ibrutinib therapy cohort will not be enrolled in the US). 5. Malabsorption syndrome, disease significantly affecting gastrointestinal (GI) function, resection of the stomach, extensive small bowel resection that is likely to affect absorption, symptomatic inflammatory bowel disease, partial or complete bowel obstruction, or gastric restrictions and bariatric surgery, such as gastric bypass. 6. Evidence of active Richter's transformation. If Richter's transformation is suspected (i.e., lactate dehydrogenase \[LDH\] increased, asymmetric fast lymph node growth or clinical suspicion), it should be ruled out with positron emission tomographycomputed tomography (PET-CT) and/or biopsy according to guidelines. 7. Central nervous system (CNS) involvement by CLL. 8. Known history of human immunodeficiency virus, serologic status reflecting active hepatitis B virus or hepatitis C virus infection, any uncontrolled active systemic infection along with participants who are on ongoing anti-infective treatment and participants who have received vaccination with a live attenuated vaccine within 4 weeks before the first dose of study intervention. 1. Participants who are hepatitis B core antibody (anti-HBc) positive and who are hepatitis B surface antibody (anti-HBs) negative will need to have a negative hepatitis B virus PCR result before enrollment. Those who are hepatitis B surface antigen (HBsAg) positive or hepatitis B virus PCR positive will be excluded. 2. Participants who are hepatitis C virus antibody positive will need to have a negative hepatitis C virus PCR result before enroll.lment. Those who are hepatitis C virus PCR positive will be excluded 9. Uncontrolled autoimmune hemolytic anemia or idiopathic thrombocytopenic purpura 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 or equivalent for longer than 2 weeks). 10. History of stroke or intracranial hemorrhage within 6 months before the first dose of study intervention. 11. History of bleeding diathesis (e.g., hemophilia or von Willebrand disease) 12. Presence of a gastrointestinal ulcer diagnosed by endoscopy within 3 months before screening. 13. Major surgical procedure within 4 weeks before first dose of study intervention. Note: Participants who have had major surgery must have recovered adequately from any toxicity and/or complications from the intervention before the first dose of study intervention. 14. Requires treatment with proton-pump inhibitors (e.g., omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, or pantoprazole). Participants receiving proton-pump inhibitors who switch to H2-receptor antagonists or antacids are eligible for enrollment in this study. 15. All participants requiring or receiving anticoagulation with warfarin or equivalent vitamin K antagonists (e.g., phenprocoumon) within 7 days before first dose of study intervention. Based on the known metabolic/transport pathways involved in the disposition of acalabrutinib and the commonly known novel oral anticoagulants (eg, apixaban, rivaroxaban, and edoxaban), no clinically relevant interaction is expected following coadministration of these agents. 16. Absolute neutrophil count (ANC) \<0.50 x 10\^9/L or platelet count \<30 x 10\^9/L, unless proven due to CLL and raised above the limits by granulocyte colony-stimulating factor (G-CSF) therapy and/or pooled platelet transfusion 17. Total bilirubin \>3.0x upper limit of normal (ULN); or aspartate aminotransferase or alanine aminotransferase \>3.0x ULN. Exception will be for Gilbert syndrome; if an investigator feels that a participant's total bilirubin is elevated secondary to Gilbert's, the participant must have a documented unconjugated bilirubin being \>80% of the total bilirubin number. The investigator must also document that hemolysis has been ruled out along with (near)-normal lactate dehydrogenase and haptoglobin 18. Estimated creatinine clearance of \<30 mL/min, calculated using the formula of Cockcroft and Gault or by direct assessment (i.e., creatinine clearance or ethylene diamine tetra-acetic acid (EDTA) clearance measurement) 19. Breastfeeding or pregnant 20. Received any chemotherapy, external beam radiation, investigational drug, or any other anti-CLL therapy within 30 days before first dose of study intervention 21. Concurrent participation in another therapeutic clinical study 22. History of or ongoing interstitial lung disease 23. Requiring long-term (\> 1 week) treatment with a strong cytochrome CYP3A inhibitor/inducer. In addition, the use of strong or moderate CYP3A inhibitors or inducers within 7 days of the first dose of study intervention is prohibited.

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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

Chandler, Arizona, 85224, United States
Research Site

Long Beach, California, 90806, United States
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Redlands, California, 92373, United States
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Whittier, California, 90603, United States
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Fort Myers, Florida, 33908, United States
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Jacksonville, Florida, 32256, United States
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St. Petersburg, Florida, 33705, United States
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Marietta, Georgia, 30060, United States
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Normal, Illinois, 61761, United States
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Peoria, Illinois, 61615, United States
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Fort Wayne, Indiana, 46845, United States
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Indianapolis, Indiana, 46260, United States
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Shreveport, Louisiana, 71105, United States
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Saint Cloud, Minnesota, 56303, United States
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Kansas City, Missouri, 64132, United States
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Bethlehem, Pennsylvania, 18015, United States
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Chattanooga, Tennessee, 37404, United States
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Nashville, Tennessee, 37203, United States
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Dallas, Texas, 75235, United States
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Adelaide, 5000, Australia
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Bedford Park, 5042, Australia
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Clayton, 3168, Australia
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Fitzroy, 3065, Australia
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Nedlands, 6009, Australia
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South Brisbane, 4101, Australia
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Belo Horizonte, 30130-100, Brazil
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Curitiba, 81520-060, Brazil
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Goiânia, 74605-020, Brazil
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Porto Alegre, 90035-003, Brazil
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Porto Alegre, 90110-270, Brazil
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Ribeirão Preto, 14048-900, Brazil
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São Paulo, 01236-030, Brazil
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São Paulo, 01323-900, Brazil
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Calgary, Alberta, T2N 4N2, Canada
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Edmonton, Alberta, T6G 1Z2, Canada
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Victoria, British Columbia, V8R 6V5, Canada
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Winnipeg, Manitoba, R3E 0V9, Canada
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Halifax, Nova Scotia, B3H 1V7, Canada
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Brampton, Ontario, L6R 3J7, Canada
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Newmarket, Ontario, L3Y 2P9, Canada
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Ottawa, Ontario, K1H 8L6, Canada
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Aalborg, 9100, Denmark
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Aarhus, 8200, Denmark
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Herlev, 2730, Denmark
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København Ø, 2100, Denmark
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Odense, 5000, Denmark
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Roskilde, 4000, Denmark
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Hus, 00029, Finland
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Kuopio, 70210, Finland
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Tampere, 33521, Finland
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Bordeaux, 33076, France
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Brest, 29609, France
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Limoges, 87042, France
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Reims, 51092, France
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Tours, 37000, France
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Vandœuvre-lès-Nancy, 54511, France
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Bayern, 63739, Germany
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Essen, 45147, Germany
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Homburg, 66421, Germany
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Porta Westfalica, 32457, Germany
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Schwäbisch Hall, 74523, Germany
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Catanzaro, 88100, Italy
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Milan, 20122, Italy
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Roma, 00161, Italy
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Roma, 00168, Italy
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Siena, 53100, Italy
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Arnhem, 6815 AD, Netherlands
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Dordrecht, 3318 AT, Netherlands
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Utrecht, 3584 CX, Netherlands
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Bergen, 5053, Norway
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Oslo, 1478, Norway
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Trondheim, 7006, Norway
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Moscow, 115478, Russia
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Moscow, 125167, Russia
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Moscow, 125284, Russia
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Nizhny Novgorod, 603126, Russia
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Petrozavodsk, 185019, Russia
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Saint Petersburg, 191024, Russia
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Saint Petersburg, 194291, Russia
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Saint Petersburg, 197022, Russia
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Saint Petersburg, 197110, Russia
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Saint Petersburg, 197341, Russia
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Smolensk, 214015, Russia
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Smolensk, 214031, Russia
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Syktyvkar, 167904, Russia
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Busan, 49241, South Korea
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Seoul, 03080, South Korea
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Seoul, 03722, South Korea
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Seoul, 06591, South Korea
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Seoul, 135-710, South Korea
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Ulsan, 44033, South Korea
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Barcelona, 08036, Spain
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Madrid, 28006, Spain
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Madrid, 28041, Spain
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Marbella, 29603, Spain
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Ourense, 32005, Spain
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Oviedo, 33011, Spain
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Vitoria-Gasteiz, 01009, Spain
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Zaragoza, 50009, Spain
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Luleå, 97180, Sweden
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Lund, 221 85, Sweden
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Uppsala, 75185, Sweden
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Taichung, 40705, Taiwan
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Tainan, 704, Taiwan
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Taipei, 10002, Taiwan
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Taipei, 11217, Taiwan
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Liverpool, L7 8XP, United Kingdom
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Newmarket, CB8 7XN, United Kingdom

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