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RECRUITINGPHASE2

Time-limited Triplet Combination of Pirtobrutinib, Venetoclax, and Obinutuzumab for Patients With Treatment-naïve Chronic Lymphocytic Leukemia (CLL) or Richter Transformation (RT)

NCT05536349•M.D. Anderson Cancer Center

Summary

To learn if the combination of pirtobrutinib (also called LOXO-305), venetoclax, and obinutuzumab is safe and effective when given to patients with chronic lymphocytic leukemia (CLL) or Richter transformation (RT) who have not previously received treatment.

Detailed Description

Primary Objective: 1\. Estimate the therapeutic activity (undetectable measurable residual disease \[U-MRD\] rate) of combined pirtobrutinib, venetoclax, and obinutuzumab in patients with previously untreated CLL/SLL (cohort 1) by undetectable measurable residual disease (U-MRD) rate and Richter transformation (cohort 2) by overall response rate (ORR) (defined as CMR//PMR). Secondary Objectives: 1. To estimate the therapeutic activity of combination therapy by determining: 1. Combined response rate (defined as CR/CRi/PR) as assessed by the investigator for cohort 1 (CLL/SLL) 2. Progression free survival (PFS) and overall survival (OS). 3. U-MRD response with next generation sequencing assay for cohort 2 2. To determine the safety and tolerability of this combination therapy Exploratory Objective: 1. To study immunological and molecular changes in the peripheral blood and bone marrow in response to pirtobrutinib, venetoclax, and obinutuzumab. 2. To evaluate the kinetics of MRD response over time

Eligibility

Age

18 - No limit years

Sex

ALL

Healthy Volunteers

Inclusion Criteria

•1. Patients with a diagnosis of previously untreated CLL/SLL meeting iwCLL 2018 indication for treatment (cohort 1) or with a diagnosis of previously untreated or relapsed/refractory RT arising from CLL (cohort 2). Previously untreated patients with RT must have received prior therapy for CLL.
•2. At least 18 years of age
•3. Eastern Cooperative Oncology Group (ECOG) Performance status of 0-2
•4. Adequate hepatic function
•1. Total bilirubin ≤1.5 x upper limit of normal (ULN) or ≤3 x ULN for patients with Gilbert's disease or documented disease involvement of liver (In pts with elevated total bilirubin due to increased indirect bilirubin, pts with direct bilirubin ≤1.5 x ULN are eligible)
•2. ALT and AST ≤3.0 x ULN, or ≤5.0 x ULN if documented disease involvement of liver
•5. Adequate renal function
•a. Creatinine clearance ≥ 50 ml/min (calculated using CKD-EPI formula)
•6. Adequate hematologic function a. Platelet count ≥50 x109/L and hemoglobin ≥ 8 g/dL (≥ 80 g/L). Platelet and hemoglobin requirements are independent of transfusions within 7 days of screening assessment and first dose of study drugs.
•b. Absolute neutrophil count ≥ 0.75 x 109/L. Absolute neutrophil count is independent of growth factor support within 7 days of screening assessment and first dose of study drugs.
+29 more criteria

Exclusion Criteria

•1. Major surgery within 4 weeks prior to the first dose of study drugs
•2. Uncontrolled active systemic infection
•3. Known positive serology for human immunodeficiency virus (HIV)
•4. Active hepatitis B infection (defined as the presence of detectable HBV DNA, HBe antigen or HBs antigen). Patients with serologic evidence of prior vaccination (HBsAg negative, anti-HBs antibody positive, anti-HBc antibody negative) are eligible. Patients who are HBsAg negative/HBsAb positive but HBcAb positive are eligible, provided HBV DNA is negative and they are willing to take appropriate anti-viral prophylaxis
•5. Active hepatitis C infection (defined as detectable hepatitis C RNA in plasma by PCR)
•6. Known active cytomegalovirus (CMV) infection. Unknown or negative status are eligible
•7. Active, uncontrolled autoimmune phenomenon (autoimmune hemolytic anemia or immune thrombocytopenia) requiring steroid therapy with \> 20 mg daily of prednisone or equivalent or for which new therapy was introduced or existing therapy was escalated within the 4 weeks prior to study enrollment to maintain adequate blood counts
•8. Clinically significant, uncontrolled cardiovascular disease (≥3 NYHA heart failure, uncontrolled or symptomatic arrythmias), or myocardial infarction within 6 months, or stroke within 6 months, or intracranial bleeding within 6 months prior to start of study drugs
•9. Prolongation of the QT interval corrected for heart rate (QTcF) \> 470 msec. Note: Patients with QTcF \> 470 msec should have EKG repeated. If QTcF again is \> 470 msec, then the patient should be referred to cardiology for evaluation. Patient can be enrolled later if cleared by cardiology and repeat QTcF less than 470 msec. QTcF is calculated using Fridericia's Formula (QTcF): QTcF = QT/(RR0.33) a. Correction of suspected drug-induced QTcF prolongation can be attempted at the investigator's discretion and only if clinically safe to do so with either discontinuation of the offending drug or switch to another drug not known to be associated with QTcF prolongation.

Locations (1)

M D Anderson Cancer Center

Houston, Texas, United States

Key Dates

Start Date

December 20, 2022

Primary Completion Date

April 25, 2028

Completion Date

April 25, 2028

Last Updated

February 24, 2026

Enrollment

ESTIMATED participants

Conditions

Leukemia

Interventions

Pirtobrutinib

DRUG

Obinutuzumab

DRUG

Venetoclax

DRUG

Valacyclovir

DRUG

Allopurinol

DRUG

Contacts

Nitin Jain, MD

CONTACT

(713) 745-6080 njain@mdanderson.org

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Data Source & Attribution

This clinical trial information is sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

ClinicalTrials.gov last update: February 24, 2026Data synced to Clareo: March 29, 2026

Modifications: This data has been reformatted for display purposes. Eligibility criteria have been parsed into inclusion/exclusion sections. Location data has been geocoded to enable distance-based search. For the authoritative and most current information, please visit ClinicalTrials.gov.

Neither the United States Government nor Clareo Health make any warranties regarding the data. Check ClinicalTrials.gov frequently for updates.

View ClinicalTrials.gov Terms and Conditions

Time-limited Triplet Combination of Pirtobrutinib, Venetoclax, and Obinutuzumab for Patients With Treatment-naïve Chronic Lymphocytic Leukemia (CLL) or Richter Transformation (RT)

Inclusion Criteria

Exclusion Criteria

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