About this trial
This phase II trial tests the effect of nemtabrutinib in combination with rituximab in treating patients with marginal zone lymphoma. Nemtabrutinib, a non-covalent Bruton's tyrosine kinase (BTK) inhibitor, may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Rituximab is a monoclonal antibody. It binds to a protein called CD20, which is found on B cells (a type of white blood cell) and some types of cancer cells. This may help the immune system kill cancer cells. Giving nemtabrutinib in combination with rituximab may be safe, tolerable and/or effective in treating patients with marginal zone lymphoma.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Documented informed consent of the participant and/or legally authorized representative
Assent, when appropriate, will be obtained per institutional guidelines
Age: ≥ 18 years
Eastern Cooperative Oncology Group (ECOG) ≤ 2
Disqualifiers
Evidence of diffuse large B-cell lymphoma (DLBCL) transformation
Subjects with presumptive evidence of transformation based on clinical assessment of factors such as, but not limited to, increasing lactate dehydrogenase, rapidly worsening disease, or frequent B-symptoms, must be ruled out for a transformation to a more aggressive disease, such as DLBCL
History of central nervous system lymphoma (either primary or metastatic) or leptomeningeal disease
Active graft versus host disease
Trial design
Single group
Treatments tested in this trial
Biopsy Procedure
Procedure/SurgeryUndergo tissue biopsy
Biospecimen Collection
Procedure/SurgeryUndergo blood sample collection
Bone Marrow Biopsy
Procedure/SurgeryUndergo bone marrow biopsy
Computed Tomography
Procedure/SurgeryUndergo CT or PET/CT
Magnetic Resonance Imaging
Procedure/SurgeryUndergo MRI
Nemtabrutinib
DrugGiven PO
Positron Emission Tomography
Procedure/SurgeryUndergo PET/CT
Rituximab
Biological/VaccineGiven IV
Treatment groups
Trial outcomes
Primary outcomes
Incidence of unacceptable toxicity (Safety lead-in)
Observed toxicities will be summarized by type, severity, and attribution.
Complete response (CR) rate (Phase 2)
Will be defined as achieving a best response of CR at any time on the study prior to any disease progression or start of other non-protocol anti-lymphoma therapy. CR rate will be estimated along with the 95% exact binomial confidence interval.
Secondary outcomes
Overall response rate (ORR)
Will be defined as achieving a best response of either CR or partial response (PR) any time on the study prior to any disease progression or start of other anti-lymphoma therapy. ORR will be estimated along with the 95% exact binomial confidence interval.
Progression-free survival (PFS)
Will be estimated using the product-limit method of Kaplan and Meier along with the Greenwood estimator of standard error, 95% confidence interval will be constructed based on log-log transformation. Median PFS will be estimated when possible.
Duration of response (DOR)
Will be estimated using the product-limit method of Kaplan and Meier along with the Greenwood estimator of standard error, 95% confidence interval will be constructed based on log-log transformation. Median DOR will be estimated when possible.
Overall survival (OS)
Will be estimated using the product-limit method of Kaplan and Meier along with the Greenwood estimator of standard error, 95% confidence interval will be constructed based on log-log transformation. Median OS will be estimated when possible.
Sponsors and contacts
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City of Hope Medical Center
Lead sponsor
National Cancer Institute (NCI)
Collaborator