About this trial
This Phase II hybrid decentralized multicenter study examines the outcomes of stopping Bruton tyrosine kinase inhibitor (BTKi) therapy in patients with chronic lymphocytic leukemia (CLL) who have remained in remission for at least two years. The primary objective is to determine how long patients remain free from disease progression or death after discontinuing treatment, measured as event free survival.
The study also evaluates whether stopping BTKi therapy leads to improvements in quality of life and reductions in treatment related side effects. Researchers will follow patients over time to assess if the cancer returns, whether resistance to therapy develops, and how patients feel during the treatment free period.
In addition, the trial will investigate how discontinuing BTKi therapy affects immune function, including whether immune recovery occurs and infection risk decreases.
Preliminary data indicate that patients may experience a treatment free interval exceeding two years after stopping therapy, with associated improvements in quality of life. By prospectively evaluating a time limited treatment strategy, this trial aims to determine whether durable disease control can be maintained off therapy while also assessing the resolution of BTKi related adverse events and changes in patient reported outcomes.
Overall, the study seeks to determine whether patients can safely discontinue BTKi therapy and potentially restart treatment later if needed, thereby maintaining disease control while reducing the burden of continuous therapy.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Written informed consent obtained to participate in the study and HIPAA authorization for release of personal health information.
Subjects is willing and able to comply with study procedures based on the judgement of the investigator.
Age ≥ 18 years at the time of consent.
Eastern Cooperative Oncology Group Performance Status of 0-3 or Karnofsky Performance Status of ≥40
Disqualifiers
Patients must not have evidence of progressive CLL as defined by IWCLL 2018 criteria.
Participants with history of malignancy other than CLL/SLL are allowed
Trial design
Single group
Treatments tested in this trial
Discontinuing Bruton tyrosine kinase inhibitors (BTKi) therapy
Other interventionDiscontinuing Bruton tyrosine kinase inhibitors (BTKi) therapy.
Treatment groups
Trial outcomes
Primary outcomes
Event-free survival (EFS)
EFS will be defined as the proportion of patients who remain alive, do not meet International Workshop on Chronic Lymphocytic Leukemia (IWCLL) criteria for initiation of next chronic lymphocytic leukemia (CLL) therapy, and have not started a new CLL - directed treatment.
Secondary outcomes
Progression Free Survival (PFS)
Progression Free Survival (PFS) will be defined as the proportion of patients who remain alive, free of relapse from complete response or partial response, free of progression of chronic lymphocytic leukemia (CLL), and have not started a new CLL treatment at 2 years after discontinuation of Bruton tyrosine kinase inhibitors (BTKi).
Overall Survival (OS)
Overall Survival (OS) will be defined as the proportion of patients who remain alive after discontinuation of Bruton tyrosine kinase inhibitors (BTKi).
Time to initial detection of measurable residual disease (MRD)
Time to initial detection of measurable residual disease (MRD) or clinical evidence of progression will respectively be defined as the time from discontinuation of BTKi to initial detection of MRD (via flow cytometry) or progression of CLL that meets IWCLL criteria and/or treating physician requirement for initiation of next CLL therapy.
Overall and complete response rates
Overall and complete response rates will be defined as the percentage of patients who respectively achieve overall and complete response to next CLL therapy, based on IWCLL criteria.
Sponsors and contacts
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