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Brief Title: Comparison Between Rituximab Plus Zanubrutinib Versus Rituximab Monotherapy in Untreated SMZL Patients
Official Title: Phase 3, Interventional, Multicentre, Open-label, Randomized Study Comparing Rituximab Plus Zanubrutinib to Rituximab Monotherapy in Previously Untreated, Symptomatic Splenic Marginal Zone Lymphoma (RITZ)
Study ID: NCT05735834
Brief Summary: The goal of this clinical trial is to compare the efficacy and tolerability of the combination of two medicinal products, rituximab, and zanubrutinib, compared to rituximab monotherapy in patients with Splenic Marginal Zone Lymphoma (SMZL), previously untreated and who need systemic treatment. The main questions it aims to answer are: * Is the combination rituximab and zanubrutinib a more effective therapy than rituximab monotherapy? * Is the combination therapy, rituximab and zanubrutinib, well tolerated? Study participants will be put into one of the two treatment groups (rituximab and zanubrutinib or rituximab alone) for a maximum of two years and will undergo regular visits until three years from treatment start.
Detailed Description: Phase III, interventional, multicenter, open label, randomized study to evaluate whether treatment with zanubrutinib in combination with rituximab will result in an improvement in Progression Free Survival (PFS) compared to treatment with rituximab in patients with previously untreated splenic marginal zone lymphoma (SMZL). Approximately 120 subjects will be randomized in a 1:1 ratio to receive zanubrutinib and rituximab (Treatment Arm A) or rituximab (Treatment Arm B). The study will include a Screening Phase, a Treatment Phase, and a Follow-Up Phase. Subjects with investigator-confirmed progressive disease (PD) according to the Lugano 2014 criteria or unacceptable toxicity, or investigator/subject decision must discontinue study treatment. Patients who complete the treatment and patients who will discontinue treatment for any reason will enter the Follow-up Phase. The Response Follow-up Phase will occur for subjects who complete the treatment or discontinue for reasons other than disease progression and will include efficacy assessments every 24 weeks until investigator-assessed disease progression. Subjects with PD during the Response Follow-up Phase will continue to be followed in the Survival Follow-up Phase. An Independent Data Monitoring Committee (IDMC) will be responsible for independent review of the interim safety analysis on the first 20 enrolled patients in the experimental arm.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Aarhus University Hospital, Aarhus, , Denmark
Institut Bergonié, Bordeaux, , France
CHU de Grenoble, Grenoble, , France
Hôpital Saint Louis, Paris, , France
Hôpital Lyon-Sud, Pierre-Bénite, , France
CHRU Nancy Brabois, Vandœuvre-lès-Nancy, , France
IRCCS Istituto Tumori Giovanni Paolo II, Bari, , Italy
IRCCS AOU di Bologna, Bologna, , Italy
ASST Spedali Civili di Brescia, Brescia, , Italy
A.O.U. Policlinico G. Rodolico-S. Marco, Catania, , Italy
IRCCS IRST Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori", Meldola, , Italy
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, , Italy
IRCCS Ospedale San Raffaele, Milan, , Italy
ASST Grande Ospedale Metropolitano Niguarda, Milan, , Italy
Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, , Italy
Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, , Italy
IRCCS Policlinico San Matteo, Pavia, , Italy
Ospedale Santa Maria delle Croci, Ravenna, , Italy
USL-IRCCS of Reggio Emilia, Arcispedale Santa Maria Nuova, Reggio Emilia, , Italy
Policlinico Tor Vergata, Rom, , Italy
Policlinico Santa Maria alle Scotte, Siena, , Italy
Ospedale di Circolo e Fondazione Macchi - ASST dei Sette Laghi, Varese, , Italy
Oslo University Hospital, Oslo, , Norway
Hospedal Clinic de Barcelona, Barcelona, , Spain
Hospital del Mar, Barcelona, , Spain
Istitut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, , Spain
Hospital Universitario Cruces, Bilbao, , Spain
Hospital Virgen Arrixaca, El Palmar, , Spain
Hospital 12 De Octubre, Madrid, , Spain
Hospital Gregorio Marañón, Madrid, , Spain
Hospital Ramon y Cajal, Madrid, , Spain
Clinica Universidad de Navarra, Pamplona, , Spain
Hospital De Salamanca, Salamanca, , Spain
Hospital De Donostia, San Sebastián, , Spain
Hospital Clinico De Valencia, Valencia, , Spain
Hospital Universitario Miguel Servet, Zaragoza, , Spain
Karolinska University Hospital, Stockholm, , Sweden
Oncology Institute of Southern Switzerland, Bellinzona, , Switzerland
INSELSPITAL, Bern University Hospital, Bern, , Switzerland
Name: Davide Rossi, MD
Affiliation: Oncology Institute of Southern Switzerland - Bellinzona (Switzerland)
Role: STUDY_CHAIR
Name: Emanuele Zucca, MD
Affiliation: International Extranodal Lymphoma Study Group (IELSG) - Bellinzona (Switzerland)
Role: STUDY_CHAIR
Name: Luca Arcaini, MD
Affiliation: Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Role: STUDY_CHAIR