Relapsed/Refractory Waldenstrom MacroglobulinemiaPhase 2ZUMA-25NCT05537766
Study of Brexucabtagene Autoleucel in Adults With Rare B-cell Malignancies
A Phase 2 study testing Brexucabtagene Autoleucel, Cyclophosphamide and Fludarabine in people with Relapsed/Refractory Waldenstrom Macroglobulinemia and Relapsed/Refractory Richter Transformation, run by Kite, A Gilead Company at 26 sites in 8 countries.
Trial summary
Master protocol: The goal of this master clinical study is to test how well the study drug, brexucabtagene autoleucel, works in participants with rare B-cell malignancies: relapsed/refractory Waldenstrom macroglobulinemia (r/r WM) (Substudy A), r/r Richter transformation (RT) (Substudy B), r/r Burkitt lymphoma (BL)… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Relapsed/Refractory Waldenstrom Macroglobulinemia, Relapsed/Refractory Richter Transformation, Relapsed/Refractory Burkitt Lymphoma
- What is being tested?
- Brexucabtagene Autoleucel, Cyclophosphamide and Fludarabine
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 19 participants
- Where
- 26 sitesin 8 countries
- Study dates
- 1 Nov 2022to 27 Jan 2025
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- All Substudies:
- Presence of toxicities due to prior therapy must be stable and recovered to Grade 1 or lower.
- Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
- Adequate hematologic and end-organ function.
- Individuals of childbearing potential who engage in heterosexual intercourse must agree to use specified method(s) of contraception.
- Substudy B:
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- Confirmed diagnosis of chronic lymphocytic leukemia (CLL) based on International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2018 criteria with histologically confirmed Richter transformation (RT) to a diffuse large B-cell lymphoma (DLBCL) subtype.
- Relapsed or refractory disease after 1 line of therapy, defined as at least 1 of the following:
- Refractory disease, defined as progressive disease or stable disease as best response to first-line therapy.
- Relapsed disease, defined as complete remission to first-line therapy followed by biopsy-proven disease relapse.
- At least 1 measurable lesion based on the Lugano Classification. Lesions that have been previously irradiated will be considered measurable only if progression has been documented following completion of radiation therapy.
- Substudy C:
- Histologically confirmed mature B-cell non-Hodgkin lymphoma (NHL) Burkitt lymphoma/leukemia.
- Relapsed or refractory disease after first-line chemoimmunotherapy, defined as 1 of the following:
- Refractory disease, defined as progressive disease or stable disease as best response to first-line therapy; individuals who are intolerant to first-line therapy are excluded.
- Relapsed disease, defined as complete remission to first-line therapy followed by biopsy-proven disease relapse.
- At least 1 measurable lesion based on the Lugano Classification. Lesions that have been previously irradiated will be considered measurable only if progression has been documented following completion of radiation therapy.
Who cannot join
- All Substudies:
- Prior chimeric antigen receptor (CAR) therapy or treatment with any anti-Cluster of Differentiation 19 (CD19) therapy.
- human immunodeficiency virus (HIV)-positive patients, unless taking appropriate anti-HIV medications, having an undetectable viral load by quantitative polymerase chain reaction (qPCR) and a CD4 count > 200 cells/μL.
- Presence of detectable cerebrospinal fluid malignant cells or brain metastases.
- History of autoimmune disease (eg, Crohn's disease, rheumatoid arthritis, systemic lupus).
- Substudy B:
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- Diagnosis of RT not of DLBCL subtype (including, but not limited to, Hodgkin lymphoma (HL) and prolymphocytic leukemia).
- Prior allogeneic or autologous stem cell transplant < 3 months prior to screening and/or < 4 months prior to planned infusion of brexucabtagene autoleucel.
- Presence of active graft-versus-host disease following prior stem cell transplant.
- Substudy C:
- Burkitt-like lymphoma with 11q aberration, high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangement, or high-grade B-cell lymphoma not otherwise specified.
- Prior allogeneic stem cell transplant < 3 months prior to screening and/or < 4 months prior to planned infusion of brexucabtagene autoleucel.
- Presence of active graft-versus-host disease following prior allogeneic stem cell transplant.
- Presence of central nervous system (CNS) involvement. Individuals with a prior history of CNS involvement are eligible if they show a negative cerebrospinal fluid (CSF) and no involvement by imaging.
- Substudies A and D have been early terminated by the sponsor.
- Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Trial locations and contacts
26 sites in 8 countries.
26 sites in 8 countries
United States12 sites
The Ohio State University Wexner Medical Center - James Cancer HospitalS
Columbus, Ohio, 43210
Colorado Blood Cancer Institute
Denver, Colorado, 80218
City of Hope (City of Hope National Medical Center)
Duarte, California, 91010
Hackensack University Medical Center
Hackensack, New Jersey, 07601
MD Anderson Cancer Center
Houston, Texas, 77030
University of Iowa
Iowa City, Iowa, 52242
Tennessee Oncology, PLLC
Nashville, Tennessee, 37203
Vanderbilt University
Nashville, Tennessee, 37232
UPMC Hillman Cancer Center
Pittsburgh, Pennsylvania, 15232
Washington University School of Medicine
St Louis, Missouri, 63110
Stanford Cancer Institute
Stanford, California, 94305
Georgetown University Medical Centre
Washington D.C., District of Columbia, 20037
Germany3 sites
Universitatsklinikum Koln
Cologne, 50937
Universitatsklinikum Heidelberg
Heidelberg, 69120
Universitatsklinikum Ulm
Ulm, 89081
Italy3 sites
IRCCS Azienda Ospedaliero - Universitaria di Bologna
Bologna, 40138
ASST Grande Ospedale Metropolitano Niguarda
Milan, 20162
Azienda Ospedale di Perugia - Ospedale S. Maria della Misericordia
Perugia, 06132
Spain3 sites
Hospital Clinic de Barcelona
Barcelona, 08036
Hospital Universitario de Salamanca
Salamanca, 37007
Hospital Universitario Virgen del Rocio
Seville, 41013
France2 sites
Hopital de la Pitie Salpetriere
Paris, 75013
Centre hospitalier de Toulouse - Hematology department
Toulouse, 31059
Austria1 site
Medical University of Vienna, Department of Internal Medicine I, Div. of Hematology
Vienna, 01090
Netherlands1 site
Radboud University Nijmegen Medical Centre
Nijmegen, 6525 GA
Switzerland1 site
Istituto Oncologico Della Svizzera Italiana (IOSI)
Bellinzona, 6500
About this study
Official title: A Phase 2, Open-Label, Multicenter, Basket Study Evaluating the Efficacy of Brexucabtagene Autoleucel in Adults With Rare B-cell Malignancies (ZUMA-25)
Master protocol: The goal of this master clinical study is to test how well the study drug, brexucabtagene autoleucel, works in participants with rare B-cell malignancies: relapsed/refractory Waldenstrom macroglobulinemia (r/r WM) (Substudy A), r/r Richter transformation (RT) (Substudy B), r/r Burkitt lymphoma (BL) (Substudy C) and r/r hairy cell leukemia (HCL) (Substudy D).
Read the detailed description
This study will use a basket study design with separate, indication-specific substudies, to investigate r/r RT and r/r BL.
After completing the treatment period, all participants will be followed in the post-treatment follow-up period. Thereafter, participants will transition to a separate long-term follow-up study (KT-US-982-5968) to continue follow-up out to 15 years.
All substudies have been early terminated by the sponsor. Below is summary of enrollment in each Substudy:
- Substudy-A This substudy was withdrawn. Therefore no participants were enrolled.
- Substudy-B enrollment closed, actual enrollment is 6.
- Substudy-C enrollment closed, actual enrollment is 12.
- Substudy-D enrollment closed, actual enrollment is 1.
- Conditions
- Relapsed/Refractory Waldenstrom Macroglobulinemia, Relapsed/Refractory Richter Transformation, Relapsed/Refractory Burkitt Lymphoma, Relapsed/Refractory Hairy Cell Leukemia
- Being tested
- Brexucabtagene Autoleucel, Cyclophosphamide, Fludarabine
- Medical subject headings
- Waldenstrom Macroglobulinemia, Recurrence, Burkitt Lymphoma, Leukemia, Hairy Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Brexucabtagene AutoleucelBiological
Also called KTE-X19
Administered intravenously
CyclophosphamideDrug
Administered intravenously
FludarabineDrug
Administered intravenously
| Study group | Role | What they receive |
|---|---|---|
| Substudy A (Relapsed/Refractory Waldenstrom Macroglobulinemia): Brexucabtagene Autoleucel | Experimental | Participants with Relapsed/Refractory Waldenstrom Macroglobulinemia will receive the following treatment during the study:Lymphodepletion chemotherapy regimen of fludarabine 30 mg/m^2/day intravenously (IV) and cyclophosphamide 500 mg/m^2/day IV for 3 days (Day -5 to Day -3). A single IV infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-cluster of differentiation 19 (CD19) chimeric antigen receptor (CAR) T cells/kg on Day 0. Receives: Biological: Brexucabtagene Autoleucel; Drug: Cyclophosphamide; Drug: Fludarabine |
| Substudy B (Relapsed/Refractory Richter Transformation): Brexucabtagene Autoleucel | Experimental | Participants with Relapsed/Refractory Richter Transformation will receive the following treatment during the study: Lymphodepletion chemotherapy regimen of fludarabine 30 mg/m^2/day IV and cyclophosphamide 500 mg/m^2/day IV for 3 days (Day -5 to Day -3).A single IV infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-CD19 CAR T cells/kg on Day 0. Receives: Biological: Brexucabtagene Autoleucel; Drug: Cyclophosphamide; Drug: Fludarabine |
| Substudy C (Relapsed/Refractory Burkitt Lymphoma): Brexucabtagene Autoleucel | Experimental | Participants with Relapsed/Refractory Burkitt Lymphoma will receive the following treatment during the study:Lymphodepletion chemotherapy regimen of fludarabine 30 mg/m^2/day IV and cyclophosphamide 500 mg/m^2/day IV for 3 days (Day -5 to Day -3).A single IV infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-CD19 CAR T cells/kg on Day 0. Receives: Biological: Brexucabtagene Autoleucel; Drug: Cyclophosphamide; Drug: Fludarabine |
| Substudy D (Relapsed/Refractory hairy cell leukemia): Brexucabtagene Autoleucel | Experimental | Participant with Relapsed/Refractory Hairy Cell Leukemia will receive the following treatment during the study: Lymphodepletion chemotherapy regimen of fludarabine 30 mg/m^2/day IV and cyclophosphamide 500 mg/m^2/day IV for 3 days (Day -5 to Day -3). A single IV infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-CD19 CAR T cells/kg on Day 0. Receives: Biological: Brexucabtagene Autoleucel; Drug: Cyclophosphamide; Drug: Fludarabine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Substudy A: Combined Rate of Complete Response (CR) and Very Good Partial Response (VGPR) Determined by Central Assessment Per the Sixth International Workshop in Waldenstrom Macroglobulinemia (WM)
The combined rate of CR and VGPR was defined as the percentage of participants who achieved a best response of either CR or VGPR per the Sixth International Workshop in WM.
Measured: Up to 2 years
Substudy B: Objective Response Rate (ORR) Determined by Central Assessment Per the Lugano Classification
ORR was defined as the percentage of participants who achieved a best response of either CR or PR per the Lugano Classification.
Measured: Up to 2 years
Substudy C: ORR Determined by Central Assessment Per the Lugano Classification
ORR was defined as the percentage of participants who achieved a best response of either CR or PR per the Lugano Classification.
Measured: Up to 2 years
Substudy D: ORR Determined by Central Assessment Per the Response Criteria Described by Grever and Colleagues
ORR was defined as the percentage of participants who achieved a best response of either CR or PR per Grever and colleagues. CR: Near normalization of peripheral blood counts: hemoglobin >11 g/dL (without transfusion); platelets >100 000/μL; absolute neutrophil count >1500/μL. Regression of splenomegaly on physical examination. Absence of morphologic evidence of HCL on both the peripheral blood smear and the bone marrow examination. PR: PR required near normalization of the peripheral blood count (as in CR) with a minimum of 50% improvement in organomegaly and bone marrow biopsy infiltration with HCL.
Measured: Up to 2 years
Secondary outcomes (25)
All Substudies (Substudies A, B, C and D): Complete Response (CR) Rate Determined by Central Assessment
CR Rate is defined as the percentage of participants with CR.
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Duration of Response (DOR)
DOR was defined as time from first objective response (OR) to disease progression (PD) or death. OR is defined in OM#25 (Substudy B), 28 (Substudy C), and 29 (Substudy D). PD: score 4 (uptake moderately >liver) or 5 (uptake markedly>liver and/or new lesions) with an increase in intensity of uptake from baseline; new FDG-avid foci consistent with lymphoma at interim or end of treatment assessment; new FDG-avid foci consistent with lymphoma rather than another etiology (eg, infection, inflammation); new or recurrent FDG-avid foci in bone marrow.
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Overall Survival (OS)
OS was defined as the time from the date of brexucabtagene autoleucel infusion to the date of death from any cause.
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Progression Free Survival (PFS)
PFS was defined as the time from the date of brexucabtagene autoleucel infusion to the date of PD or death from any cause. PD is defined in outcome measure #6.
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Time to Next Treatment (TTNT)
TTNT defined as the time from the date of brexucabtagene autoleucel infusion to the start of new anti-cancer (including stem cell transplant) therapy prior to documented progression, or death from any cause. KM estimates were used in the outcome measure analysis.
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Time to First Objective Response
Time to first objective response was defined as time from the date of brexucabtagene autoleucel infusion to the date of first response per the Sixth International Workshop in WM for r/rWM, per the Lugano Classification for r/rRT and r/r BL, and per Grever and colleagues for r/rHCL. Objective response (OR) is defined in OM#25 (Substudy B), 28 (Substudy C), and 29 (Substudy D).
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Time to Best Objective Response
Time to best objective response was defined as time from the date of brexucabtagene autoleucel infusion to the date of best response per the Sixth International Workshop in WM for r/rWM, per the Lugano Classification for r/rRT and r/r BL, and per Grever and colleagues for r/rHCL. Objective response (OR) is defined in OM#25 (Substudy B), 28 (Substudy C), and 29 (Substudy D).
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants Experiencing Treatment-emergent Adverse Events (TEAEs)
TEAE was defined as any adverse event with onset on or after the brexucabtagene autoleucel infusion.
Measured: First infusion date of brexucabtagene autoleucel up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants With Increase in Laboratory Values Reported as Grade 3 or Higher
Laboratory results were graded according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. CTCAE grading is a standardized system from the NCI that classifies the severity of side effects (adverse events) from cancer treatments, using a 1-5 scale: Grade 1 (Mild), Grade 2 (Moderate), Grade 3 (Severe), Grade 4 (Life-threatening), and Grade 5 (Death) The incidence of post-infusion worst-grade lab toxicities for all analytes were summarized.
Measured: First infusion date of brexucabtagene autoleucel up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants With Decrease in Laboratory Values Reported as Grade 3 or Higher
Laboratory results were graded according to NCI CTCAE version 5.0. The incidence of post-infusion worst-grade lab toxicities for all analytes were summarized.
Measured: First dose date up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants Experiencing Adverse Events (AEs) Defined as Dose Limiting Toxicities (DLTs)
Dose-limiting toxicity is defined as protocol-defined brexucabtagene autoleucel-related events with onset within the first 28 days following brexucabtagene autoleucel infusion.
Measured: First infusion date of brexucabtagene autoleucel up to 28 days
All Substudies (Substudies A, B, C and D): Number of Participants With Positive Anti-brexucabtagene Autoleucel Antibodies
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants With Replication-competent Retrovirus (RCR) in Peripheral Blood Mononuclear Cells (PBMCs)
Measured: Up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants With Deterioration Scores From Screening in the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire-30 (EORTC QLQ-C30)
EORTC QLQ-C30 is a quality of life (QOL) questionnaire for cancer participants, that has 30 items. 5 functional scales (physical, role, emotional, cognitive, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, loss of appetite, constipation, diarrhea, and financial difficulties). Scoring of the QLQ-C30 was performed according to QLQ-C30 Scoring manual. Participants with deterioration scores from screening for various questions of EORTC QLQ C-30 are reported. Deterioration was defined as scores at specific time point lesser than scores at baseline.
Measured: Day -5, Day 0, Day 28, Month 3, Month 6, Month 9 and Month 12
All Substudies (Substudies A, B, C and D): Number of Participants With Deterioration Scores From Screening in the European Quality of Life Five Dimensions Five Levels Questionnaire (EQ-5D-5L)
EQ-5D-5L was an instrument for use as a measure of health outcome. The EQ-5D-5L consisted of 2 sections: EuroQoL (5 dimensions) (EQ-5D) descriptive system and the EuroQoL visual analogue scale (EQ-VAS). EQ-5D comprised the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension had 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. Number of participants with deterioration scores from screening for each category are reported. Deterioration was defined as scores at specific time point lesser than scores at baseline.
Measured: Day -5, Day 0, Day 28, Month 3, Month 6, Month 9 and Month 12
All Substudies (Substudies A, B, C and D): Change From Screening in the EQ-ED-5L Visual Analogue Scale (EQ-VAS) Score
The EQ-VAS recorded the participant's self-rated health on a vertical VAS, where the end points were labeled "the best health you can imagine" and "the worst health you can imagine." The EQ-VAS could be used as a quantitative measure of a health outcome that reflected the participant's own judgment. The EQ-VAS recorded the participant's self-rated health on a vertical VAS, with a score numbered from 0 to 100, where '100 meant the best health you can imagine' and '0 meant the worst health you can imagine".
Measured: Screening, Day -5, Day 0, Day 28, Month 3, Month 6, Month 9 and Month 12
Substudy A: ORR (CR, VGPR, or PR) Determined by Central Assessment Per the Sixth International Workshop in WM
ORR was defined as the percentage of participants who achieved a best response of CR, VGPR, or PR per the Sixth International Workshop in WM.
Measured: Up to 2 years
Substudy A: Percentage of Participants With Combined CR and VGPR Determined by Investigator Assessment Per the Sixth International Workshop in WM
The combined rate of CR and VGPR was defined as the percentage of participants who achieved a best response of either CR or VGPR.
Measured: Up to 2 years
Substudy A: PR Rate Determined by Central Assessment Per the Sixth International Workshop in WM
PR rate was defined as percentage of participants who achieve PR.
Measured: Up to 2 years
Substudy A: VGPR Rate Determined by Central Assessment Per the Sixth International Workshop in WM
VGPR rate was defined as percentage of participants who achieve VGPR.
Measured: Up to 2 years
Substudy B: Number of Participants With OR Determined by Investigator Assessment Per the Lugano Classification
OR: CR (complete metabolic response (CMR)+complete radiological response (CRR))+PR (partial MR response (PMR)+partial RR(PRR)). CMR: score 1(no uptake above background)/2(uptake≤mediastinum)/3(uptake >mediastinum but ≤liver)with/without a residual mass on positron emission tomography 5-point scale;no new lesions,CRR:target nodes/nodal masses regressed to ≤1.5 cm in longest transverse diameter of lesion (LDi);no extralymphatic sites of disease;absent non-measured lesion(NMLs);organ enlargement regress to normal; no new sites;bone marrow normal by morphology. PMR:score 4(uptake moderately>liver)/5(uptake markedly>liver, new lesions) with reduced uptake compared with baseline and residual mass;no new lesions;responding disease at interim/residual disease at end of treatment. PRR:≥50% decrease in sum of product of diameters up to 6 target nodes and extra-nodal sites;absent/ normal,regressed,but no increase of NMLs;spleen regressed by>50% in length beyond normal.
Measured: Up to 2 years
Substudy B: Number of Participants With OR Based on Clonal Relationship to the Underlying CLL by Central Assessment Per the Lugano Classification
OR is defined as participants with CR or PR.
Measured: Up to 2 years
Substudy B: Number of Participants With OR (CR, CRi, or PR) Determined by Investigator Per International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2018 Criteria
OR was defined as the number of participants who achieved a best response of either CR, CRi, or PR by investigator assessment per IWCLL 2018 criteria. CR: Lymph nodes- none ≥1.5 cm; Liver or spleen size- Spleen size <13 cm; liver size normal; Constitutional symptoms, Circulating lymphocyte count- none; Platelet count- ≥100 × 109/L; Hemoglobin- ≥11.0 g/dL (untransfused and without erythropoietin); Marrow- Normocellular, no CLL cells, no B-lymphoid nodules. CRi: ; PR: Lymph nodes- Decrease ≥50% (from baseline); Liver or spleen size- Decrease ≥50% (from baseline); Constitutional symptoms- any, Circulating lymphocyte count- Decrease ≥50% from baseline; Platelet count- ≥100 × 109/L or increase ≥50% over baseline; Hemoglobin-≥11 g/dL or increase ≥50% over baseline; Marrow- Presence of CLL cells, or of B-lymphoid nodules, or not done.
Measured: Up to 2 years
Substudy C: Number of Participants With OR Determined by Investigator Assessment Per the Lugano Classification
OR was defined as the number of participants who achieved a best response of either CR or PR per the Lugano Classification. CR and PR per Lugano classification is defined in outcome measure #25.
Measured: Up to 2 years
Substudy D: Number of Participants With OR Determined by Investigator Assessment Per Grever and Colleagues
OR was defined as the number of participants who achieved a best response of either CR or PR per Grever and colleagues. CR: Near normalization of peripheral blood counts: hemoglobin >11 g/dL (without transfusion); platelets>100 000/μL; absolute neutrophil count >1500/μL. Regression of splenomegaly on physical examination. Absence of morphologic evidence of HCL on both the peripheral blood smear and the bone marrow examination. PR: PR required near normalization of the peripheral blood count (as in CR) with a minimum of 50% improvement in organomegaly and bone marrow biopsy infiltration with HCL.
Measured: Up to 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Sep 2022
- Study start1 Nov 2022
- Primary completion27 Jan 2025
- Study completion27 Jan 2025
Why it stopped: Sponsor decision to terminate study.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Relapsed/Refractory Waldenstrom MacroglobulinemiaStudies of the same condition, open and under way.
- More trials run by Kite, A Gilead CompanyThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 19 participants (actual)
Sponsor and investigators
- Lead sponsor
- Kite, A Gilead Company
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Kite Study Director, Study director, Kite, A Gilead Company
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05537766
- Sponsor's protocol ID
- KT-US-568-0138
- Other IDs
- 2022-501259-10, 2022-501260-18, 2022-501261-46, 2022-501262-21
- Acronym
- ZUMA-25
- Status last verified
- Mar 2026
- First submitted
- 8 Sep 2022
- Last updated
- 10 Mar 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 10 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 2, Open-Label, Multicenter, Basket Study Evaluating the Efficacy of Brexucabtagene Autoleucel in Adults With Rare B-cell Malignancies (ZUMA-25)
- ClinicalTrials.gov ID
- NCT05537766
- Acronym / sponsor ID
- ZUMA-25 / KT-US-568-0138
- Conditions
- Relapsed/Refractory Waldenstrom Macroglobulinemia, Relapsed/Refractory Richter Transformation, Relapsed/Refractory Burkitt Lymphoma, Relapsed/Refractory Hairy Cell Leukemia
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Sponsor decision to terminate study.
- Enrolment
- 19 participants (actual)
- Lead sponsor
- Kite, A Gilead CompanyIndustry (pharma, biotech, devices)
- Study start
- 1 Nov 2022 (actual)
- Primary completion
- 27 Jan 2025 (actual)
- Study completion
- 27 Jan 2025 (actual)
- First posted
- 13 Sep 2022 (actual)
- Results
- Posted 10 Mar 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Master protocol: The goal of this master clinical study is to test how well the study drug, brexucabtagene autoleucel, works in participants with rare B-cell malignancies: relapsed/refractory Waldenstrom macroglobulinemia (r/r WM) (Substudy A), r/r Richter transformation (RT) (Substudy B), r/r Burkitt lymphoma (BL) (Substudy C) and r/r hairy cell leukemia (HCL) (Substudy D).
Detailed description
This study will use a basket study design with separate, indication-specific substudies, to investigate r/r RT and r/r BL.
After completing the treatment period, all participants will be followed in the post-treatment follow-up period. Thereafter, participants will transition to a separate long-term follow-up study (KT-US-982-5968) to continue follow-up out to 15 years.
All substudies have been early terminated by the sponsor. Below is summary of enrollment in each Substudy:
- Substudy-A This substudy was withdrawn. Therefore no participants were enrolled.
- Substudy-B enrollment closed, actual enrollment is 6.
- Substudy-C enrollment closed, actual enrollment is 12.
- Substudy-D enrollment closed, actual enrollment is 1.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Substudy A (Relapsed/Refractory Waldenstrom Macroglobulinemia): Brexucabtagene Autoleucel | Experimental | Biological: Brexucabtagene Autoleucel, Drug: Cyclophosphamide, Drug: FludarabineParticipants with Relapsed/Refractory Waldenstrom Macroglobulinemia will receive the following treatment during the study:Lymphodepletion chemotherapy regimen of fludarabine 30 mg/m^2/day intravenously (IV) and cyclophosphamide 500 mg/m^2/day IV for 3 days (Day -5 to Day -3). A single IV infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-cluster of differentiation 19 (CD19) chimeric antigen receptor (CAR) T cells/kg on Day 0. |
| Substudy B (Relapsed/Refractory Richter Transformation): Brexucabtagene Autoleucel | Experimental | Biological: Brexucabtagene Autoleucel, Drug: Cyclophosphamide, Drug: FludarabineParticipants with Relapsed/Refractory Richter Transformation will receive the following treatment during the study: Lymphodepletion chemotherapy regimen of fludarabine 30 mg/m^2/day IV and cyclophosphamide 500 mg/m^2/day IV for 3 days (Day -5 to Day -3).A single IV infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-CD19 CAR T cells/kg on Day 0. |
| Substudy C (Relapsed/Refractory Burkitt Lymphoma): Brexucabtagene Autoleucel | Experimental | Biological: Brexucabtagene Autoleucel, Drug: Cyclophosphamide, Drug: FludarabineParticipants with Relapsed/Refractory Burkitt Lymphoma will receive the following treatment during the study:Lymphodepletion chemotherapy regimen of fludarabine 30 mg/m^2/day IV and cyclophosphamide 500 mg/m^2/day IV for 3 days (Day -5 to Day -3).A single IV infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-CD19 CAR T cells/kg on Day 0. |
| Substudy D (Relapsed/Refractory hairy cell leukemia): Brexucabtagene Autoleucel | Experimental | Biological: Brexucabtagene Autoleucel, Drug: Cyclophosphamide, Drug: FludarabineParticipant with Relapsed/Refractory Hairy Cell Leukemia will receive the following treatment during the study: Lymphodepletion chemotherapy regimen of fludarabine 30 mg/m^2/day IV and cyclophosphamide 500 mg/m^2/day IV for 3 days (Day -5 to Day -3). A single IV infusion of brexucabtagene autoleucel at target dose of 2 × 10^6 anti-CD19 CAR T cells/kg on Day 0. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (17 listed)
- Presence of toxicities due to prior therapy must be stable and recovered to Grade 1 or lower.
- Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
- Adequate hematologic and end-organ function.
- Individuals of childbearing potential who engage in heterosexual intercourse must agree to use specified method(s) of contraception.
- Confirmed diagnosis of chronic lymphocytic leukemia (CLL) based on International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2018 criteria with histologically confirmed Richter transformation (RT) to a diffuse large B-cell lymphoma (DLBCL) subtype.
Key exclusion criteria (16 listed)
- Prior chimeric antigen receptor (CAR) therapy or treatment with any anti-Cluster of Differentiation 19 (CD19) therapy.
- human immunodeficiency virus (HIV)-positive patients, unless taking appropriate anti-HIV medications, having an undetectable viral load by quantitative polymerase chain reaction (qPCR) and a CD4 count > 200 cells/μL.
- Presence of detectable cerebrospinal fluid malignant cells or brain metastases.
- History of autoimmune disease (eg, Crohn's disease, rheumatoid arthritis, systemic lupus).
- Diagnosis of RT not of DLBCL subtype (including, but not limited to, Hodgkin lymphoma (HL) and prolymphocytic leukemia).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Brexucabtagene AutoleucelAlso: KTE-X19Administered intravenously | Biological | Substudy A (Relapsed/Refractory Waldenstrom Macroglobulinemia): Brexucabtagene Autoleucel, Substudy B (Relapsed/Refractory Richter Transformation): Brexucabtagene Autoleucel, Substudy C (Relapsed/Refractory Burkitt Lymphoma): Brexucabtagene Autoleucel, Substudy D (Relapsed/Refractory hairy cell leukemia): Brexucabtagene Autoleucel |
| CyclophosphamideAdministered intravenously | Drug | Substudy A (Relapsed/Refractory Waldenstrom Macroglobulinemia): Brexucabtagene Autoleucel, Substudy B (Relapsed/Refractory Richter Transformation): Brexucabtagene Autoleucel, Substudy C (Relapsed/Refractory Burkitt Lymphoma): Brexucabtagene Autoleucel, Substudy D (Relapsed/Refractory hairy cell leukemia): Brexucabtagene Autoleucel |
| FludarabineAdministered intravenously | Drug | Substudy A (Relapsed/Refractory Waldenstrom Macroglobulinemia): Brexucabtagene Autoleucel, Substudy B (Relapsed/Refractory Richter Transformation): Brexucabtagene Autoleucel, Substudy C (Relapsed/Refractory Burkitt Lymphoma): Brexucabtagene Autoleucel, Substudy D (Relapsed/Refractory hairy cell leukemia): Brexucabtagene Autoleucel |
Primary outcome
Substudy A: Combined Rate of Complete Response (CR) and Very Good Partial Response (VGPR) Determined by Central Assessment Per the Sixth International Workshop in Waldenstrom Macroglobulinemia (WM)
Time frame: Up to 2 years
The combined rate of CR and VGPR was defined as the percentage of participants who achieved a best response of either CR or VGPR per the Sixth International Workshop in WM.
Substudy B: Objective Response Rate (ORR) Determined by Central Assessment Per the Lugano Classification
Time frame: Up to 2 years
ORR was defined as the percentage of participants who achieved a best response of either CR or PR per the Lugano Classification.
Substudy C: ORR Determined by Central Assessment Per the Lugano Classification
Time frame: Up to 2 years
ORR was defined as the percentage of participants who achieved a best response of either CR or PR per the Lugano Classification.
Substudy D: ORR Determined by Central Assessment Per the Response Criteria Described by Grever and Colleagues
Time frame: Up to 2 years
ORR was defined as the percentage of participants who achieved a best response of either CR or PR per Grever and colleagues. CR: Near normalization of peripheral blood counts: hemoglobin >11 g/dL (without transfusion); platelets >100 000/μL; absolute neutrophil count >1500/μL. Regression of splenomegaly on physical examination. Absence of morphologic evidence of HCL on both the peripheral blood smear and the bone marrow examination. PR: PR required near normalization of the peripheral blood count (as in CR) with a minimum of 50% improvement in organomegaly and bone marrow biopsy infiltration with HCL.
25 secondary outcomes
All Substudies (Substudies A, B, C and D): Complete Response (CR) Rate Determined by Central Assessment
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Duration of Response (DOR)
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Overall Survival (OS)
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Progression Free Survival (PFS)
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Time to Next Treatment (TTNT)
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Time to First Objective Response
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Time to Best Objective Response
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants Experiencing Treatment-emergent Adverse Events (TEAEs)
Time frame: First infusion date of brexucabtagene autoleucel up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants With Increase in Laboratory Values Reported as Grade 3 or Higher
Time frame: First infusion date of brexucabtagene autoleucel up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants With Decrease in Laboratory Values Reported as Grade 3 or Higher
Time frame: First dose date up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants Experiencing Adverse Events (AEs) Defined as Dose Limiting Toxicities (DLTs)
Time frame: First infusion date of brexucabtagene autoleucel up to 28 days
All Substudies (Substudies A, B, C and D): Number of Participants With Positive Anti-brexucabtagene Autoleucel Antibodies
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants With Replication-competent Retrovirus (RCR) in Peripheral Blood Mononuclear Cells (PBMCs)
Time frame: Up to 2 years
All Substudies (Substudies A, B, C and D): Number of Participants With Deterioration Scores From Screening in the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire-30 (EORTC QLQ-C30)
Time frame: Day -5, Day 0, Day 28, Month 3, Month 6, Month 9 and Month 12
All Substudies (Substudies A, B, C and D): Number of Participants With Deterioration Scores From Screening in the European Quality of Life Five Dimensions Five Levels Questionnaire (EQ-5D-5L)
Time frame: Day -5, Day 0, Day 28, Month 3, Month 6, Month 9 and Month 12
All Substudies (Substudies A, B, C and D): Change From Screening in the EQ-ED-5L Visual Analogue Scale (EQ-VAS) Score
Time frame: Screening, Day -5, Day 0, Day 28, Month 3, Month 6, Month 9 and Month 12
Substudy A: ORR (CR, VGPR, or PR) Determined by Central Assessment Per the Sixth International Workshop in WM
Time frame: Up to 2 years
Substudy A: Percentage of Participants With Combined CR and VGPR Determined by Investigator Assessment Per the Sixth International Workshop in WM
Time frame: Up to 2 years
Substudy A: PR Rate Determined by Central Assessment Per the Sixth International Workshop in WM
Time frame: Up to 2 years
Substudy A: VGPR Rate Determined by Central Assessment Per the Sixth International Workshop in WM
Time frame: Up to 2 years
Substudy B: Number of Participants With OR Determined by Investigator Assessment Per the Lugano Classification
Time frame: Up to 2 years
Substudy B: Number of Participants With OR Based on Clonal Relationship to the Underlying CLL by Central Assessment Per the Lugano Classification
Time frame: Up to 2 years
Substudy B: Number of Participants With OR (CR, CRi, or PR) Determined by Investigator Per International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2018 Criteria
Time frame: Up to 2 years
Substudy C: Number of Participants With OR Determined by Investigator Assessment Per the Lugano Classification
Time frame: Up to 2 years
Substudy D: Number of Participants With OR Determined by Investigator Assessment Per Grever and Colleagues
Time frame: Up to 2 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Mar 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Gilead Clinical Trials WebsiteLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kite Study Director study director
Kite, A Gilead Company
26 sites in 8 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Brexucabtagene Autoleucel, Cyclophosphamide and Fludarabine in people with Relapsed/Refractory Waldenstrom Macroglobulinemia and Relapsed/Refractory Richter Transformation, run by Kite, A Gilead Company at 26 sites in 8 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 17 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 10 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 26 sites in United States, Germany, Italy, Spain, France and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 10 Mar 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Substudy A: Combined Rate of Complete Response (CR) and Very Good Partial Response (VGPR) Determined by Central Assessment Per the Sixth International Workshop in Waldenstrom Macroglobulinemia (WM) (time frame: Up to 2 years). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Mar 2026.