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Large B-cell LymphomaPhase 2ZeTANCT06167785

A Study to Evaluate Zanubrutinib and Tislelizumab in Progressive Lymphoma Post CAR-T

A Phase 2 study testing Tislelizumab, Zanubrutinib and Tislelizumab + Zanubrutinib in people with Large B-cell Lymphoma, run by University Health Network, Toronto at 1 site in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This is a phase ll study of participants with large B Cell lymphoma previously treated with anti-CD19 Chimeric antigen receptor (CAR-T) therapy. The purpose of the study is to to evaluate the efficacy of zanubrutinib and tislelizumab in patients with progressive lymphoma post anti-CD 19 CAR-T failure. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Large B-cell Lymphoma
What is being tested?
Tislelizumab, Zanubrutinib and Tislelizumab + Zanubrutinib
Could I receive a placebo?
No, everyone receives an active treatment
How many people
76 participants
Where
1 siteCanada
Study dates
4 Jun 2025to Dec 2029
Phase
Phase 2
Are there results?
Not yet: the study is under way

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

  • Age ≥ 18 years
  • Able and willing to provide written informed consent and to comply with the study protocol
  • Radiologically measurable disease (≥ 1 nodal lesion > 2.0 cm in the longest diameter, and/or extranodal lesion > 1.0cm in the longest diameter)
  • Intervention arm: Radiological measurable disease per inclusion criterion #3 with more than one site of disease.
  • Relapse or refractory Large B cell Lymphoma post-CD19 directed CAR-T cell therapy within 6 weeks prior to enrollment (histological confirmation highly recommended although not mandatory)
  • Intervention arm: Hemoglobin ≥ 80 g/L at screening*
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  • Intervention arm: Platelet count ≥ 75 x 109/L at screening*
  • Intervention arm: Neutrophil count ≥ 1.0 x 109/L at screening*
  • Intervention arm: ECOG performance status ≤ 2 at screening
  • AST and ALT < 2.5 x ULN at screening
  • Serum total bilirubin < 1.5 x ULN, except in patients with documented Gilberts syndrome at screening
  • Creatinine clearance ≥ 30 mL/min as estimated by Cockcroft-gault equation at screening * Counts can be supported with growth factors or transfusions as per standard transfusion protocols.

Who cannot join

  • Life expectancy < 30 days at the time of enrollment
  • Prior exposure to BTK or PD-1 inhibitor at any time prior to enrollment
  • Prior anaphylactic reaction to monoclonal antibody therapy at any time prior to enrollment
  • Intervention arm: On higher than physiologic doses (10mg daily) of prednisone daily at least 7 days prior to initiation of trial treatment. SOC arm: On prednisone for symptom management only.
  • Uncontrolled autoimmune disease
  • Known active CNS involvement disease
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  • History of prior allogeneic transplant or organ transplant
  • Active bleeding or history of bleeding diathesis including, but not limited to,
  • History of severe bleeding disorder such as hemophilia A, hemophilia B, von Willebrand disease, or history of spontaneous bleeding requiring blood transfusion or other medical intervention
  • History of stroke or intracranial hemorrhage within 180 days before first dose of study drug
  • Difficulty with or unable to swallow oral medication, or known conditions that would significantly affect gastrointestinal function that would limit absorption of oral medication
  • History of chronic or active, uncontrolled bacterial, viral or fungal infection; human T-cell lymphotropic virus type 1 seropositive status.
  • Serologic status reflecting active viral hepatitis B or C infection as follows:
  • presence of hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb). Patients with presence of HBcAb, but absence of HBsAg, are eligible if hepatitis B virus (HBV) DNA is undetectable (< 20IU), and if they are willing to be on appropriate prophylaxis and undergo monitoring for HBV reactivation if clinically indicated.
  • Presence of hepatitis C virus (HCV) antibody. Patients with presence of HCV antibody are eligible if HCV RNA is undetectable.
  • Individuals with known active HIV infection are eligible if CD4 and viral titres are controlled
  • Any serious intercurrent illness, life threatening condition, organ system dysfunction including:
  • (1) Clinically significant cardiovascular including:
  • prolonged QTc > 480ms,
  • history of Mobitz II second degree or third degree heart block without a permanent pacemaker in situ,
  • uncontrolled hypertension as indicated by a minimum of 2 consecutive blood pressure reading on 2 separate occasions showing systolic BP > 170 mmHg and/or diastolic BP > 105mmHg at screening,
  • uncontrolled or history of symptomatic arrhythmias (ie. sustained ventricular tachycardia, ventricular fibrillation, Torsades de Pointes),
  • congestive heart failure or NYHA class ≥ 3,
  • myocardial infarction within 6 months prior to enrollment;
  • (2) History of significant cerebrovascular events including stroke or intracranial hemorrhage within 6 months prior to enrollment
  • History of other active malignancies within 2 years prior to enrollment, with the exception of adequately treated in-situ carcinoma of cervix; localized basal cell or squamous cell carcinoma of skin; or previous malignancy confined and treated locally (surgery or other modality) with curative intent.
  • Female patients of childbearing potential must practice highly effective methods (Section 6.7.1.1) of contraception initiated prior to first dose of study drug, for the duration of the study, and for ≥ 120 days after the last dose of zanubrutinib or tislelizumab
  • Male patients are eligible if vasectomized or if they agree to the use of barrier contraception with highly effective methods during the study treatment period and for ≥ 120 days after the last dose of zanubrutinib or tislelizumab.
  • Major surgery within 4 weeks of the first dose of study drug
  • Vaccination with a live vaccine within 28 days prior to the first dose of study drug
  • Patient requires treatment with warfarin or other vitamin K antagonists
  • Severe or debilitating pulmonary disease (dyspnea at rest, significant shortness of breath, congestive obstructive pulmonary disease).
  • History of interstitial lung disease or non-infectious pneumonitis or pulmonary fibrosis, except for those induced by radiation therapy.
  • Active and symptomatic fungal, bacterial, and/or viral infection; human T-cell lymphotropic virus type 1 seropositive status.
  • Any illness or condition that in the opinion of the investigator may affect safety of treatment or evaluation of any study endpoint.
  • Active autoimmune diseases or history of severe autoimmune diseases; these include but are not limited to a history of immune related neurologic disease, multiple sclerosis, autoimmune (demyelinating) neuropathy, Guillain-Barre syndrome, myasthenia gravis, systemic lupus erythematosus, rheumatoid arthritis, connective tissue diseases, scleroderma, inflammatory bowel disease, Crohn's disease, ulcerative colitis, autoimmune hepatitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, or clinically manifest antiphospholipid syndrome. Note: Subjects are permitted to enroll if they have vitiligo, eczema, type I diabetes mellitus, or endocrine deficiencies, including thyroiditis managed with replacement hormones including physiologic doses of corticosteroids. Subjects with Sjögren's syndrome and psoriasis controlled with topical medication and subjects with positive serology, such as antinuclear antibodies or antithyroid antibodies should be evaluated for the presence of target organ involvement and potential need for systemic treatment but should otherwise be eligible.
  • A condition requiring systemic treatment with either corticosteroids (> 20 mg daily prednisone or equivalent) or other immunosuppressive medications within 14 days of study drug administration, except for PCNSL and SCNSL. Note: adrenal replacement doses ≤ 20 mg daily prednisone or equivalents are permitted in the absence of active autoimmune disease; subjects are permitted to use topical, ocular, intra-articular, intranasal, and inhalational corticosteroids (with minimal systemic absorption).
  • Major surgery in the past 4 weeks prior to the first day of screening.
  • Patients with contraindications for zanubrutinib and Tislelizumab
  • Pregnant or lactating women.
  • Hypersensitivity to zanubrutinib and Tislelizumab or any of the other ingredients of the applicable study drugs
  • Patients with toxicities (as a result of prior anticancer therapy) which have not recovered to baseline or stabilized, except for AEs not constituting a likely safety risk
  • With uncontrolled diabetes or > Grade 1 laboratory test abnormalities in potassium, sodium, or corrected calcium despite standard medical management or ≥ Grade 3 hypoalbuminemia ≤ 14 days before randomization.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

John Kuruvilla, FRCPC contact

4169462821

LymphomaClinicalTrials@uhn.ca

Canada1 site, 1 recruiting
  • University Health Network (UHN)

    Toronto, Ontario, M5G 2M9

    John Kuruvilla, FRCPC, 4169462821, LymphomaClinicalTrials@uhn.ca

    John Kuruvilla, FRCPC

    Recruiting

Other trials in Canada

About this study

Official title: A Prospective, Multicenter, Phase II Trial to Evaluate the Efficacy of Zanubrutinib and Tislelizumab as Well as Standard of Care for the Treatment of Patients With Progressive Lymphoma Post Anti-CD19 CAR-T Cell Therapy

This is a phase ll study of participants with large B Cell lymphoma previously treated with anti-CD19 Chimeric antigen receptor (CAR-T) therapy. The purpose of the study is to to evaluate the efficacy of zanubrutinib and tislelizumab in patients with progressive lymphoma post anti-CD 19 CAR-T failure.

Read the detailed description

Given that this group of patients is a heavily pre-treated group of individuals, the study will be broken into 2 distinct parts; an initial safety run-in period and an expanded cohort.

During both distinct parts of the study, patients meeting all the eligibility criteria except for the criteria specific to enrollment in the intervention arm, can be enrolled into the standard of care (SOC) arm.

Initial safety run-in period: intervention arm:

The initial safety run-in period will evaluate the tolerability and safety of tislelizumab or zanubrutinib monotherapy. In this initial phase, a total of 10 patients (5/ arm) will receive either zanubrutinib or tislelizumab monotherapy). Once the 10th patient has received 2 cycles of monotherapy, an early safety interim analysis will be complete to ensure the safety and tolerability of individual agents. These patients can continue to receive monotherapy until the results of the early safety interim analysis are known, at which point, if the study will move into the expanded cohort phase, these patients are eligible to receive the combination therapy.

Enrollment into the intervention arm will be paused after the enrollment of the 10th patient in the initial safety run-in period intervention arm, until it is determined the study will move into the expanded cohort phase. Enrollment of patients into the SOC arm can continue during this time.

Expanded cohort: intervention arm:

If monotherapy with tislelizumab and zanubrutinib are determined to be safe following the early safety interim analysis, then combination therapy will be explored in the expanded cohort. Patients will receive tislelizumab in combination with oral zanubrutinib. Patients that initially received monotherapy with tislelizumab or zanubrutinib, as part of the safety run in, will have the other drug added in for the remaining cycles. Patients will be allowed to continue in the study as long as they have acceptable toxicity profile and do not show disease progression, for up to a total of 34 cycles (~ 2 years) of treatment.

Being tested
Tislelizumab, Zanubrutinib, Tislelizumab + Zanubrutinib

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TislelizumabDrug

    Tislelizumab 200mg intravenously every 3 weeks

  • ZanubrutinibDrug

    Zanubrutinib 160 mg oral twice daily

  • Tislelizumab + ZanubrutinibDrug

    Tislelizumab 200mg intravenously day 1 of each cycle every 3 weeks + Zanubrutinib 160 mg oral twice daily starts day 1 of each cycle

Study groups in NCT06167785
Study groupRoleWhat they receive
TislelizumabExperimentalTislelizumab 200mg intravenously every 3 weeks - initial safety run-in period
Receives: Drug: Tislelizumab
ZanubrutinibExperimentalZanubrutinib 160 mg oral twice daily - initial safety run-in period
Receives: Drug: Zanubrutinib
Tislelizumab + ZanubrutinibExperimentalTislelizumab 200mg intravenously day 1 of each cycle every 3 weeks * Zanubrutinib 160 mg oral twice daily starts day 1 of each cycle - expanded cohort
Receives: Drug: Tislelizumab + Zanubrutinib
Standard of CareNo interventionPatients will receive standard of care, which is up to the investigator's discretion. This may include, but not limited to, palliative chemotherapy, steroids and/or radiation as deemed appropriate.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. determine the best overall response rate (ORR)

    To determine the best overall response rate (ORR) of the combination of zanubrutinib and tislelizumab as well as standard of care in patients previously treated with anti-CD19 CAR-T cell therapy. The best ORR is defined as the proportion of patients with a complete response (CR) or a partial response (PR) during the study, as determined by the investigator using Lugano 2014 criteria.

    Measured: 2 years

Secondary outcomes (4)
  1. Duration of response (DOR)

    DOR is defined as the time from the first occurrence of a documented objective response (CR or PR) to disease progression or relapse, as determined by the investigator using Lugano 2014 criteria, or death from any cause, whichever occurs first

    Measured: 2 years

  2. Progression free survival (PFS)

    PFS is defined as the date of enrollment until disease progression, relapse or death from any cause

    Measured: 2 years

  3. Event free survival (EFS)

    EFS is defined as the date of enrollment until disease progression, relapse, death, or discontinuation of treatment for one of three reasons: toxicity, patient preference, initiation of new treatment without documented progression

    Measured: 2 years

  4. Overall survival (OS)

    OS is define as the date of enrollment to death from any cause

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Dec 2023
  2. Study start4 Jun 2025
  3. Primary completionApr 2029 (estimated)
  4. Study completionDec 2029 (estimated)

Resources

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
Sequential
Masking
None (open label)
Enrolment
76 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06167785
Sponsor's protocol ID
OZUHN-024
Acronym
ZeTA
Status last verified
Jun 2026
First submitted
24 Aug 2023
Last updated
9 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tislelizumab, Zanubrutinib and Tislelizumab + Zanubrutinib in people with Large B-cell Lymphoma, run by University Health Network, Toronto at 1 site in Canada.

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 12 inclusion and 43 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: looking for participants now, as of the sponsor's last update on 9 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact John Kuruvilla, FRCPC (4169462821, LymphomaClinicalTrials@uhn.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

determine the best overall response rate (ORR) (time frame: 2 years). 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 9 Jun 2026.

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