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Waldenström MacroglobulinemiaPhase 2NCT06986174

A Phase 2 Study to Evaluate the Safety and Efficacy of Pacritinib in Relapsed or Refractory Waldenström Macroglobulinemia

A Phase 2 study testing Pacritinib in people with Waldenström Macroglobulinemia and Lymphoplasmacytic Lymphoma, run by Shayna Sarosiek, MD at 1 site in United States.

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 study is being done to examine the safety and effectiveness of pacritinib as a possible treatment for participants with Waldenström macroglobulinemia (WM). The name of the study drug involved in this study is: -Pacritinib (a type of kinase inhibitor) Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Pacritinib
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteUnited States
Study dates
21 Nov 2025to 1 Oct 2032
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
  • ECOG performance status ≤2
  • Clinicopathological diagnosis of Waldenström Macroglobulinemia
  • Symptomatic disease meeting criteria for treatment using consensus panel criteria from the Second International Workshop on Waldenström macroglobulinemia. At least one of the following:
  • constitutional symptoms: recurrent fever, night sweats, fatigue or weight loss
  • progressive or symptomatic lymphadenopathy or splenomegaly
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  • hemoglobin ≤10 g/dL
  • platelet count ≤100 k/uL
  • hyperviscosity syndrome
  • symptomatic peripheral neuropathy
  • systemic amyloidosis
  • renal insufficiency
  • symptomatic cryoglobulinemia
  • Serum IgM level ≥ 2 times the upper limit of normal
  • Participants must meet the following organ and marrow functions as defined below:
  • absolute neutrophil count ≥0.5 k/uL without growth factor within 7 days
  • platelet count ≥50 k/uL without platelet transfusion within 7 days
  • total bilirubin ≤1.5 times the upper limit of normal or ≤3 times the upper limit of normal with documented liver involvement, hemolysis or Gilbert's disease
  • AST (SGOT) and ALT (SGPT) ≤2.5 times the upper limit of normal or ≤5 times the upper limit of normal with documented liver involvement
  • Creatinine clearance ≥30 ml/min using Cockcroft/Gault equation
  • Ability to understand and the willingness to sign a written informed consent document. (Providing consents in as many languages as possible is encouraged)
  • At least 2 prior lines of treatment for Waldenström Macroglobulinemia. Participants must either be BTK inhibitor exposed or not be a candidate for BTK therapy.
  • Women of childbearing potential: Females of childbearing potential (FCBP) will be required to use two highly effective forms of contraception simultaneously or will remain abstinent from heterosexual intercourse during the following periods related to this study:
  • while participating in the study; and 2) for at least three months (90 days) after discontinuation from the study. FCBP must be referred to a qualified provider of contraceptive methods if needed.

Who cannot join

  • Current history of uncontrolled HIV
  • Patients with a known history of HIV must have a viral load assessed for eligibility and must be on a stable antiretroviral regimen that can be administered concurrent with pacritinib.
  • Known active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection based on criteria below
  • Hepatitis B virus (HBV): Patients with positive hepatitis B surface antigen (HBsAg) are excluded. Patients with positive hepatitis B core antibody (antiHBc) and negative HBsAg require hepatitis B polymerase chain reaction (PCR) evaluation before enrollment. Patients who are hepatitis B PCR positive will be excluded.
  • Hepatitis C virus (HCV): positive hepatitis C antibody. If positive hepatitis C antibody result, patient will need to have a negative result for hepatitis C ribonucleic acid (RNA) before enrollment. Patients who are hepatitis C RNA positive will be excluded.
  • Participants with chronic liver disease and hepatic impairment meeting Child-Pugh class B or C (Appendix B)
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  • Participants who are pregnant, breast feeding, or planning to become pregnant while enrolled in this study or within 3 month after last study dose (2 weeks for breastfeeding)
  • Current CNS involvement by WM
  • Active alcohol or drug abuse
  • Concurrent administration of medications that are moderate or strong inhibitors or inducers of CYP3A within 14 days or 5 half-lives, whichever is shorter, prior to first dose of study drug.
  • Concurrent participation in another therapeutic clinical trial
  • History of another malignancy, except adequately treated local basal cell or squamous cell carcinoma of the skin, cervical carcinoma in situ, superficial bladder cancer, localized prostate cancer, or other adequately treated cancer currently in complete remission
  • Prior or ongoing clinically significant illness, including active infections requiring antibiotics, of medical condition that, in the investigator's opinion, could affect the safety of the patient; alter the absorption, distribution, metabolism or excretion of the study drug; or impair the assessment of study results
  • Inability to swallow pills
  • Significant cardiovascular disease defined as:
  • Unstable angina, or
  • History of myocardial infarction within 6 months prior to planned start
  • Previously documented left ventricular ejection fraction (LVEF) by any method of ≤ 45% in the 12 months prior to planned start; assessment of LVEF via echocardiogram or multigated acquisition (MUGA) scan during screening should be performed in selected patients as medically indicated, or
  • Any Class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification, or
  • Uncontrolled or symptomatic arrhythmias
  • Prolonged QT Interval with baseline QTc >480 msec using the Bazette formula
  • Ongoing, active infection.
  • Active bleeding requiring blood transfusion or other medical intervention. Participants requiring anticoagulation therapy are not excluded.

Trial locations and contacts

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

United States1 site, 1 recruiting
  • Dana Farber Cancer Institute

    Boston, Massachusetts, 02115

    Shayna Sarosiek, MD, 617-632-4218, Shayna_sarosiek@dfci.harvard.edu

    Shayna Sarosiek, MD

    Recruiting

Other trials in United States

About this study

This study is being done to examine the safety and effectiveness of pacritinib as a possible treatment for participants with Waldenström macroglobulinemia (WM).

The name of the study drug involved in this study is:

-Pacritinib (a type of kinase inhibitor)

Read the detailed description

This is a single-arm, open-label, Phase II study to evaluate the safety and efficacy of pacritinib in participants with symptomatic Waldenström macroglobulinemia (WM).

Pacritinib is a targeted therapy that blocks a protein called JAK2 that helps cells live and grow. It also inhibits IRAK1, which is important for the survival of WM cells. By blocking JAK2 \& IRAK1, pacritinib may kill abnormal cells or stop them from growing.

The U.S. Food and Drug Administration (FDA) has not approved pacritinib for WM but it has been approved for Myelofibrosis.

The research study procedures include screening for eligibility, in-clinic visits, questionnaires, blood tests, urine tests, Computerized Tomography (CT) scans, X-rays, echocardiograms (ECGs), bone marrow biopsies and aspirations

Participants will receive study treatment for up to 4 years and will be followed for 2 years, or until there is start of a new treatment.

It is expected that about 30 people will take part in this research study.

Sobi AG, Inc. is supporting this research study by providing study drug and funding.

Being tested
Pacritinib
Keywords
Waldenström Macroglobulinemia, Lymphoplasmacytic Lymphoma, Lymphoma, B-Cell Lymphoproliferative Disorder, Indolent Lymphoma
Medical subject headings
Waldenstrom Macroglobulinemia, Lymphoma, B-Cell, Marginal Zone, Lymphoma

What participants receive

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

  • PacritinibDrug

    Also called SB1518, VONJO, Pacritinib Citrate

    Kinase inhibitor, capsule, taken orally per protocol.

Study groups in NCT06986174
Study groupRoleWhat they receive
PacritinibExperimental30 participants will complete: * Baseline visit with assessments and ECGs * Cycles 1 through 2 (28 days per cycle): --Day 1: Predetermined dose of Pacritinib 2x daily * Cycle 3, 6, 9, 12, and every 3 cycles for 48 cycles total (28 days per cycle): --Day 1: Predetermined dose of Pacritinib 2x daily * Bone marrow biopsies/aspirations at Cycles 6 and 12 and then yearly * End of Treatment visit with CT scan and bone marrow biopsy/aspiration * Follow up: every 12 weeks for 2 years
Receives: Drug: Pacritinib

What is being measured

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

  1. Objective Response Rate (ORR)

    ORR was defined as the percentage of participants achieving complete response (CR), very good partial response (VGPR), partial response (PR) and minimal response (MR) on treatment based on IWWM-11 criteria.

    Measured: Up to 48 months

Secondary outcomes (20)
  1. Complete Response Rate

    Complete response rate was defined as the percentage of participants achieving complete response (CR) on treatment based on IWWM-11 criteria, defined as having resolution of WM related symptoms, normalization of serum IgM levels with complete disappearance of IgM paraprotein by immunofixation, and resolution of any adenopathy or splenomegaly. A complete response requires reconfirmation demonstrating normal serum IgM levels, and absence of IgM paraprotein by immunofixation by a measurement repeated at least 2 weeks later.

    Measured: Up to 48 months

  2. Very Good Partial Response Rate

    Very good partial response rate was defined as the percentage of participants achieving very good partial response (VGPR) on treatment based on IWWM-11 criteria, defined as ≥90% reduction in serum IgM levels, or normalization of serum IgM levels with persistent IgM monoclonal spike in SPEP or immunofixation.

    Measured: Up to 48 months

  3. Partial Response Rate

    Partial response rate was defined as the percentage of participants achieving partial response (PR) on treatment based on IWWM-11 criteria, Partial response (PR) is defined as achieving a ≥50% to <90% reduction in serum IgM levels.

    Measured: Up to 48 months

  4. Minimal Response Rate

    Minimal response rate was defined as the percentage of participants achieving minimal response (MR) on treatment based on IWWM-11 criteria, defined as ≥25 to <50% reduction in serum IgM levels.

    Measured: Up to 48 months

  5. Stable Disease Rate

    Stable disease rate was defined as the percentage of participants achieving stable disease (SD) on treatment based on IWWM-11 criteria, defined as <25% reduction to <25% increase in serum IgM levels.

    Measured: Up to 48 months

  6. Progressive Disease Rate

    Stable disease rate was defined as the percentage of participants achieving progressive disease (SD) on treatment based on IWWM-11 criteria, defined as defined as a≥25% increase in serum IgM level occurring with an absolute increase of at least 500 mg/dL from nadir or progression of clinically significant disease-related symptom(s). Reconfirmation of the initial IgM increase is required when IgM is the sole criterion for progressive disease confirmation. Death from any cause or initiation of a new anti-neoplastic therapy will also be considered a progression event. Additionally, a new lesion (>1.5 cm in any axis) or unequivocal evidence of an increase by >50% in any axis to >1.5 cm in size of previously involved extramedullary disease sites from their nadir measurement. Development of Bing Neel syndrome, amyloidosis, or other extramedullary disease manifestations, as well as disease transformation will be considered as progressive events.

    Measured: Up to 48 months

  7. Time to Response (TTR)

    TTR is the time from treatment initiation until the attainment of a minor response.

    Measured: Up to 48 months

  8. Time to Major Response (TTMR)

    TTMR is the time from treatment initiation until attaining a PR or better.

    Measured: Up to 48 months

  9. Median Progression-free Survival (PFS)

    PFS based on Kaplan-Meier methodology is defined as the time from treatment initiation until disease progression, death from any cause, or last follow-up visit.

    Measured: Up to 48 months

  10. Time to Next Treatment (TTNT)

    TTNT is the time between treatment initiation and initiation of the next therapy.

    Measured: Up to 48 months

  11. Median Overall Survival (OS)

    OS is defined as the time from treatment initiation until death from any cause or last follow-up visit

    Measured: Up to 6 years

  12. Bone marrow response

    Absolute change in bone marrow burden of disease from baseline

    Measured: Up to 48 months

  13. Overall Response Rate Among Participants Without MYD88 Mutations

    Overall Response Rate in participants who tested negative for a MYD88 mutation= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).

    Measured: Up to 48 months

  14. Overall Response Rate Among Participants With MYD88 Mutations

    Overall Response Rate in participants who tested positive for a MYD88 mutation= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).

    Measured: Up to 48 months

  15. Overall Response Rate Among Participants Without CXCR4 Mutations

    Overall Response Rate in participants who tested negative for a CXCR4 mutation= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).

    Measured: Up to 48 months

  16. Overall Response Rate Among Participants With CXCR4 Mutations

    Overall Response Rate in participants who tested positive for a CXCR4 mutation= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).

    Measured: Up to 48 months

  17. Overall Response Rate Among Participants With TP53 Mutations

    Overall Response Rate in participants who tested positive for a TP53 mutation= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).

    Measured: Up to 48 months

  18. Overall Response Rate Among Participants Without TP53 Mutations

    Overall Response Rate in participants who tested negative for a TP53 mutation= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).

    Measured: Up to 48 months

  19. Number of Participants With Treatment-related Adverse Events

    Number of participants who experienced an adverse event while on pacritinib

    Measured: Up to 48 months

  20. Overall Response Rate Among Participants who progressed on covalent BTK-inhibitors

    Overall Response Rate in participants who previously progressed on covalent BTK inhibitors= Minor response (>25%-50% reduction in serum IgM from baseline) + Partial Response (>50-90% reduction in serum IgM from baseline) + Very Good Partial Response (>90% reduction in serum IgM from baseline) + Complete Response (resolution of all symptoms, normalization of serum IgM with disappearance of IgM paraprotein, resolution of any adenopathy or splenomegaly).

    Measured: Up to 48 months

Timeline

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

  1. First posted22 May 2025
  2. Study start21 Nov 2025
  3. Primary completion1 Oct 2028 (estimated)
  4. Study completion1 Oct 2032 (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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06986174
Sponsor's protocol ID
24-660
Status last verified
Dec 2025
First submitted
15 May 2025
Last updated
5 Dec 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: \[contact information for Sponsor Investigator or designee\]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Pacritinib in people with Waldenström Macroglobulinemia and Lymphoplasmacytic Lymphoma, run by Shayna Sarosiek, MD at 1 site in United States.

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 24 inclusion and 23 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 5 Dec 2025. 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 United States. 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 Shayna Sarosiek, MD (617-632-4218, Shayna_Sarosiek@dfci.harvard.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response Rate (ORR) (time frame: Up to 48 months). 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 5 Dec 2025.

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