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DLBCL - Diffuse Large B Cell LymphomaPhase 2NCT07744750

Pirtobrutinib+Sonrotoclax(PS) Regimen in the Treatment of B-Cell Lymphoma

A Phase 2 study testing Pirtobrutinib, Sotoclax+/- Obinutuzumab (PSO) Combination for B cell lymphoma in people with DLBCL - Diffuse Large B Cell Lymphoma and Richter Transformation, run by Changzhou No.2 People's Hospital at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This prospective, open-label, Phase II clinical trial evaluates the efficacy and safety of pirtobrutinib combined with sotoclax across three distinct B-cell lymphoma cohorts: histologically transformed diffuse large B-cell lymphoma (DLBCL), relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Pirtobrutinib, Sotoclax+/- Obinutuzumab (PSO) Combination for B cell lymphoma
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteChina
Study dates
30 Aug 2026to 31 Aug 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

  • Cohort 1: Histologically transformed DLBCL
  • Histopathologically confirmed histologically transformed DLBCL, including transformation from indolent lymphomas such as CLL, WM, FL, and MZL.
  • Whole-body PET/CT performed within 28 days prior to study enrollment demonstrating at least one measurable lesion in two perpendicular dimensions (longest diameter >15 mm for nodal lesions, or longest diameter >10 mm for extranodal lesions).
  • Except patients with Richter transformation, patients transformed from MZL, FL, WM, etc., must have received at least one line of systemic anti-lymphoma therapy either during the indolent phase or after transformation.
  • Cohort 2: Relapsed/refractory CLL/SLL
  • Histopathologically confirmed relapsed/refractory CLL/SLL.
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  • Disease relapse or refractoriness after at least one line of systemic anti-lymphoma therapy, which may include a BTK inhibitor.
  • Cohort 3: Relapsed/refractory MZL
  • 1.Histopathologically confirmed relapsed/refractory MZL. 2.Received systemic therapy containing an anti-CD20 monoclonal antibody or a BTK inhibitor.
  • 3.Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-2. 4.Age ≥ 18 years. 5.Adequate organ and bone marrow function defined as follows:
  • Hematologic function (assessed within 7 days prior to Cycle 1 Day 1 [C1D1]): a. Absolute neutrophil count (ANC) ≥ 0.5 × 10⁹/L. Patients with values below this threshold may be eligible if there is documented bone marrow involvement impairing hematopoiesis. b. Platelet count ≥ 50 × 10⁹/L without transfusion support. Patients with values below this threshold may be eligible if there is documented bone marrow infiltration impairing hematopoiesis. c. If transfusions are administered to treat thrombocytopenia or anemia, the patient must demonstrate a response to transfusion support.
  • Coagulation function: Activated partial thromboplastin time (aPTT), prothrombin time (PT), or international normalized ratio (INR) ≤ 1.5 × upper limit of normal (ULN).
  • Hepatic function: Serum total bilirubin (TBIL) ≤ 1.5 × ULN; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN.
  • Renal function: Serum creatinine (Cr) ≤ 1.5 × ULN or creatinine clearance (CCr) ≥ 30 mL/min.
  • Cardiac function: New York Heart Association (NYHA) functional class less than Class III; ejection fraction ≥ 50% on echocardiogram.
  • 6.Estimated survival > 3 months. 7.Able to provide written informed consent and comply with protocol-specified study visits and procedures.
  • 8.Female subjects of childbearing potential, or male subjects whose female partners are of childbearing potential, must utilize effective contraceptive measures throughout the treatment period and for 90 days after the last dose of study treatment.

Who cannot join

  • DLBCL with central nervous system or leptomeningeal involvement;
  • Prior treatment with a non-covalent BTK inhibitor;
  • Prior treatment with immune checkpoint inhibitors;
  • Contraindication or hypersensitivity to any drug in the combination treatment regimen;
  • Concurrent other malignancies requiring treatment or intervention;
  • Major surgery within 4 weeks prior to treatment (excluding vascular access catheterization or biopsy);
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  • Any life-threatening disease, medical condition or organ dysfunction that, in the Investigator's opinion, may compromise patient safety or compliance with study procedures;
  • Uncontrolled clinical cardiac signs or diseases, including: i. Heart failure of NYHA Class ≥ II ii. Unstable angina pectoris iii. Myocardial infarction within the past 12 months iv. Clinically significant supraventricular or ventricular arrhythmias requiring treatment or intervention;
  • Patients with active bleeding;
  • Active and uncontrolled systemic bacterial, viral, fungal or parasitic infection (excluding fungal nail infection), or other clinically significant active disease process rendering the patient unsuitable for trial participation as judged by the Investigator.
  • Patients with active chronic hepatitis B or active hepatitis C. Patients positive for Hepatitis B surface antigen (HBsAg) and/or Hepatitis B core antibody (HBcAb), or Hepatitis C virus (HCV) antibody at screening must undergo further Hepatitis B virus (HBV) DNA testing (≤2500 copies/mL or ≤500 IU/mL) to rule out active hepatitis B or active hepatitis C requiring treatment before enrollment. Nevertheless, eligible patients with positive HBsAg and/or HBcAb must receive anti-hepatitis B antiviral therapy.
  • Patients infected with Human Immunodeficiency Virus (HIV) and/or patients with acquired immunodeficiency syndrome (AIDS);
  • Inability to swallow tablets, presence of malabsorption syndrome, or any other gastrointestinal disease or dysfunction that may affect absorption of the study drug;
  • Pregnant or lactating women;
  • Patients with psychiatric disorders or those unable to provide informed consent;
  • Patients deemed unsuitable for participation in this study by the Investigator.

Trial locations and contacts

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

China1 site
  • Jiangsu Province Hospital The First Affiliated Hospital with Nanjing Medical University

    Nanjing, Jiangsu

    Huayuan Zhu

Other trials in China

About this study

Official title: A Prospective, Phase II, Multicenter Clinical Study of Pirtobrutinib Combined With Sonrotoclax Regimen in the Treatment of B-Cell Lymphoma

This prospective, open-label, Phase II clinical trial evaluates the efficacy and safety of pirtobrutinib combined with sotoclax across three distinct B-cell lymphoma cohorts: histologically transformed diffuse large B-cell lymphoma (DLBCL), relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), and relapsed/refractory marginal zone lymphoma (MZL). Dosing regimen :pirtobrutinib 200 mg orally once daily plus sotoclax with a 4-week dose escalation schedule (1, 2, 5, 10, 20, 40, 80, 160 mg/day, then 320 mg/day on days 1-28, starting Cycle 2) administered orally. Cohorts 1 and 2 additionally incorporate obinutuzumab 1000 mg intravenously on Cycle 1 days 1, 8, and 15, followed by days 1 of Cycles 2 through 6, with a maximum of six cycles. Each treatment cycle spans 28 days.

For Cohort 1 (RT DLBCL), the primary objective centers on early response assessment following three cycles of the PSO regimen (pirtobrutinib-sotoclax-obinutuzumab), with PET/CT evaluation serving as the critical decision point. Patients demonstrating progressive disease or stable disease discontinue study treatment, while those achieving complete or partial response may proceed to investigator-selected bridging therapies including bispecific antibodies, CAR-T cell therapy, or hematopoietic stem cell transplantation, or alternatively continue PSO combination therapy. Obinutuzumab is capped at six cycles, whereas pirtobrutinib and sotoclax may continue for up to 25 cycles. Comprehensive biomarker strategies include ctDNA analysis from peripheral blood at baseline and after Cycle 1 (following full-dose sotoclax exposure), with serial assessments at Cycles 3, 7, 14, and every six cycles during Year 2 for patients continuing PSO beyond Cycle 3. Patients with measurable baseline tumor cells in peripheral blood or bone marrow undergo flow cytometry-based MRD detection at 10-⁴ sensitivity at corresponding timepoints. T-cell subset and functional analyses are performed at baseline, Cycle 3, and every three cycles thereafter to characterize immune dynamics during treatment.

Read more

Cohort 2 (relapsed/refractory CLL/SLL) follows a continuous treatment paradigm without an early stopping rule, with efficacy assessment after fourteen cycles. Patients achieving complete remission with MRD negativity at 10-⁴ may elect treatment discontinuation. Sotoclax is administered for a maximum of twenty-four cycles, with pirtobrutinib maintenance for patients failing to achieve MRD-negative complete remission. The biomarker program incorporates both flow cytometry MRD at 10-⁴ and next-generation sequencing MRD at 10-⁶ sensitivity, providing unprecedented depth of residual disease characterization. Sampling occurs at baseline, Cycle 1, Cycle 3, Cycle 7, Cycle 14, and every six cycles in Year 2.

Cohort 3 (relapsed/refractory MZL) mirrors the CLL/SLL treatment structure but omits obinutuzumab, testing the doublet of pirtobrutinib plus sotoclax. The fourteen-cycle efficacy assessment and MRD-guided stopping rule apply identically, with sotoclax limited to twenty-four cycles and pirtobrutinib maintenance for non-responders. ctDNA surveillance occurs at baseline, Cycle 3, Cycle 7, Cycle 14, and every six cycles in Year 2, complemented by serial T-cell immunophenotyping.

Read the detailed description

This is a prospective, open-label, Phase II clinical study aimed at investigating the efficacy and safety of pirtobrutinib combined with sotoclax in the treatment of B-cell lymphoma.

Cohort 1: Histologically transformed DLBCL Pirtobrutinib: 200 mg, po, qd Sotoclax: Dose escalation over 4 weeks: 1, 2, 5, 10, 20, 40, 80, 160 mg/day, followed by 320 mg/day, d1-28, po, starting from Cycle 2 Obinutuzumab: 1000 mg, iv, C1: d1, d8, d15; C2-C6: d1 Each cycle consists of 28 days. Patients receive treatment with pirtobrutinib combined with sotoclax and obinutuzumab (PSO regimen) for 3 cycles, followed by PET/CT evaluation. Patients with PD/SD will be discontinued from the study. Patients with CR/PR will, at the investigator's discretion, proceed to bridging therapy with bispecific antibodies, CAR-T, or HSCT, or continue treatment with pirtobrutinib combined with sotoclax and obinutuzumab. Efficacy assessments will be conducted every 3 cycles. Obinutuzumab will be administered for a maximum of 6 cycles; pirtobrutinib and sotoclax combination therapy will be administered for a maximum of 25 cycles.

Peripheral blood will be collected at baseline and after 1 cycle of treatment (following full-dose sotoclax in C1) for ctDNA detection. For patients who continue PSO combination therapy after 3 cycles, peripheral blood plasma will be collected after 3 cycles, 7 cycles, 14 cycles, and every 6 cycles in Year 2 for ctDNA detection.

For patients with measurable tumor cells in peripheral blood and/or bone marrow at baseline, minimal residual disease (MRD) will be assessed by flow cytometry (10-⁴ sensitivity) at baseline, after 1 cycle, after 3 cycles, after 7 cycles, after 14 cycles, and every 6 cycles in Year 2.

Peripheral blood will be collected at baseline, after 3 cycles, and every 3 cycles thereafter for T-cell subset and functional analysis.

Cohort 2: Relapsed/Refractory CLL/SLL Pirtobrutinib: 200 mg, po, qd Sotoclax: Dose escalation over 4 weeks: 1, 2, 5, 10, 20, 40, 80, 160 mg/day, followed by 320 mg/day, d1-28, po, starting from Cycle 2 Obinutuzumab: 1000 mg, iv, C1: d1, d8, d15; C2-C6: d1 Each cycle consists of 28 days. Patients receive treatment with pirtobrutinib combined with sotoclax and obinutuzumab. Efficacy assessment will be conducted after 14 cycles. Patients who achieve CR with MRD negativity (10-⁴) may choose to discontinue treatment. Sotoclax will be administered for a maximum of 24 cycles; patients who have not achieved MRD negativity will continue pirtobrutinib maintenance.

For patients with measurable tumor cells in peripheral blood and/or bone marrow at baseline, MRD will be assessed by flow cytometry (10-⁴ sensitivity) and NGS-MRD (10-⁶ sensitivity) at baseline, after 1 cycle, after 3 cycles, after 7 cycles, after 14 cycles, and every 6 cycles in Year 2.

Cohort 3: Relapsed/Refractory MZL Pirtobrutinib: 200 mg, po, qd Sotoclax: Dose escalation over 4 weeks: 1, 2, 5, 10, 20, 40, 80, 160 mg/day, followed by 320 mg/day, d1-28, po, starting from Cycle 2 Each cycle consists of 28 days. Patients receive treatment with pirtobrutinib combined with sotoclax. Efficacy assessment will be conducted after 14 cycles. Patients who achieve CR with MRD negativity (10-⁴) may choose to discontinue treatment. Sotoclax will be administered for a maximum of 24 cycles; patients who have not achieved MRD negativity will continue pirtobrutinib maintenance.

Peripheral blood plasma will be collected at baseline, after 3 cycles, after 7 cycles, after 14 cycles, and every 6 cycles in Year 2 for ctDNA detection.

Peripheral blood will be collected at baseline, after 3 cycles, and every 3 cycles thereafter for T-cell subset and functional analysis.

Being tested
Pirtobrutinib, Sotoclax+/- Obinutuzumab (PSO) Combination for B cell lymphoma
Medical subject headings
Dendritic Cell Sarcoma, Interdigitating

What participants receive

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

  • Pirtobrutinib, Sotoclax+/- Obinutuzumab (PSO) Combination for B cell lymphomaDrug

    Pirtobrutinib, Sotoclax+/- Obinutuzumab (PSO) Combination for B cell lymphoma

Study groups in NCT07744750
Study groupRoleWhat they receive
PS+/-O for B cell lymphomaExperimentalCohort1:Pirtobrutinib, Sotoclax, and Obinutuzumab (PSO) Combination for RT DLBCL Cohort2: Pirtobrutinib, Sotoclax, and Obinutuzumab (PSO) Combination for R/R CLL/SLL Cohort3:Pirtobrutinib and Sotoclax Combination for R/R MZL
Receives: Drug: Pirtobrutinib, Sotoclax+/- Obinutuzumab (PSO) Combination for B cell lymphoma

What is being measured

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

  1. Objective Response Rate (ORR) after 14 cycles of induction therapy

    Objective Response Rate (ORR) after 14 cycle induction therapy

    Measured: week 56,at the end of 14 cycle of PSO/PS regimen(each cycle is 28 days)

Secondary outcomes (4)
  1. Complete Response Rate (CRR) after 14 cycles of induction therapy

    Complete Response Rate (CRR) after 14 cycles of induction therapy

    Measured: week 56,at the end of 14 cycle of PSO/PS regimen(each cycle is 28 days)

  2. Overall Survival (OS)

    Measured: up to 3 years

  3. Event-Free Survival (EFS)

    Measured: up to 3 years

  4. Number of participants with treatment-related adverse events (TRAEs) as assessed by CTCAE v5.0

    Measured: up to 3 years

Timeline

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

  1. First posted4 Aug 2026
  2. Study start30 Aug 2026 (estimated)
  3. Primary completion31 Aug 2027 (estimated)
  4. Study completion31 Aug 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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07744750
Sponsor's protocol ID
2026CELH027-01
Status last verified
Jul 2026
First submitted
29 Jul 2026
Last updated
6 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Pirtobrutinib, Sotoclax+/- Obinutuzumab (PSO) Combination for B cell lymphoma in people with DLBCL - Diffuse Large B Cell Lymphoma and Richter Transformation, run by Changzhou No.2 People's Hospital at 1 site in China.

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: opening soon, as of the sponsor's last update on 6 Aug 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 China. 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 Huayuan Zhu, PhD (+86 13813810650, huayuan.zhu@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response Rate (ORR) after 14 cycles of induction therapy (time frame: week 56,at the end of 14 cycle of PSO/PS regimen(each cycle is 28 days)). 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 6 Aug 2026.

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