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Richter TransformationPhase 2CLLRT2NCT07917780

A Prospective, Open-label, Randomized, Multicenter Phase-III Trial to Evaluate the Efficacy of Pirtobrutinib and Epcoritamab Compared With R-(Mini)-CHOP for Treatment of Patients With DLBCL-type Richter Transformation

A Phase 2 study testing Epcoritamab, Pirtobrutinib and Cyclophosphamide in people with Richter Transformation, run by German CLL Study Group at 12 sites in 5 countries.

Recruiting

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

Sites and contacts
Official record
Search all trials

Trial summary

The aim of the trial is to Evaluate the Efficacy of Pirtobrutinib and Epcoritamab Compared With R-(Mini)-CHOP for Treatment of Patients With DLBCL-type Richter Transformation Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Richter Transformation
What is being tested?
Epcoritamab, Pirtobrutinib and Cyclophosphamide
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
116 participants
Where
12 sitesin 5 countries
Study dates
18 Jun 2026to 15 May 2030
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 ≥80 years OR considered frail defined by a frailty score of >2 on the FRAIL scale via the patient´s assessment
  • Has documented treatment-naïve CLL or small lymphocytic lymphoma (SLL) according to iwCLL 2018 criteria3
  • CLL/SLL requiring treatment according to the iwCLL 2018 criteria3
  • Adequate marrow function independent of growth factor or transfusion support within 2 weeks of screening as follows, unless cytopenia is due to marrow involvement of CLL:
  • Absolute neutrophil count ≥ 1.0 × 10^9/L
  • Platelet counts ≥ 30 × 10^9/L; in cases of thrombocytopenia clearly due to marrow in-volvement of CLL (per the discretion of the investigator); platelet count should be ≥ 10 × 10^9/L if there is bone marrow involvement
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  • Total haemoglobin ≥ 9 g/dL (without transfusion support, unless anaemia is due to mar-row involvement of CLL)
  • Adequate liver function as indicated by a total bilirubin, AST, and ALT ≤2 times the institutional upper limit of normal (ULN) value unless directly attributable to the patient's CLL or Gilbert's syndrome
  • Adequate renal function defined by a value ≥30 mL/min, determined either by creatinine clearance directly measured with a 24-hour urine collection or via estimated GFR calculated according to the CKD-EPI equation or Cystatin C measurements (e.g. in sarcopenic patients).
  • Negative serological testing for hepatitis B (HBsAg negative and anti-HBc negative; patients positive for anti-HBc may be included if PCR for HBV DNA is negative and HBV-DNA PCR is performed repeatedly until 6 months after last month of treatment), negative testing for hepa-titis C RNA within 6 weeks prior to registration
  • Life expectancy ≥ 3 months
  • In case of a recent previous (i.e. debulking) treatment, patients must have recovered from acute toxicities and treatment regimen must be stopped within the following time periods be-fore start of the study treatment in the CLL-Frail2 trial:
  • chemotherapy ≥ 28 days
  • antibody treatment ≥ 14 days
  • corticosteroids may be applied until the start of the study therapy; these have to be re-duced to an equivalent of ≤ 20mg prednisolone per day during treatment
  • Signed informed consent and, in the investigator's judgment, able to comply with the study protocol
  • Ability and willingness to provide written informed consent and to adhere to the study visit schedule and other protocol requirements

Who cannot join

  • 1. Previous CLL-directed therapies 2. Transformation of CLL to aggressive NHL (Richter's transformation or pro-lymphocytic leu-kaemia) 3. Patients with a history of confirmed progressive multifocal leukoencephalopathy (PML) 4. Uncontrolled autoimmune condition 5. Malignancies other than CLL currently requiring systemic therapies (unless the malignant dis-ease is in a stable remission at the discretion of the treating physician) 6. Uncontrolled infection currently requiring systemic treatment 7. Any serious medical condition or abnormality in clinical laboratory tests that, in the investiga-tor's judgment, precludes the patient's safe participation in and completion of the study 8. Requirement of treatment with any moderate or strong CYP3A4 inhibitor or strong CYP3A4 inducer (≤ 14 days or 5 half-lives, whichever is shorter) before the first dose of study drug, or requiring ongoing treatment with a moderate or strong CYP3A inhibitor or a strong CYP3A in-ducer.
  • 9. Requirement of therapy with phenprocoumon or other vitamin K antagonists 10. Known active infection with HIV, or serologic status reflecting active 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 (< 20 IU), and if they are willing to undergo monitoring for HBV reactivation
  • Presence of hepatitis C virus (HCV) antibody. Patients with presence of HCV antibody are eligible if HCV RNA is undetectable 11. Major surgery within 4 weeks of the first dose of study drug 12. Any uncontrolled or clinically significant cardiovascular disease including the following:
  • New York Heart Association class III or IV congestive heart failure
  • History of clinically significant arrhythmias (eg, sustained ventricular tachycardia, ventricu-lar fibrillation, torsades de pointes) 13. History of severe bleeding disorder such as hemophilia A, hemophilia B, von Willebrand dis-ease if not CLL/SLL related, or history of spontaneous bleeding requiring blood transfusion or other medical intervention 14. Unable to swallow capsules or disease significantly affecting gastrointestinal function such as malabsorption syndrome, resection of the stomach or small bowel, bariatric surgery proce-dures, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction.
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  • 15. Use of investigational agents, e.g. monoclonal antibodies or other experimental drugs within clinical trials, which might interfere with the study drug within 28 days (or 5 times half-life [t1/2] of the compound, whichever is longer) prior to registration 16. Known hypersensitivity to zanubrutinib or sonrotoclax or any of the excipients 17. Pregnant women and nursing mothers (a negative pregnancy test is required for all women of childbearing potential within 7 days before start of treatment) 18. Fertile men or women of childbearing potential unless:
  • surgically sterile or ≥ 2 years after the onset of menopause, or
  • willing to use two methods of reliable contraception including one highly effective contra-ceptive method (Pearl Index <1) and one additional effective (barrier) method during study treatment and for 7 days after sonrotoclax and 30 days after zanubrutinib respec-tively 19. Vaccination with a live vaccine <28 days prior to registration 20. Legal incapacity 21. Prisoners or subjects who are institutionalized by regulatory or court order 22. Persons who are in dependence to the sponsor or an investigator

Trial locations and contacts

12 sites in 5 countries. Contact the study team or a site near you to ask about taking part.

12 sites in 5 countries

Germany6 sites, 6 recruiting
  • Uniklinik Köln

    Cologne, 50937

    Barbara Eichhorst, Prof., +4922147888220, barbara.eichhorst@uk-koeln.de

    Recruiting
  • Technische Universitaet Dresden

    Dresden, 01307

    Johannes Schetelig, Prof., +493514585604, Johannes.Schetelig@ukdd.de

    Not yet recruiting
  • Universitätsklinikum Frankfurt

    Frankfurt, 60590

    Sebastian Scheich, +496963013767, s.scheich@med.uni-frankfurt.de

    Recruiting
  • Universitätsklinikum Heidelberg

    Heidelberg, 69120

    Peter Dreger, Prof., +496221568030, Peter.Dreger@med.uni-heidelberg.de

    Not yet recruiting
  • Universitätsklinikum Schleswig-Holstein Campus Kiel

    Kiel, 24105

    Matthias Ritgen, Dr., +4943150022555, m.ritgen@med2.uni-kiel.de

    Not yet recruiting
  • Universitätsklinik Ulm

    Ulm, 89081

    Christof Schneider, Dr., +4973150056012, christof.schneider@uniklinik-ulm.de

    Recruiting

Other trials in Germany

Austria2 sites, 2 recruiting
  • Medizinische Universitaet Innsbruck

    Innsbruck, 6020

    Dominik Wolf, Prof., +4351250424003, mui-oversight@i-med.ac.at

    Not yet recruiting
  • Medizinische Universität Wien

    Vienna, 1090

    Alexander Gaiger, +4314040044765, alexander.gaiger@meduniwien.ac.at

    Recruiting

Other trials in Austria

Ireland2 sites, 2 recruiting
  • Beaumont Hospital

    Dublin, Dublin 9

    Patrick Thornton, +613 8559 5000, philip.thompson@petermac.org

    Recruiting
  • University Hospital Galway

    Galway, H91 YR71

    Amjad Hayat, +35391544281, amjad.hayat@hse.ie

    Recruiting

Other trials in Ireland

Australia1 site, 1 recruiting
  • Peter MacCallum Cancer Center

    Melbourne, 3000

    Philip Thompson, Prof., +613 8559 5000, philip.thompson@petermac.org

    Recruiting

Other trials in Australia

Denmark1 site, 1 recruiting
  • Rigshospitalet

    Copenhagen, 2100

    Caspar Da Cunha-Bang, MD, +4535450410, Caspar.Da.Cunha-Bang@regionh.dk

    Not yet recruiting

Other trials in Denmark

About this study

The aim of the trial is to Evaluate the Efficacy of Pirtobrutinib and Epcoritamab Compared With R-(Mini)-CHOP for Treatment of Patients With DLBCL-type Richter Transformation

Read the detailed description

This trial is a phase 2 study and - according to the definitions of the ICH Harmonized Tripartite Guide-line E8 - a therapeutic exploratory type of study, which is designed as a prospective, multicenter, open label trial. The trial aims to investigate the efficacy and safety of a fixed-duration treatment ap-proach in patients aged 80 years or older and/or those exhibiting symptoms of frailty.

Being tested
Epcoritamab, Pirtobrutinib, Cyclophosphamide, Doxorubicin, Vincristine

What participants receive

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

  • EpcoritamabBiological

    Also called Epkinly®

    Cycle 1 Day 1-21: Pirtobrutinib 200 mg QD po Day 1: Epcoritamab 0.16 mg sc Day 8: Epcoritamab 0.8 mg sc Day 15: Epcoritamab 48 mg sc

    Cycle 2-28 Epcoritamab 48 mg sc

  • PirtobrutinibDrug

    Also called Jaypirca®

    Pirtobrutinib 200 mg QD po

  • CyclophosphamideDrug

    750 mg/m2 iv (R-CHOP) or 400 mg/m2 iv (R-mini-CHOP)

  • DoxorubicinDrug

    50 mg/m2 iv (R-CHOP) or 25 mg/m2 iv (R-mini-CHOP)

  • VincristineDrug

    1.4 mg/m2 iv (R-CHOP) or 1 mg/m2 iv (R-mini-CHOP)

  • RituximabDrug

    375 mg/m2 iv (R-CHOP) or 375 mg/m2 iv or sc (R-mini-CHOP)

Study groups in NCT07917780
Study groupRoleWhat they receive
Arm A: R-(mini)-CHOPActive comparatorCycle 1-6 Day 1: Cyclophosphamide 750 mg/m2 iv Doxorubicin 50 mg/m2 iv Vincristine 1.4 mg/m2 (max 2 mg) iv Rituximab 375 mg/m2 iv Day 1-5: Prednisolone 100 mg po If R-CHOP-ineligible*, R-mini-CHOP3 is administered: Cycle 1-6 Day 1: Cyclophosphamide 400 mg/m2 iv Doxorubicin 25 mg/m2 iv Vincristine 1 mg iv Rituximab 375 mg/m2 iv or sc Day 1-5: Prednisolone 100 mg po
Receives: Drug: Cyclophosphamide; Drug: Doxorubicin; Drug: Vincristine; Drug: Rituximab
Arm B: Epcoritamab-PirtobrutinibExperimental12 cycles: Cycle 1 Day 1-21: Pirtobrutinib 200 mg QD po Day 1: Epcoritamab 0.16 mg sc Day 8: Epcoritamab 0.8 mg sc Day 15: Epcoritamab 48 mg sc Cycle 2-4 Day 1-21: Pirtobrutinib 200 mg QD po Day 1, 8, 15: Epcoritamab 48 mg sc Cycle 5+6 Day 1-21: Pirtobrutinib 200 mg QD po Day 1: Epcoritamab 48 mg sc Cycle 7-12: Day 1-28: Pirtobrutinib 200 mg QD po Day 1: Epcoritamab 48 mg sc For patients with CR, PR or SD after 12 cycles (=EO[C]T), maintenance treatment with pirtobrutinib 200 mg QD until unacceptable toxicity, disease progression or allogeneic stem cell transplantation will be offered.
Receives: Biological: Epcoritamab; Drug: Pirtobrutinib

What is being measured

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

  1. PFS

    Investigator-assessed progression-free survival (PFS) according to Lugano criteria

    Measured: approx. 40 months after first subject in

Secondary outcomes (9)
  1. ORR

    Overall response rate (ORR) at the end of (combination) treatment according to Lugano criteria

    Measured: approx. 40 months after first subject in

  2. CRR

    Complete response rate (CRR) at the end of (combination) treatment according to Lugano criteria

    Measured: approx. 40 months after first subject in

  3. Best response according to Lugano criteria

    Best response according to Lugano criteria

    Measured: approx. 40 months after first subject in

  4. Undetectable minimal residual disease (uMRD)

    Undetectable minimal residual disease (uMRD) rates in peripheral blood at the end of (combination) treatment

    Measured: approx. 40 months after first subject in

  5. DOR

    Duration of response (DOR) according to Lugano criteria

    Measured: approx. 40 months after first subject in

  6. Overall survival (OS)

    Overall survival (OS)

    Measured: approx. 40 months after first subject in

  7. TTNT

    Time to next treatment (TTNT)

    Measured: approx. 40 months after first subject in

  8. TFS

    Treatment-free survival (TFS)

    Measured: approx. 40 months after first subject in

  9. SCT

    Proportion of patients receiving allogeneic stem cell transplantation (SCT) for consolidation

    Measured: approx. 40 months after first subject in

Timeline

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

  1. First posted5 Nov 2026
  2. Study start18 Jun 2026
  3. Primary completion15 May 2030 (estimated)
  4. Study completion15 May 2030 (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
Randomised
Intervention model
Parallel groups
Model description
randomized (1:1) and stratified
Masking
None (open label)
Enrolment
116 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07917780
Sponsor's protocol ID
CLLRT2
Acronym
CLLRT2
Status last verified
Oct 2026
First submitted
28 Oct 2026
Last updated
5 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Epcoritamab, Pirtobrutinib and Cyclophosphamide in people with Richter Transformation, run by German CLL Study Group at 12 sites in 5 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 9 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 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Germany, Austria, Ireland, Australia, Denmark. 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?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

PFS (time frame: approx. 40 months after first subject in). 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 Nov 2026.

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