NCT07831395

Single-Arm, Multicenter, Prospective Phase II Clinical Study of Rituximab Combined With Pirtobrutinib, Lisaftoclax and Liposomal Mitoxantrone for Richter Syndrome Transformed From Chronic Lymphocytic Leukemia

Study Summary

This single-arm, multicenter, open-label phase II trial evaluates the efficacy and safety of rituximab + pirtobrutinib + lisaftoclax + liposomal mitoxantrone in adults with CLL-transformed Richter syndrome (CLL-RS). All eligible patients receive 4 cycles (21 days each) of the quadruple regimen: rituximab 375 mg/m² IV on Day 0, pirtobrutinib 200 mg PO daily (D1-21), lisaftoclax ramp-up to 600 mg QD (D1-21), and liposomal mitoxantrone 18 mg/m² IV on D1, with TLS prophylaxis/monitoring. Primary endpoint: CR rate after 4 cycles. Secondary endpoints: ORR, DOR, PFS, OS, MRD negativity, and safety. Post-induction: CR/PR patients proceed to allo-HSCT, CAR-T, or maintenance; SD/PD receive alternative/palliative care. Long-term follow-up starts after discontinuation.

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Interventions

Lisaftoclax (APG-2575)DRUG
Lisaftoclax oral with mandatory 6-day dose ramp-up (20mg→50mg→100mg→200mg→400mg→600mg QD), maintained at 600mg QD Days 1-21; standardized tumor lysis syndrome (TLS) prophylaxis (hydration + urate-lowering agents) and intensive serial TLS lab monitoring during dose escalation
RituximabDRUG
Rituximab 375 mg/m² IV infusion on Cycle Day 0; premedication with paracetamol, diphenhydramine and corticosteroids for infusion reaction prophylaxis
PirtobrutinibDRUG
Pirtobrutinib 200 mg oral QD, Days 1-21 of each cycle
Liposomal mitoxantroneDRUG
Liposomal mitoxantrone 18 mg/m² IV infusion on Cycle Day 1

Study Locations

FacilityCityStateCountry
Henan Cancer HospitalZhengzhouHenanChina
The second Xiangya hospital of central south universityChangshaHunanChina
The First affiliated hospital of Nanchang UniversityNanchangJiangxiChina
Nanfang Hospital Southern Medical UniversityGuangzhouChina
Jiangsu Province HospitalNanjingChina
Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina

Official Trial Information

View on ClinicalTrials.gov

Data sourced from ClinicalTrials.gov. Last updated: October 12, 2026