[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"transformed-chronic-lymphocytic-leukemia-to-diffuse-large-b-cell-lymphoma\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:transformed-chronic-lymphocytic-leukemia-to-diffuse-large-b-cell-lymphoma":27},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,3,0,[8,41,75],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":4,"studyType":21,"phases":22,"briefSummary":24,"conditions":25,"keywords":4,"overallStatus":29,"whyStopped":4,"lastUpdateSubmitDate":30,"lastUpdatePostDateStruct":31,"startDateStruct":34,"completionDateStruct":36,"leadSponsor":38,"locationsCount":4},"100609869","phase-3-adding-pirtobrutinib-to-the-usual-treatment-for-people-with-newly-diagnosed-richter-transformation-the-piramid-trial-100609869",false,"NCT07220187","Adding Pirtobrutinib to the Usual Treatment for People With Newly Diagnosed Richter Transformation, The PIRAMID Trial","A Randomized Phase III Study of Pirtobrutinib Plus R-CHOP vs. R-CHOP for Participants With Previously Untreated Richter Transformation (PIRAMID)","Inclusion Criteria:\n\n* Participants must have been diagnosed with Richter Transformation (RT) (CLL\u002Fsmall lymphocytic lymphoma \\[SLL\\] to LBCL)\n\n  * Participants must have histologically or cytologically confirmed LBCL\n* Participants must have measurable disease determined by PET\u002FCT or hematopathology (by morphology or flow cytometry) assessment within 42 days prior to registration\n* Participants must have staging PET\u002FCT imaging performed within 42 days prior to registration\n* Participants are allowed prior treatments for CLL\u002FSLL or its complications (autoimmune hemolytic anemia \\[AIHA\\], immune thrombocytopenic purpura \\[ITP\\]), with the exception of pirtobrutinib\n* Participants must not have prior treatment for Richter transformation except for corticosteroids up to equivalent dose of prednisone 700 mg total for less than 7 days for disease control. Treatment for CLL\u002FSLL with CLL\u002FSLL directed drugs (including BTK inhibitors with the exception of pirtobrutinib) after the Richter transformation diagnosis is allowed for the purpose of disease control. CLL targeted therapies must be stopped within 3 days before initiation of therapy on protocol. Chemotherapy or anti-CD20 monoclonal antibody therapy must be stopped within 2 weeks before initiation of therapy on protocol\n* Participants must not have contraindication for receiving anthracycline. Participants must not have received more than a cumulative dose of 100mg\u002Fm\\^2 in those participants who will receive R-CHOP or not more than 250 mg\u002Fm\\^2 in those participants who will receive R-mini-CHOP of prior doxorubicin (or equivalent dose of another anthracycline, such as epirubicin) therapy (at any time prior to registration)\n* Patients requiring strong CYP3A inducers are not eligible and can only be enrolled if\n\n  * an alternative treatment to the strong CYP3A inducer is available for them and\n  * the last dose of the strong CYP3A inducer is administered at least 7 days before initiation of pirtobrutinib for patients in safety run-in and arm 1\n* Participant must be ≥ 18 years old at the time of registration\n* Participant must have Eastern Cooperative Oncology Group (ECOG)\u002FZubrod Performance Status of 0-2\n* Participant must have a complete medical history and physical exam within 28 days prior to registration\n* Absolute neutrophil count (ANC) ≥ 0.75 x 10\\^3\u002FµL or ≥ 0.50 x 10\\^3\u002FµL in participants with suspected marrow involvement considered to impair hematopoiesis (within 28 days prior to registration)\n* Platelets ≥ 50 x 10\\^3\u002FµL or ≥ 30 x 10\\^3\u002FµL in participants with suspected marrow involvement considered to impair hematopoiesis (within 28 days prior to registration)\n* Hemoglobin ≥ 8 g\u002FdL (≥ 80 g\u002FL) or ≥ 6 g\u002FdL in participants with suspected bone marrow involvement considered to impair hematopoiesis (within 28 days prior to registration)\n* Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) or ≤ 3 x ULN with documented liver involvement and\u002For Gilbert's disease (within 28 days prior to registration)\n* Aspartate aminotransferase (AST) \u002F alanine aminotransferase (ALT) ≤ 3 × institutional ULN or ≤ 5 ULN with documented liver involvement (within 28 days prior to registration)\n* Participants must have a calculated creatinine clearance ≥ 30 mL\u002Fmin using the Cockcroft-Gault Formula. This specimen must have been drawn and processed within 28 days prior to registration. For the Cockcroft-Gault formula for calculated creatinine clearance, see the tools on the CRA Workbench https:\u002F\u002Ftxwb.crab.org\u002FTXWB\u002FTools.aspx\n* Participants must have a left ventricular ejection fraction (LVEF) ≥ 45% as measured by echocardiogram or radionuclide (MUGA) ventriculography within 56 days prior to registration\n* Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, must have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, participants must be class 2B or better\n* HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial. Participants' HIV-directed therapy cannot have known interactions with pirtobrutinib\n* Participants with a known history of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load while on suppressive therapy on the most recent test results obtained within 6 months prior to registration\n* Participants with a known history of hepatitis C virus (HCV) infection must have been treated and cured. Participants currently being treated for HCV infection must have undetectable HCV viral load test on the most recent test results obtained within 6 months prior to registration\n* Participants must be able to swallow and retain oral medications and have no known gastrointestinal disorders likely to interfere with absorption of oral medications\n* Participants must not have a prior or concurrent malignancy in addition to CLL\u002FSLL and Richter transformation whose natural history or treatment (in the opinion of the treating physician) has the potential to interfere with the safety or efficacy assessment of the investigational regimen\n* Participants must not have had major surgery within 28 days prior to registration\n* Participants must not have experienced a major bleeding event or grade ≥ 3 arrhythmia on prior treatment with a BTK inhibitor.\n\n  * NOTE: Major bleeding is defined as bleeding having one or more of the following features: potentially life-threatening bleeding with signs or symptoms of hemodynamic compromise; bleeding associated with a decrease in the hemoglobin level of at least 2g per deciliter; or bleeding in a critical area or organ (e.g., retroperitoneal, intraarticular, pericardial, epidural, or intracranial bleeding or intramuscular bleeding with compartment syndrome\n* Participants must not be pregnant or nursing (nursing includes breast milk fed to an infant by any means, including from the breast, milk expressed by hand, or pumped). Individuals who are of reproductive potential must have agreed to use an effective contraceptive method with details provided as a part of the consent process. A person who has had menses at any time in the preceding 12 consecutive months or who has semen likely to contain sperm is considered to be of \"reproductive potential.\" In addition to routine contraceptive methods, \"effective contraception\" also includes refraining from sexual activity that might result in pregnancy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) including hysterectomy, bilateral oophorectomy, bilateral tubal ligation\u002Focclusion, and vasectomy with testing showing no sperm in the semen\n* Participants must be offered the opportunity to participate in specimen banking\n* Participants must agree to have blood and lymphatic tissue specimens submitted for the integrated translational medicine study\n* For randomized participants only: Participants who can complete PRO-CTCAE and FACIT GP5 questionnaires forms in English or Spanish must be offered the opportunity to participate in the patient-reported outcome","ALL","18 Years",{"count":19,"type":20},102,"ESTIMATED","INTERVENTIONAL",[23],"PHASE3","This phase III trial compares the effect of adding pirtobrutinib to the usual treatment with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) to R-CHOP alone for the treatment of Richter transformation, which is when chronic lymphocytic leukemia or small lymphocytic lymphoma turns into large B-cell lymphoma, a more aggressive (faster-growing) form of lymphoma. Pirtobrutinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Rituximab is a monoclonal antibody. It binds to a protein called CD20, which is found on B cells (a type of white blood cell) and some types of cancer cells. This may help the immune system kill cancer cells. Cyclophosphamide is in a class of medications called alkylating agents. It works by damaging the cell's DNA and may kill cancer cells. It may also lower the body's immune response. Doxorubicin is in a class of medications called anthracyclines. Doxorubicin damages the cell's DNA and may kill cancer cells. It also blocks a certain enzyme needed for cell division and DNA repair. Vincristine is in a class of medications called vinca alkaloids. It works by stopping cancer cells from growing and dividing and may kill them. Prednisone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Adding pirtobrutinib to R-CHOP may kill more cancer cells than R-CHOP alone in patients with Richter transformation.",[26,27,28],"Richter Syndrome","Transformed Chronic Lymphocytic Leukemia to Diffuse Large B-Cell Lymphoma","Transformed Small Lymphocytic Lymphoma to Diffuse Large B-Cell Lymphoma","NOT_YET_RECRUITING","2026-06-09",{"date":32,"type":33},"2026-06-11","ACTUAL",{"date":35,"type":20},"2026-08-31",{"date":37,"type":20},"2036-10",{"name":39,"class":40},"SWOG Cancer Research Network","NETWORK",{"id":42,"slug":43,"hasResults":11,"nctId":44,"briefTitle":45,"officialTitle":46,"acronym":4,"eligibilityCriteria":47,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":48,"targetDuration":4,"studyType":21,"phases":50,"briefSummary":52,"conditions":53,"keywords":61,"overallStatus":64,"whyStopped":4,"lastUpdateSubmitDate":65,"lastUpdatePostDateStruct":66,"startDateStruct":68,"completionDateStruct":70,"leadSponsor":72,"locationsCount":5},"100506386","phase-2-zanubrutinib-and-lisocabtagene-maraleucel-for-the-treatment-of-richters-syndrome-100506386","NCT05873712","Zanubrutinib and Lisocabtagene Maraleucel for the Treatment of Richter's Syndrome","A Phase II Study Evaluating the Safety and Efficacy of the Combination of Zanubrutinib Plus Lisocabtagene Maraleucel for Richter's Syndrome","Inclusion Criteria:\n\n* Diagnosis of RS - occurrence of diffuse large B-cell lymphoma (DLBCL) in patients with antecedent or concurrent CLL\u002FSLL (CLL\u002FSLL diagnosis per IWCLL 2018 criteria).\n* Must have relapsed\u002Frefractory disease as defined by one of the following:\n\n  * Participants must have undergone \\>= 1 prior systemic therapeutic regimen administered for \\>= 1 cycle for either CLL or RS, and have had either documented disease progression to the most recent treatment regimen, or refractory disease. OR\n  * Developed RS while receiving treatment for CLL\n* Age \\>= 18 years\n* Eastern Cooperative Oncology Group (ECOG) performance status =\\\u003C 2\n* Total bilirubin =\\\u003C 2.0 times the institutional upper limit of normal (unless documented Gilbert's syndrome)\n* Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \\[SGOT\\]) =\\\u003C 2.5 x institutional upper limit of normal\n* Alanine aminotransferase (ALT) (serum glutamic-pyruvic transaminase \\[SGPT\\]) =\\\u003C 2.5 x institutional upper limit of normal\n* Creatinine clearance \\>= 30 mL\u002Fmin\n\n  * Using 24-hour creatinine clearance or standard Cockcroft-Gault equation\n* Absolute lymphocyte count \\> 100\u002FuL at screening\n* Left ventricular ejection fraction \\>= 40% by multigated acquisition (MUGA) or echocardiogram (ECHO)\n* Adequate bone marrow independent of growth factor support or infusion support at screening unless evidence shows that the cytopenia(s) is due to marrow involvement by CLL\u002Fsmall lymphocytic lymphoma (SLL). If cytopenias are due to disease in the bone marrow any degree of anemia or thrombocytopenia are allowed, absolute neutrophil count (ANC) must be \\>= 500\n* Absolute neutrophil count (ANC) \\>= 1000\u002Fmm\\^3 (independent of growth factor support or infusion support at screening unless evidence shows that the cytopenia\\[s\\] is due to marrow involvement by CLL\u002FSLL). If cytopenias are due to disease in the bone marrow any degree of anemia or thrombocytopenia are allowed, ANC must be \\>= 500\n* Platelets \\>= 30,000\u002Fmm\\^3 (independent of growth factor support or infusion support at screening unless evidence shows that the cytopenia\\[s\\] is due to marrow involvement by CLL\u002FSLL). If cytopenias are due to disease in the bone marrow any degree of anemia or thrombocytopenia are allowed\n* Hemoglobin \\>= 7 g\u002FdL (independent of growth factor support or infusion support at screening unless evidence shows that the cytopenia\\[s\\] is due to marrow involvement by CLL\u002FSLL). If cytopenias are due to disease in the bone marrow any degree of anemia or thrombocytopenia are allowed\n* Radiographically measurable lymphadenopathy (or measurable extra-nodal disease) per Lugano criteria\n* Must meet all institutional standards for receiving CAR T-cell therapy\n* Subjects (or legal guardians) must have the ability to understand and the willingness to sign a written informed consent document\n* For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use a contraceptive method with a failure rate of \\\u003C 1% per year, initiated prior to first dose of study drug, during the treatment period and for at least 1 year after the CAR-T cell infusion or 1 month after last dose of zanubrutinib, whichever is longer.\n\n  * A woman is considered to be of childbearing potential if she is postmenarcheal, has not reached a postmenopausal state (\\\u003C 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and\u002For uterus). Examples of contraceptive methods with a failure rate of \\\u003C 1% per year include bilateral tubal ligation, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices, and copper intrauterine devices\n* For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures, and agreement to refrain from donating sperm, as defined below:\n\n  * With female partners of childbearing potential, men must remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of \\\u003C 1% per year during the treatment period and for at least 1 year after the anti-CD19 CAR-T cell infusion or 1 month after last dose of zanubrutinib, whichever is longer. Men should avoid fathering a child and refrain from donating sperm during this same period.\n  * With pregnant female partners, men must remain abstinent or use a condom during the treatment period and for at least 1 year after the human anti- CD19 CAR-T cell infusion or 1 month post last dose of zanubrutinib, whichever is longer, to avoid potential embryonal or fetal exposure. The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception\n\nExclusion Criteria:\n\n* A history of treatment including any of the following: prior CD19 directed therapy, treatment with alemtuzumab within 6 months before enrollment, prior allogeneic hematopoietic stem cell transplant (SCT) or donor lymphocyte infusion (DLI) within 2 months prior to enrollment\n* Prior allogeneic stem cell transplant with active graft-versus-host disease (GVHD), or requiring immunosuppressive drugs for treatment of GVHD, or have taken calcineurin inhibitors within 4 weeks prior to consent\n* Inadequate recovery from adverse events related to prior therapy to grade =\\\u003C 1 (excluding grade 2 alopecia, neuropathy, and hypertension)\n* Is unable to swallow oral medication, or has significant gastrointestinal disease that would limit absorption of oral medication\n* Active bleeding or history of bleeding diathesis (e.g., hemophilia or von Willebrand disease)\n* Uncontrolled autoimmune hemolytic anemia (AIHA) or idiopathic thrombocytopenic purpura (ITP)\n* Presence of a gastrointestinal ulcer diagnosed by endoscopy within 3 months before screening\n* Clinically significant cardiovascular disease such as symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of screening, or any class 3 or 4 cardiac disease as defined by the New York Heart Association Functional Classification. Note: Subjects with controlled atrial fibrillation\u002Fflutter can enroll on study\n* Requires or receiving anticoagulation with warfarin or equivalent vitamin K antagonists\n* Prothrombin time (PT)\u002Finternational normalized ratio (INR) or activated partial thromboplastin time (PTT) (in the absence of lupus anticoagulant) \\> 2 x upper limit normal (ULN)\n* Treatment with a moderate or strong CYP3A inhibitor or inducer within 7 days prior to first dose of zanubrutinib\n* Patients may not have an active intercurrent disease or concurrent malignancy that is expected to limit survival to \\\u003C 5 years\n* Human immunodeficiency virus (HIV) seropositivity at screening\n* Subjects with uncontrolled intercurrent illness including, but not limited to ongoing or active infection, unstable angina pectoris, pulmonary abnormalities or psychiatric illness\u002Fsocial situations that would limit compliance with study requirements\n* Pregnant or breastfeeding women are excluded from this study because CAR-T cell therapy may be associated with the potential for teratogenic or abortifacient effects. Women of childbearing potential must have a negative serum pregnancy test. Because there is an unknown, but potential risk for adverse events in nursing infants secondary to treatment of the mother with CAR-T cells, breastfeeding should be discontinued. These potential risks may also apply to other agents used in this study\n* Evidence of myelodysplasia or cytogenetic abnormality indicative of myelodysplasia on any bone marrow biopsy prior to initiation of therapy\n* Serologic status reflecting active hepatitis B or C infection at screening. Patients that are positive for hepatitis B core antibody, hepatitis B surface antigen (HBsAg), or hepatitis C antibody must have a negative polymerase chain reaction (PCR) at screening. PCR positive patients will be excluded\n* History of autoimmune disease (i.e. rheumatoid arthritis, systemic lupus erythematosus) with requirement of immunosuppressive medication within 6 months\n* Chronic use of corticosteroids \\>= 20mg prednisone equivalent PO daily\n* Live vaccines given in 28 days prior to lymphodepleting chemotherapy",{"count":49,"type":20},24,[51],"PHASE2","This phase II trial tests how well zanubrutinib and lisocabtagene maraleucel (liso-cel) work together in treating patients with Richter's syndrome that has come back (recurrent) or does not respond to treatment (refractory). Richter's syndrome occurs when chronic lymphocytic leukemia and\u002For small lymphocytic leukemia transforms into an aggressive lymphoma, which is a cancer of the lymph nodes. Zanubrutinib is a class of medication called a kinase inhibitor. These drugs work by preventing the action of abnormal proteins that tell cancer cells to multiply, which helps stop the spread of cancer. Liso-cel is a type of treatment known as chimeric antigen receptor (CAR) T cell therapy. CAR T-cell therapy is a type of treatment in which a patient's T cells (a type of immune system cell) are changed in the laboratory so they will attack cancer cells. T cells are taken from a patient's blood. Then the gene for a special receptor that binds to a certain protein on the patient's cancer cells is added to the T cells in the laboratory. The special receptor is called a chimeric antigen receptor (CAR). Large numbers of the CAR T cells are grown in the laboratory and given to the patient by infusion for treatment of certain cancers. Giving zanubrutinib and liso-cell together may kill more cancer cells in patients with recurrent or refractory Richter's syndrome.",[54,55,27,56,57,58,59,60],"Recurrent Transformed Chronic Lymphocytic Leukemia","Refractory Transformed Chronic Lymphocytic Leukemia","Recurrent Transformed B-Cell Non-Hodgkin Lymphoma","Recurrent Transformed Non-Hodgkin Lymphoma","Refractory Transformed Non-Hodgkin Lymphoma","Refractory Transformed B-cell Non-Hodgkin Lymphoma","Refractory Transformed",[62,63],"Richter's Transformation","Richter's Syndrome","RECRUITING","2026-02-27",{"date":67,"type":33},"2026-03-03",{"date":69,"type":33},"2023-07-28",{"date":71,"type":20},"2026-12-31",{"name":73,"class":74},"Aseel Alsouqi","OTHER",{"id":76,"slug":77,"hasResults":11,"nctId":78,"briefTitle":79,"officialTitle":80,"acronym":4,"eligibilityCriteria":81,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":82,"targetDuration":4,"studyType":21,"phases":84,"briefSummary":86,"conditions":87,"keywords":4,"overallStatus":64,"whyStopped":4,"lastUpdateSubmitDate":88,"lastUpdatePostDateStruct":89,"startDateStruct":91,"completionDateStruct":93,"leadSponsor":95,"locationsCount":97},"100572622","phase-1-zanubrutinib-in-combination-with-odronextamab-for-the-treatment-of-patients-with-richters-transformation-100572622","NCT06735664","Zanubrutinib in Combination With Odronextamab for the Treatment of Patients With Richter's Transformation","A Phase I Study of Covalent BTK Inhibitor Zanubrutinib in Combination With a CD3-CD20 Bispecific Antibody Odronextamab in Patients With Richter's Transformation","Inclusion Criteria:\n\n* Documented informed consent of the participant and\u002For legally authorized representative\n\n  * Assent, when appropriate, will be obtained per institutional guidelines\n* Age: ≥ 18 years\n* Eastern Cooperative Oncology Group (ECOG) ≤ 2\n* Histologically confirmed diagnosis of Richter transformation (RT; transformed CLL). Only patients who have diffuse large B-cell lymphoma histology in transformation are eligible (for example, patients with transformation into Hodgkin lymphoma subtype are not eligible)\n* Evidence of CD20 positivity at screening (by immunohistochemistry \\[IHC\\] or flow cytometry)\n* Treatment naïve or relapsed\u002F refractory disease. Patients with either previously untreated RT and previously treated RT are eligible, regardless of whether or not they had received CLL-directed therapy\n* Radiographically measurable lymphadenopathy (≥ 1.5 cm) or splenomegaly, or bone marrow involvement by diffuse large B cell lymphoma (DLBCL)\u002FRT\n* Fully recovered from the acute toxic effects (except alopecia) to ≤ grade 1 to prior anti-cancer therapy\n* Without bone marrow involvement: Absolute neutrophil count (ANC) ≥ 1,000\u002Fmm\\^3\n\n  * NOTE: A participant may not have received granulocyte colony stimulating factor (G-CSF) within 3 days of first dose of the assigned study treatment in order to meet this eligibility requirement\n* With bone marrow involvement: ANC ≥ 500\u002Fmm\\^3\n\n  * NOTE: A participant may not have received granulocyte colony stimulating factor (G-CSF) within 3 days of first dose of the assigned study treatment in order to meet this eligibility requirement\n* Without bone marrow involvement: Platelets ≥ 50,000\u002Fmm\\^3\n\n  * NOTE: A participant may not have received platelet transfusion within 7 days of first dose of the assigned study treatment in order to meet this eligibility requirements\n* With bone marrow involvement: Platelets ≥ 25,000\u002Fmm\\^3\n\n  * NOTE: A participant may not have received platelet transfusion within 7 days of first dose of the assigned study treatment in order to meet this eligibility requirements\n* With bone marrow involvement: Hemoglobin (Hgb) ≥ 7 g\u002FdL\n* Total bilirubin ≤ 2 x upper limit of normal (ULN) or ≤ 3 x ULN for Gilbert's disease or compensated hemolysis directly attributable to CLL\n* Aspartate aminotransferase (AST) ≤ 3 x ULN\n* Alanine aminotransferase (ALT) ≤ 3 x ULN\n* Alkaline phosphatase (ALP) ≤ 2.5 x ULN or ≤ 5 x ULN if attributed to lymphoma involvement of the liver\n* Serum creatinine ≤ 1.5 x ULN OR creatinine clearance of ≥ 50 mL\u002Fmin per 24 hour urine test or the Cockcroft-Gault formula\n* If not receiving anticoagulants: International normalized ratio (INR) OR prothrombin (PT) ≤ 1.5 x ULN\n* If on anticoagulant therapy: PT must be within therapeutic range of intended use of anticoagulants\n* If not receiving anticoagulants: Activated partial thromboplastin time (aPTT) ≤ 1.5 x ULN\n* If on anticoagulant therapy: aPTT must be within therapeutic range of intended use of anticoagulants\n* Left ventricular ejection fraction (LVEF) ≥ 45%\n\n  * Note: To be performed within 28 days prior to day 1 of protocol therapy\n* Seronegative for hepatitis C virus (HCV), hepatitis B virus (HBV) (surface antigen negative) and no history of HIV OR\n\n  * If seropositive for HBV or HCV, nucleic acid quantitation must be performed. Viral load must be undetectable\n  * HIV-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial\n* Women of childbearing potential (WOCBP): Negative serum pregnancy test\n* Agreement by females and males of childbearing potential to use an effective method of birth control or abstain from heterosexual activity for the course of the study through at least 6 months after the last dose of study therapy. Sperm donation is prohibited during the study and for 6 months after the last dose of the assigned study treatment. Highly effective contraceptive measures include:\n\n  * Stable use of combined (estrogen and progestogen containing) hormonal contraception (oral, intravaginal, transdermal) or progestogen-only hormonal contraception (oral, injectable, implantable) associated with inhibition of ovulation initiated ≥ 2 menstrual cycles prior to screening\n  * Intrauterine device (IUD); intrauterine hormone-releasing system (IUS)\n  * Bilateral tubal ligation\u002Focclusion\n  * Vasectomized partner (provided that the male vasectomized partner is the sole sexual partner of the study patient and that the partner has obtained medical assessment of surgical success for the procedure)\n  * Sexual abstinence, only if defined as refraining from heterosexual intercourse during the entire period of risk associated with the study drugs\n  * Childbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for \\> 1 year (women only)\n  * A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy. However, in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient to determine the occurrence of a postmenopausal state. The above definitions are according to the clinical trial facilitation group guidance. Pregnancy testing and contraception are not required\n\nExclusion Criteria:\n\n* Allogeneic bone marrow or organ transplant within 6 months or evidence of active graft versus host diseae (GVHD)\n* Prior CD20-targeted bispecific antibody therapy\n* Chronic systemic corticosteroid use \\> 10 mg\u002Fday of prednisone or equivalent within 72 hours (h) of start of study treatment. Patients who received corticosteroid treatment with ≤ 10 mg\u002Fday of prednisone or equivalent must be documented to be on a stable dose of at least 4 weeks' duration prior to day 1 of cycle 1. Patients may have received a brief (≤ 10 days) course of systemic steroids (≤ 80 mg prednisone equivalent per day) up to 24 hours prior to initiation of study therapy for control of lymphoma-related symptoms\n* Therapeutic anticancer antibodies within 2 weeks prior to day 1 of protocol therapy\n* Radio- or toxin-immunoconjugates within 10 weeks prior to day 1 of protocol therapy\n* Live vaccine within 28 days prior to day 1 of protocol therapy\n* Any investigational therapy within 28 days or 5 half-lives of the drug, whichever is shorter, prior to the start of study treatment\n* Standard radiotherapy within 14 days of first administration of study treatment\n* Prior organ transplantation\n* Chemotherapy, within 2 weeks prior to day 1 of protocol therapy; targeted therapy within 6 half-lives or two weeks, whichever is shorter\n* Requires treatment with a strong CYP3A4 inducers\u002F inhibitor while on protocol therapy\n* Uncontrolled immune hemolysis or thrombocytopenia\n* History of allergic reactions attributed to compounds of similar chemical or biologic composition to study drug\n* Known hypersensitivity to both allopurinol and rasburicase\n* Unstable cardiac disease as defined by one of the following:\n\n  * Cardiac events such as myocardial infarction (MI) within the past 6 months\n  * NYHA (New York Heart Association) heart failure class III-IV\n  * Uncontrolled atrial fibrillation or hypertension\n* Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis or pulmonary embolism within 3 months before the start of study treatment\n* Unstable angina (angina symptoms at rest), new-onset angina (begun within the last 3 months)\n* Active uncontrolled cardiac arrythmia\n* History or concurrent condition of interstitial lung disease and\u002For severely impaired lung function\n* Evidence of central nervous system (CNS) involvement within 6 months prior to initiation of study therapy\n* Major surgery (under general anesthesia) within 30 days prior to day 1 of protocol therapy\n* Clinically significant uncontrolled illness\n* Evidence of any active infection (bacterial, viral, fungal, mycobacterial, parasitic or other) at study enrollment or within 2 weeks of study enrollment, if requiring ongoing treatment and\u002For has the potential to cause disseminated disease or severe infection upon immunosuppression. There should be evidence that the infection has cleared or is well controlled by start of study therapy\n* Active COVID-19 infection\n* Uncontrolled infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV)\n\n  * NOTE: Participants with HIV who have controlled infection (undetectable viral load and CD4 count above 350 cells\u002FuL either spontaneously or on a stable antiviral regimen) are permitted\n  * NOTE: Participants who are hepatitis B surface antigen positive or who are hepatitis B core antibody positive should undergo evaluation by a specialist and be considered to have controlled infection (serum hepatitis B virus deoxyribonucleic acid \\[DNA\\] polymerase chain reaction \\[PCR\\] that is below the limit of detection AND receiving anti-viral therapy for hepatitis B) before they are permitted onto study\n  * NOTE: Participants who are HCV antibody positive who have controlled infection (undetectable HCV ribonucleic acid \\[RNA\\] by PCR either spontaneously or in response to a successful prior course of anti-HCV therapy) are permitted\n* Cytomegalovirus (CMV) infection as noted by detectable levels on peripheral blood polymerase chain reaction (PCR) assay. Patients who show detectable levels of CMV at screening will need to be treated with appropriate antiviral therapy and demonstrate at least 2 undetectable levels of CMV by PCR assay (at least 7 days apart) before being re-considered for eligibility\n* Other active malignancy. Patients with a prior (in the past 5 years) or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial. History of the following is allowed:\n\n  * Malignancy treated with curative intent and no known active disease present for ≥ 2 years prior to initiation of therapy on current study\n  * Adequately treated non-melanoma skin cancer or lentigo maligna (melanoma in situ) without evidence of disease\n  * Adequately treated in situ carcinomas (e.g., cervical, esophageal, etc.) without evidence of disease\n  * Asymptomatic prostate cancer managed with \"watch and wait\" strategy\n* Females only: Pregnant or breastfeeding\n* Inability to swallow and retain oral medication\n* Any other condition that would, in the investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures\n* Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility\u002Flogistics)",{"count":83,"type":20},23,[85],"PHASE1","This phase I trial tests the safety and side effects of zanubrutinib in combination with odronextamab and how well it works in treating patients with Richter's transformation. Zanubrutinib, a tyrosine kinase inhibitor, blocks a protein called Bruton tyrosine kinase (BTK), which may help keep cancer cells from growing. Odronextamab is a bispecific monoclonal antibody that can bind to two different antigens at the same time. Odronextamab binds to CD20 found on B-cells (a type of white blood cell) and on many B-cell cancers and to CD3 on T-cells (also a type of white blood cell) and may interfere with the ability of cancer cells to grow and spread. Giving zanubrutinib in combination with odronextamab may be safe, tolerable and\u002For effective in treating patients with Richter's transformation.",[54,55,26,27],"2025-09-14",{"date":90,"type":33},"2025-09-16",{"date":92,"type":33},"2025-08-14",{"date":94,"type":20},"2027-12-13",{"name":96,"class":74},"City of Hope Medical Center",1]