Recruiting
Phase 2

Vemurafenib & Obinutuzumab

Sponsor:

Memorial Sloan Kettering Cancer Center

Code:

NCT06561360

Conditions

Hairy Cell Leukemia

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Vemurafenib

Obinutuzumab

Cladribine

Rituximab

Study Details

Brief summary:

The researchers are doing this study to compare the safety of vemurafenib in combination with obinutuzumab to the standard of approach of cladribine in combination with rituximab. The researchers will look at which treatment causes fewer or milder side effects. Researchers think vemurafenib and obinutuzumab (non-chemotherapy drugs) may cause fewer side effects compared with the usual approach of chemotherapy drugs. They will also compare the two approaches to see which approach is more effective at eliminating cancer cells.

Conditions

Hairy Cell Leukemia

Study ID

NCT06561360

Start date

Sep 9, 2024

Status verified date

Sep, 2026

Completion date

Sep 9, 2027

Anticipated

Primary completion date

Sep 9, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Patients must be ≥ 18 years of age
  • Histologically confirmed classical HCL by the enrolling institution
  • Presence of BRAF V600E mutation as confirmed by PCR, NGS or immunohistochemistry. If patient is known to have negative BRAF mutation, repeat testing is advisable as well as discussion with the main study principal investigator.
  • Has not received any prior therapy for the disease
  • Patients who meet the standard treatment initiation criteria, as defined by ANC ≤1.0, Hgb ≤ 10.0 or PLT ≤100K
  • ECOG performance status of 0 - 2
  • Acceptable pre-study organ function during screening as defined as:

  • Total bilirubin ≤ 1.5 times the upper limit of normal (ULN), except in patients with known Gilbert's syndrome who may be enrolled if direct bilirubin ≤ 3 x ULN);
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5x ULN; and
  • Serum creatinine ≤ 1.5x ULN
  • Electrocardiogram (ECG) without evidence of clinically significant ventricular arrhythmias or ischemia as determined by the investigator and a rate-corrected QT interval (QTc, Bazett's formula) of < 480 msec
  • For women of childbearing potential, agreement to the use of two acceptable methods of contraception, including one barrier method, during the study and for 6 months after discontinuation of vemurafenib and cladribine, and 18 months after discontinuation of rituximab and obinutuzumab
  • For men with female partners of childbearing potential, agreement to use a latex condom and to advise their female partner to use an additional method of contraception during the study and for 6 months after discontinuation of vemurafenib
  • Negative serum pregnancy test within 7 days of commencement of treatment in women of childbearing potential

Exclusion Criteria:

  • Have had previous treatment for HCL, including purine analogs, vemurafenib, rituximab, obinutuzumab, and other investigational agents. Previous treatment with transfusions and other supportive care such as G-CSF and erythropoietin are allowed.
  • Known hypersensitivity to any of the study drugs.
  • Patients with known long QT syndrome or uncorrectable electrolyte abnormalities
  • Clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis.
  • Presence of positive test results for hepatitis B virus (HBV), hepatitis B surface antigen (HBsAg) or hepatitis C (HCV) antibody

° Patients with occult or prior HBV infection (defined as positive total hepatitis B core antibody \[HBcAb\] and negative HBsAg) may be included if HBV DNA is undetectable. These patients must be willing to undergo monthly DNA testing and take HBV viral prophylaxis such as entecavir.
  • Known infection with HIV or human T-cell leukemia virus 1 (HTLV-1)
  • Active uncontrolled infection, e.g. persistent bacteremia, supplemental oxygen or pressor supports, etc.
  • Live vaccination within 28 days of randomization
  • Patients with concurrent active malignancies as defined by malignancies requiring any therapy other than expectant observation or hormonal therapy, with the exception of squamous and basal cell carcinoma of the skin, in situ cervical cancer, adequately treated stage I/II cancer from which the patient is current in complete remission, or any other cancer from which the patient has been disease free for five years
  • Malabsorption syndrome or other condition that precludes enteral route of administration
  • Patients with HCL variant (as defined by absence of expression of CD25)
  • Pregnant or lactating, or intending to become pregnant during the study

Study Design

Enrollment

86 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Vemurafenib plus Obinutuzumab

Patients assigned to the study arm will receive vemurafenib orally twice daily (b.i.d.) continuously in cycles of 4 weeks (28 days) for a total of 4 cycles. Obinutuzumab will be administered concomitantly with vemurafenib starting at cycle 2 of treatment in cycles of 4 weeks. Obinutuzumab infusions will be administered on days 1, 8 and 15 during the cycle 2 and every 4 weeks during the cycle 3 and 4 of treatment.

active comparator: Standard treatment of Cladribine plus Rituximab

Patients assigned to the SOC arm will receive cladribine IV on days 1-5 concurrently with rituximab IV per week for 8 times, i.e., weekly x8 from day 1.

Interventions

Vemurafenib

Vemurafenib orally twice daily (b.i.d.) continuously in cycles of 4 weeks (28 days) for a total of 4 cycles.

Obinutuzumab

Obinutuzumab will be administered concomitantly with vemurafenib starting at cycle 2 of treatment in cycles of 4 weeks.

Cladribine

Cladribine IV on days 1-5 concurrently with rituximab.

Rituximab

Rituximab on days 1-5 concurrently with rituximab.

Primary outcome measure

  • incidences of ≥ grade 3 treatment-related toxicities [ Time Frame: within 6 months of treatment ]

Central Contacts and Locations

Central contacts

Jae Park, MD

646-608-3743parkj6@mskcc.org

Mark Geyer, MD

646-608-3745

Locations

Memorial Sloan Kettering at Basking Ridge (All Protocol Activities)

Recruiting

Basking Ridge, New Jersey, United States, 07920

Contacts

Jae Park, MD

646-608-3743

Memorial Sloan Kettering Monmouth (Limited Protocol Activities)

Recruiting

Middletown, New Jersey, United States, 07748

Contacts

Jae Park, MD

646-608-3743

Memorial Sloan Kettering Bergen (Limited Protocol Activities)

Recruiting

Montvale, New Jersey, United States, 07645

Contacts

Jae Park, MD

646-608-3743

Memorial Sloan Kettering Cancer Commack - Suffolk (Limited Protocol Activities)

Recruiting

Commack, New York, United States, 11725

Contacts

Jae Park, MD

646-608-3743

Memorial Sloan Kettering Westchester (All Protocol Activities)

Recruiting

Harrison, New York, United States, 10604

Contacts

Jae Park, MD

646-608-3743

Memorial Sloan Kettering Cancer Center (All Protocol Activities)

Recruiting

New York, New York, United States, 10065

Contacts

Jae Park, MD

646-608-3743

Memorial Sloan Kettering Nassau (Limited Protocol Activities)

Recruiting

Uniondale, New York, United States, 11553

Contacts

Jae Park, MD

646-608-3743

Ohio State University

Recruiting

Columbus, Ohio, United States, 43210

Contacts

Michael Grever, MD

614-293-3196

Principal Investigator:

Michael Grever, MD

More Information

Sponsor

Memorial Sloan Kettering Cancer Center

Last update posted

Sep 9, 2026

Last verified

Sep, 2026

Keywords

  • Vemurafenib
  • Obinutuzumab
  • Cladribine
  • Rituximab
  • 24-160

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Memorial Sloan Kettering Cancer Center on 2026-09-09.