Recruiting
Phase 3

Tirabrutinib vs. R-TMZ

Sponsor:

Ono Pharmaceutical Co., Ltd.

Code:

NCT07104032

Conditions

Relapsed/Refractory Primary Central Nervous System Lymphoma

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Tirabrutinib

Rituximab

Temozolomide

Study Details

Brief summary:

The purpose of this clinical trial is to evaluate efficacy and safety of tirabrutinib alone compared with rituximab and temozolomide (R-TMZ) combination therapy in participants with Relapsed/Refractory Primary Central Nervous System Lymphoma (PCNSL).

Conditions

Relapsed/Refractory Primary Central Nervous System Lymphoma

Study ID

NCT07104032

Start date

Jun 12, 2026

Status verified date

Sep, 2026

Completion date

Dec, 2029

Anticipated

Primary completion date

Dec, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria

1. Pathology report confirming the diagnosis of B-cell PCNSL
2. Relapsed or refractory B-cell PCNSL with at least 1 prior high-dose methotrexate (HD-MTX) based therapy for PCNSL:

  • Relapsed disease: Participants who achieved a response (CR, CRu, PR) to the last treatment and subsequently experienced disease progression.
  • Refractory disease: Participants whose best response to the last treatment was stable disease or PD.
3. One or more bi-dimensionally measurable brain lesions with a minimum diameter greater than or equal to (≥)1 centimeter (cm) × ≥1 cm in gadolinium-enhanced magnetic resonance imaging (MRI)
4. Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0-2
5. Adequate bone marrow, renal, and hepatic function per central lab values
6. Participants must agree to comply with all defined contraceptive requirements

Exclusion Criteria

1. Participants with isolated intraocular PCNSL or spinal PCNSL with no brain lesions
2. Participants with non-B-cell PCNSL
3. Participants with systemic presence of lymphoma
4. Refractory to temozolomide with or without rituximab-containing regimens in the last PCNSL treatment
5. Concomitant systemic corticosteroid exposure within 14 days before starting study drug per Investigator assessment with the exception of the following:

  • Equivalent of up to 10 milligram per day (mg/day) of prednisone for a disease other than PCNSL
  • Equivalent of up to 50 mg/day of prednisone (equal to 8 mg/day dexamethasone) for participants with lesions of the brain and/or spinal cord
6. Active malignancy, other than PCNSL requiring systemic therapy
7. Poorly controlled comorbidity, or history of medical conditions contraindicated per Investigator assessment
8. Participants who are unable to swallow oral medication
9. Prior Bruton's tyrosine kinase inhibitor treatment

Study Design

Enrollment

132 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Tirabrutinib

Tirabrutinib 480 milligram (mg) orally every day (QD), as monotherapy in 28-day cycles.

active comparator: Rituximab-Temozolomide (R-TMZ)

Rituximab 375 milligram per square meter (mg/m2) intravenously (IV) and temozolomide 150 mg/m2/day orally, as combination therapy for Cycle 1 through 6.

Interventions

Tirabrutinib

Administered orally.

Rituximab

Administered intravenously (IV).

Temozolomide

Administered orally.

Primary outcome measure

  • Progression Free Survival (PFS) [ Time Frame: Estimated up to 24 months ]

Central Contacts and Locations

Central contacts

Locations

Mayo Clinic Cancer Center

Recruiting

Phoenix, Arizona, United States, 85054

Contacts

Principal Investigator:

Mazie Tsang, MD

HonorHealth Cancer Center

Recruiting

Scottsdale, Arizona, United States, 85251

Contacts

Principal Investigator:

Amir Azadi, MD

Providence Medical Foundation

Recruiting

Fullerton, California, United States, 92835

Contacts

Principal Investigator:

Jose Carrillo, MD

UC Irvine Health

Recruiting

Orange, California, United States, 92868

Contacts

Principal Investigator:

Daniela Bota, MD, PhD

Yale Cancer Center

Recruiting

New Haven, Connecticut, United States, 06520

Contacts

Principal Investigator:

Sylvia Kurz, MD

John Hopkins University

Recruiting

Washington D.C., District of Columbia, United States, 20016

Contacts

Principal Investigator:

Solmaz Sahebjam, MD

University of Florida Gainesville

Recruiting

Gainesville, Florida, United States, 32610

Contacts

Principal Investigator:

Ashley Ghiaseddin, MD

Mayo Clinic Cancer Center

Recruiting

Jacksonville, Florida, United States, 32224

Contacts

Principal Investigator:

Han Tun, MD

University of Maryland

Recruiting

Baltimore, Maryland, United States, 21201

Contacts

Principal Investigator:

Seung Lee, MD

Massachusetts General Hospital

Recruiting

Boston, Massachusetts, United States, 02114

Contacts

Principal Investigator:

Tracy Batchelor, MD

Beth Israel Deaconess Medical Center

Recruiting

Boston, Massachusetts, United States, 02115

Contacts

Principal Investigator:

Ka-Wai Grace Ho, MD

Dana-Farber Cancer Institute

Recruiting

Boston, Massachusetts, United States, 02115

Contacts

Principal Investigator:

Lakshmi Nayak, MD

Mayo Clinic Cancer Center

Recruiting

Rochester, Minnesota, United States, 55905

Contacts

Principal Investigator:

Patrick Johnston, MD, PhD

Hackensack University Medical Center

Recruiting

Hackensack, New Jersey, United States, 07601

Contacts

Principal Investigator:

Andrew Ip, MD

Atlantic Health Overlook Medical Center

Recruiting

Summit, New Jersey, United States, 07901

Contacts

Principal Investigator:

Robert Aiken, MD

NYU Langone Health

Recruiting

New York, New York, United States, 10016

Contacts

Principal Investigator:

J Ricardo McFaline Figueroa, MD

Columbia University Irving Medical Center

Recruiting

New York, New York, United States, 10032

Contacts

Principal Investigator:

Aya Haggiagi, MD

Memorial Sloan Kettering Cancer Center

Recruiting

New York, New York, United States, 10065

Contacts

Principal Investigator:

Christian Grommes, MD

Duke University Medical Center

Recruiting

Durham, North Carolina, United States, 27710

Contacts

Principal Investigator:

Katherine Peters, MD, PhD

Providence Neurological Specialties West

Recruiting

Portland, Oregon, United States, 97225

Contacts

Principal Investigator:

Prakash Ambady, MD

Penn State Health Milton S Hershey Medical Center

Recruiting

Hershey, Pennsylvania, United States, 17033

Contacts

Principal Investigator:

Dawit Aregawi, MD

UPMC Hillman Cancer Center

Recruiting

Pittsburgh, Pennsylvania, United States, 15232

Contacts

Principal Investigator:

Jan Drappatz, MD

Rhode Island Hospital

Recruiting

Providence, Rhode Island, United States, 02903

Contacts

Principal Investigator:

Thomas Ollila, MD

University of Washington

Recruiting

Seattle, Washington, United States, 98195

Contacts

Principal Investigator:

Vyshak Venur, MD

More Information

Sponsor

Ono Pharmaceutical Co., Ltd.

Last update posted

Sep 3, 2026

Last verified

Sep, 2026

Keywords

  • Bruton's tyrosine kinase (BTK)
  • IGNITE
  • PCNSL
  • Primary Central Nervous System Lymphoma
  • Relapsed/Refractory Primary Central Nervous System Lymphoma

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-08. This information was provided to ClinicalTrials.gov by Ono Pharmaceutical Co., Ltd. on 2026-09-03.