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Tirabrutinib

Phase 2

Chronic Lymphocytic Leukemia | Small molecule | Oncology |Gilead Sciences, Inc.|Last Updated: Mar 24, 2022

Success Probability

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Trial Design

CONTROLLED
Total Trials2
Total Enrollment71

FDA Designations

No designations recorded

Clinical trial landscape

Tirabrutinib · 5 trials · 5 indications

Phase 2 2Phase 1 3
NCT02983617Safety and Efficacy of the Combination of Tirabrutinib and Entospletinib With and Without Obinutuzumab in Adults With Chronic Lymphocytic Leukemia (CLL)Chronic Lymphocytic Leukemia
COMPLETED36 Analytics
NCT02968563Study to Evaluate the Safety and Efficacy of the Combination of Tirabrutinib and Idelalisib With and Without Obinutuzumab in Adults With Relapsed or Refractory Chronic Lymphocytic Leukemia (CLL)Chronic Lymphocytic Leukemia
COMPLETED35 Analytics
PHASE2COMPLETED
Safety and Efficacy of the Combination of Tirabrutinib and Entospletinib With and Without Obinutuzumab in Adults With Chronic Lymphocytic Leukemia (CLL)
Chronic Lymphocytic LeukemiaUnlock trial analytics
PHASE2COMPLETED
Study to Evaluate the Safety and Efficacy of the Combination of Tirabrutinib and Idelalisib With and Without Obinutuzumab in Adults With Relapsed or Refractory Chronic Lymphocytic Leukemia (CLL)
Chronic Lymphocytic LeukemiaUnlock trial analytics

Study Endpoints

Primary Endpoints

Rate of Complete Remission/Complete Remission With Incomplete Recovery of the Bone Marrow (CR/CRi), as Assessed by Investigator Using Modified International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 Criteria at Week 25
Week 25

Rate of CR per modified IWCLL 2008 criteria at Week 25 was defined as the percentage of participants who achieved CR/complete remission with incomplete recovery of the bone marrow (CRi) at Week 25. CR: meeting following criteria and no disease related symptoms: no lymphadenopathy \> 1.5 cm/hepatomegaly/splenomegaly; lymphocytes \< 4000/μL; bone marrow sample must be normocellular with 30% lymphocytes and no B-lymphoid nodules; platelets \> 100,000/µL; hemoglobin \> 11 g/dL; and neutrophils \> 1500/µL. CRi: CR criteria (no lymphadenopathy \> 1.5 cm/hepatomegaly/splenomegaly; lymphocytes \< 4000/μL; bone marrow \[hypocellular\] with 30% lymphocytes and no B-lymphoid nodules), persistent anemia/thrombocytopenia/neutropenia unrelated to CLL but related to drug toxicity.

Rate of Complete Response/Complete Remission (CR), as Assessed by Investigator Using Modified International Workshop on Chronic Lymphocytic Leukemia (IWCLL) 2008 Criteria at Week 25
Week 25

Rate of CR per modified IWCLL 2008 criteria at Week 25 was defined as the percentage of participants who achieved CR/complete remission with incomplete recovery of the bone marrow (CRi) at Week 25. CR: meeting following criteria and no disease related symptoms: no lymphadenopathy \> 1.5 cm/hepatomegaly/splenomegaly; lymphocytes \< 4000/μL; bone marrow sample must be normocellular with 30% lymphocytes and no B-lymphoid nodules; platelets \> 100,000/µL; hemoglobin \> 11 g/dL; and neutrophils \> 1500/µL. CRi: CR criteria (no lymphadenopathy \> 1.5 cm/hepatomegaly/splenomegaly; lymphocytes \< 4000/μL; bone marrow \[hypocellular\] with 30% lymphocytes and no B-lymphoid nodules), persistent anemia/thrombocytopenia/neutropenia unrelated to CLL but related to drug toxicity.

Part A: Percentage of Participants Who Experienced Treatment-Emergent Adverse Events (TEAEs)
First dose date up to last dose (maximum: 7 days) plus 30 days

An adverse event (AE) is any untoward medical occurrence in a clinical study participant administered a medicinal product, which does not necessarily have a causal relationship with the treatment. An AE can therefore be any unfavorable and/or unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Treatment-emergent adverse events (TEAEs) were defined as 1 or both of the following: Any AEs with an onset date on or after the study drug start date and no later than 30 days after permanent discontinuation of study drug and/or Any AEs leading to premature discontinuation of study drug.

Part A: Percentage of Participants With Treatment-Emergent Laboratory Abnormalities
First dose date up to last dose (maximum: 7 days) plus 30 days

A treatment-emergent laboratory abnormality was defined as an increase of at least 1 abnormality grade from the predose assessment after the first dose of study drug and within 30 days after last study drug administration. Laboratory abnormalities without clinical significance were not recorded as AEs or serious AEs. Treatment-emergent laboratory abnormalities were graded per Common Terminology Criteria for Adverse Events (CTCAE), version 4.03 where 0 = none, 1 = mild, 2 = moderate, 3 = severe, 4 = potentially life threatening.

Part A: Percentage of Participants With 12-Lead Electrocardiogram (ECG) Abnormalities
First dose date up to last dose (maximum: 7 days) plus 30 days
Part A: Cmax: Maximum Observed Plasma Concentration of Tirabrutinib
Cohorts 1 and 2, Day 1: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, and 24 hours postdose; Day 7: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, 24, 36, 48, 60, 72, 96, and 120 hours postdose

Cmax is maximum observed concentration of drug in plasma.

Part A: Clast: Last Observed Quantifiable Plasma Concentration of Tirabrutinib
Cohorts 1 and 2, Day 1: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, and 24 hours postdose; Day 7: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, 24, 36, 48, 60, 72, 96, and 120 hours postdose

Clast is the last observed concentration of drug in plasma.

Part A: Tmax: Time (Observed Time Point) of Cmax of Tirabrutinib
Cohorts 1 and 2, Day 1: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, and 24 hours postdose; Day 7: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, 24, 36, 48, 60, 72, 96, and 120 hours postdose

Tmax is the time observed for the Cmax of tirabrutinib.

Part A: Tlast: Time (Observed Time Point) of Clast of Tirabrutinib
Cohorts 1 and 2, Day 1: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, and 24 hours postdose; Day 7: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, 24, 36, 48, 60, 72, 96, and 120 hours postdose

Tlast is the time observed for the Clast of tirabrutinib.

Part A: AUCtau: Area Under the Plasma Concentration (AUC) Versus Time Curve Over the Dosing Interval of Tirabrutinib
Cohorts 1 and 2, Day 7: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, 24, 36, 48, 60, 72, 96, and 120 hours postdose relative to the morning dose

AUC is concentration of drug over time (area under the plasma concentration versus time curve).

Part A: AUClast: AUC Versus Time Curve From Time Zero to the Last Quantifiable Concentration of Tirabrutinib
Cohorts 1 and 2, Day 1: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, and 24 hours postdose; Day 7: 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, 24, 36, 48, 60, 72, 96, and 120 hours postdose

AUC is concentration of drug over time (area under the plasma concentration versus time curve).

Part B: Percentage of Participants Who Experienced TEAEs
First dose date up to last dose (maximum: 29 days) plus 30 days

An AE is any untoward medical occurrence in a clinical study participant administered a medicinal product, which does not necessarily have a causal relationship with the treatment. An AE can therefore be any unfavorable and/or unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAEs were defined as 1 or both of the following: Any AEs with an onset date on or after the study drug start date and no later than 30 days after permanent discontinuation of study drug and/or Any AEs leading to premature discontinuation of study drug.

Part B: Percentage of Participants With Treatment-Emergent Laboratory Abnormalities
First dose date up to last dose (maximum: 29 days) plus 30 days

A treatment-emergent laboratory abnormality was defined as an increase of at least 1 abnormality grade from the predose assessment after the first dose of study drug and within 30 days after last study drug administration. Laboratory abnormalities without clinical significance were not recorded as AEs or serious AEs. Treatment-emergent laboratory abnormalities were graded per CTCAE, version 4.03 where 0 = none, 1 = mild, 2 = moderate, 3 = severe, 4 = potentially life threatening.

Part B: Percentage of Participants With 12-Lead ECG Abnormalities
First dose date up to last dose (maximum: 29 days) plus 30 days
Percentage of Participants Who Experienced Treatment-Emergent Adverse Events (AEs)
First dose of tirabrutinib up to 36 months in the parent study and up to 61 months in the rollover study

Treatment-emergent AEs were defined as one or both of the following: * Any AEs with an onset date on or after the study drug start date of parent study and no later than 30 days after permanent discontinuation of study drug in this rollover study; * Any AEs leading to premature discontinuation of study drug.

Percentage of Participants Who Experienced Treatment-Emergent Marked Laboratory Abnormalities
First dose of tirabrutinib up to 36 months in the parent study and up to 61 months in the rollover study

Treatment-emergent marked laboratory abnormalities were defined as values that increase from baseline by at least 3 toxicity grades at any postbaseline time point, up to and including the date of the last dose of study drug plus 30. If the relevant baseline laboratory value is missing, any Grade 3 or 4 values observed within the timeframe specified above will be considered treatment-emergent marked abnormalities. Laboratory assessments included tests for Chemistry, Hematology, Coagulation and Urinalysis.

Percentage of Participants Experiencing Dose-Limiting Toxicities
Day 1 through Day 28

Dose Limiting Toxicities (DLT) were defined as follows: * All Common Terminology Criteria (CTC) Grade 4 tirabrutinib related adverse events * All CTC Grade 3 tirabrutinib related adverse events, with the exception of the following: * CTC Grade 3 lymphocytosis considered an expected outcome of therapy Any toxicity which in the opinion of the Investigator is attributed to a participant's underlying disease was not considered a DLT.

Secondary Endpoints

Rate of CR With Bone Marrow Minimal Residual Disease (CR/BM MRD) Negativity, as Assessed by the Investigator Using the Modified IWCLL 2008 Criteria at Week 25
Week 25
Rate of CR With Peripheral Minimal Residual Disease (CR/PB MRD) Negativity, as Assessed by the Investigator Using the Modified IWCLL 2008 Criteria at Week 25
Week 25
Overall Response Rate (ORR), as Assessed by the Investigator Using the Modified IWCLL 2008 Criteria at Week 25
Week 25
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Tirabrutinib + EntospletinibEXPERIMENTALParticipants will receive tirabrutinib 80 mg (4 x 20 mg tablets/2 x 40 mg tablets/1 x 80 mg tablet) + entospletinib 400 mg (2 x 200 mg tablets) for up to 104 weeks.
Tirabrutinib + Entospletinib + ObinutuzumabEXPERIMENTALParticipants will receive tirabrutinib 80 mg (4 x 20 mg tablets/ 2 x 40 mg tablets/ 1 x 80 mg tablet) + entospletinib 400 mg (2 x 200 mg tablets) for up to 104 weeks + obinutuzumab 100 mg on Day 1, 900 mg on Day 1 or 2, and 1000 mg subsequently for up to 8 doses on Day 1 of Weeks 2, 3, 5, 9, 13, 17 and 21.
Tirabrutinib + IdelalisibEXPERIMENTALTirabrutinib 80 mg (4 x 20 mg tablets/2 x 40 mg tablets/1 x 80 mg tablet) once daily + idelalisib 100 mg (1 x 100 mg tablet) once daily for up to 104 weeks.
Tirabrutinib + Idelalisib + ObinutuzumabEXPERIMENTALTirabrutinib 80 mg (4 x 20 mg tablets/ 2 x 40 mg tablets/ 1 x 80 mg tablet) once daily + idelalisib 100 mg (1 x 100 mg tablet) once daily for up to 104 weeks + obinutuzumab 100 mg on Day 1, 900 mg on Day 1 or 2, and 1000 mg subsequently for up to 8 doses on Day 1 of Weeks 2, 3, 5, and then every 4 weeks through Week 21.
Cohort 1, Part A: Tirabrutinib 20 mg QDEXPERIMENTALTirabrutinib 20 mg capsules orally once daily (QD) in the morning for 1 week.
Cohort 1, Part A: PlaceboPLACEBO_COMPARATORPlacebo to match tirabrutinib capsules orally QD in the morning for 1 week.
Cohort 2, Part A: Tirabrutinib 10 mg BIDEXPERIMENTALTirabrutinib 10 mg capsules orally twice daily (BID) (morning and approximately 12 hours later) for 7 days. On Day 7, only morning dose was administered.
Cohort 2, Part A: PlaceboPLACEBO_COMPARATORPlacebo to match tirabrutinib capsules orally BID (morning and approximately 12 hours later) for 7 days. On Day 7, only morning dose was administered.
Part B: Tirabrutinib 20 mg QDEXPERIMENTALTirabrutinib 20 mg capsules orally QD for 4 weeks.
Part B: PlaceboPLACEBO_COMPARATORPlacebo to match tirabrutinib capsules orally QD for 4 weeks.
Tirabrutinib 40 mg once daily (CLL)EXPERIMENTALParticipants with relapsed/refractory chronic lymphocytic leukemia (CLL) received tirabrutinib 40 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 80 mg once daily (CLL)EXPERIMENTALParticipants with relapsed/refractory CLL received tirabrutinib 80 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 160 mg once daily (CLL)EXPERIMENTALParticipants with relapsed/refractory CLL received tirabrutinib 160 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 320 mg once daily (CLL)EXPERIMENTALParticipants with relapsed/refractory CLL received tirabrutinib 320 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 400 mg once daily (CLL)EXPERIMENTALParticipants with relapsed/refractory CLL received tirabrutinib 400 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 500 mg once daily (CLL)EXPERIMENTALParticipants with relapsed/refractory CLL received tirabrutinib 500 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 600 mg once daily (CLL)EXPERIMENTALParticipants with relapsed/refractory CLL received tirabrutinib 600 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 300 mg twice daily (CLL)EXPERIMENTALParticipants with relapsed/refractory CLL received tirabrutinib 300 mg twice daily for up to 96 months from first dose in the parent study.
Tirabrutinib 160 mg once daily (NHL)EXPERIMENTALParticipants with relapsed/refractory non-Hodgkin's lymphoma (NHL) received tirabrutinib 160 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 320 mg once daily (NHL)EXPERIMENTALParticipants with relapsed/refractory NHL received tirabrutinib 320 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 480 mg once daily (NHL)EXPERIMENTALParticipants with relapsed/refractory NHL received tirabrutinib 480 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 600 mg once daily (NHL)EXPERIMENTALParticipants with relapsed/refractory NHL received tirabrutinib 600 mg once daily for up to 96 months from first dose in the parent study.
Tirabrutinib 20 mg Once Daily (CLL)EXPERIMENTALParticipants with relapsed/refractory chronic lymphocytic leukaemia (CLL) received tirabrutinib 20 mg once daily.
Tirabrutinib 20 mg Once Daily (NHL)EXPERIMENTALParticipants with relapsed/refractory non-Hodgkin's lymphoma (NHL) received tirabrutinib 20 mg once daily.
Tirabrutinib 40 mg Once Daily (NHL)EXPERIMENTALParticipants with relapsed/refractory NHL received tirabrutinib 40 mg once daily.
Tirabrutinib 80 mg Once Daily (NHL)EXPERIMENTALParticipants with relapsed/refractory NHL received tirabrutinib 80 mg once daily.
Tirabrutinib 240 mg Twice Daily (NHL)EXPERIMENTALParticipants with relapsed/refractory NHL received tirabrutinib 240 mg twice daily.

Interventions

NameTypeDescription
TirabrutinibDRUGAdministered orally once daily
EntospletinibDRUGAdministered orally once daily
ObinutuzumabDRUGAdministered intravenously
IdelalisibDRUGTablets administered orally
PlaceboDRUGCapsules administered orally.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites15

Key Inclusion Criteria: * Documentation of relapsed or refractory CLL * Requiring treatment per modified International Workshop on CLL (IWCLL) 2008 criteria; adults without radiographically measureable disease (defined as ≥ 1 lesion \> 1.5 centimetres (cm) in diameter as assessed by computed tomogr...

Countries:GermanyUnited StatesFranceUnited Kingdom
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Frequently asked questions about Tirabrutinib

What is Tirabrutinib used for?

Tirabrutinib is an investigational small molecule being studied for Non Hodgkins Lymphoma, Rheumatoid Arthritis, Chronic Lymphocytic Leukemia, and Relapsed/Refractory B-cell Malignancies. It is developed by Gilead Sciences, Inc. (GILD) and is currently in Phase 2 clinical development.

Who makes Tirabrutinib?

Tirabrutinib is developed by Gilead Sciences, Inc., a biopharmaceutical company traded on NASDAQ under the ticker GILD. The drug is an investigational small molecule in Phase 2 clinical development for oncology indications including Non Hodgkins Lymphoma and Chronic Lymphocytic Leukemia.

What phase is Tirabrutinib in?

Tirabrutinib is in Phase 2 clinical development. It is an investigational drug, not yet approved by regulatory authorities. Clinical trials have been completed for Non Hodgkins Lymphoma, Chronic Lymphocytic Leukemia, and Relapsed/Refractory B-cell Malignancies, with ongoing development for these oncology indications.

What clinical trials has Tirabrutinib been in?

Tirabrutinib has been studied in several completed trials. NCT01659255 evaluated safety and tolerability as monotherapy in relapsed/refractory NHL and CLL. NCT02457559 assessed long-term safety in B-cell malignancies. NCT02968563 and NCT02983617 tested combinations with other agents in CLL. All trials are completed.

Is Tirabrutinib FDA approved?

Tirabrutinib is not FDA approved. It is an investigational drug currently in Phase 2 clinical development for Non Hodgkins Lymphoma, Rheumatoid Arthritis, Chronic Lymphocytic Leukemia, and Relapsed/Refractory B-cell Malignancies. It has not received regulatory approval and remains under clinical investigation.