Binimetinib for Hairy Cell Leukemia Without BRAF Mutation
This study is testing a drug called binimetinib for people with hairy cell leukemia (HCL) or variant HCL (HCLv) who do not have a specific genetic change called a BRAF mutation. Most people with HCL have a BRAF mutation, and there are treatments for them. However, for those without this mutation, treatment options are limited. This study aims to see if binimetinib, which targets a different gene called MEK, can be an effective treatment. You may be able to join if you are 18 or older, have a confirmed diagnosis of HCL or HCLv, and meet certain health criteria like low blood counts. The study will measure how many people respond to the treatment over time.
- Study design
- This is an interventional study with a planned enrollment of 40 participants. The phase of the study is not specified.
- What's involved
- You would take binimetinib orally twice a day continuously in 28-day cycles. The trial record does not specify the number of visits or other procedures.
- Compensation
- Not stated in the trial record.
- Follow-up
- Your response to the treatment will be measured every year after starting the study.
AI-generated from the public study record. Only the study team can confirm whether you're eligible — confirm details with them before making decisions.
NCT04322383
Binimetinib for People With Relapsed/Refractory BRAF Wild Type Hairy Cell Leukemia and Variant
Recruiting
PHASE2Ages 18+InterventionalTreatmentNational Cancer Institute (NCI)Government-funded
~40 participants
Updated 2026-07-24 on ClinicalTrials.gov
What's tested:binimetinib
At a glance
Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
overall response rate
Measured over every year
Conditions
Where it's being run
1 sites across 1 statesMaryland1
Study leadership
- Robert J Kreitman, M.D. · PRINCIPAL_INVESTIGATOR · National Cancer Institute (NCI)
Who to contact
Opens a ready-to-send draft in your own email app — review before sending.
Do you actually qualify for this trial?
Add a private profile and we'll compare every criterion below against your situation — and tell you which ones are met, uncertain, or excluding.
Eligibility criteria
Inclusion
Histologically confirmed diagnosis of HCL or HCLv according to morphological and immunophenotypic criteria of World Health Organization (WHO) classification \[WHO, 2008 revised 2016\] of lymphoid neoplasm. Participants should have at least one of the following indications for therapy:
Absolute neutrophil count (ANC) \<1 x10\^3/mcL
Hemoglobin \<10g/dL
Platelets\<100 x10\^3/mcL
Symptomatic splenomegaly
Enlarging HCL mass or bone lesion \> 2cm in short axis
Leukemia cell count \>5x10\^3/mcL
Leukemic doubling time \<6 months
Refractory or relapsed disease - defined as either:
Refractory- no response or disease progression in \<=1 year following first-line treatment with a purine analog, or
Relapsed- having relapsed following treatment with at least 1 prior purine-analog treatments
Participants must be BRAF WT as confirmed from fresh bone marrow aspirate and/or peripheral blood sample, or lymph node/mass by the Laboratory of Pathology (LP), NCI.
Participants who are ineligible for, unable to obtain in a timely manner, cannot access, unwilling to undergo or have failed Moxetumomab Pasudotox trial at NCI.
Age \>=18 years
Eastern Cooperative Oncology Group (ECOG) performance status \<=2 (Karnofsky \>=60%).
Adequate organ and marrow function as defined below:
Total bilirubin \<= 3x upper limit of normal (ULN), unless consistent with Gilbert's (ratio between total and direct bilirubin \> 5)
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \<= 5x ULN
Alkaline phosphatase \<=5x ULN
Serum creatinine \<= 1.5 mg/dL or creatinine clearance \>= 60 mL/min/1.73 m\^2 for participants with creatinine levels above institutional normal calculated using estimated glomerular filtration rate (eGFR)
Serum albumin \>= 2 g/dL
Prothrombin time (PT)/International Normalized Ratio (INR) \< 2.5x ULN (If on warfarin, PT/INR \< 3.5x ULN; If on any other anticoagulation, Prothrombin time (PT) \< 2.5x ULN
Fibrinogen \>= 0.5x lower limit of normal
The effects of binimetinib on the developing human fetus are unknown therefore participants must use effective methods of contraception as directed below.
Females of childbearing potential (FOCBP) who are sexually active with a non-sterilized male partner must use a highly effective method of contraception and not donate ova prior to study entry and or the duration of study treatment and until 30 days after the last dose of binimetinib. Periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of contraception. Females of childbearing potential are defined as those who are not surgically sterile (i.e., bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy) or those who are premenarchal or postmenopausal (defined as 12 months with no menses without an alternative medical cause). A highly effective method of contraception is defined as one that results in a low failure rate (i.e., less than 1% per year) when used consistently and correctly. Not all methods of contraception are highly effective. Female participants must use a hormonal method in addition to a barrier method alone, to minimize the chance of pregnancy. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
Non-sterilized male participants who are sexually active with a female partner of childbearing potential must agree to use methods of contraception that are highly effective or acceptable, and not donate sperm from study entry until 90 days after the last dose of binimetinib.
Breastfeeding participants must be willing to discontinue breastfeeding from study treatment initiation through 3 days after the last dose of the study drug.
Ability of participant to understand and the willingness to sign a written informed consent document.
Must co-enroll in study 10-C-0066: Collection of Human Samples to Study Hairy Cell and other Leukemias, and to Develop Recombinant Immunotoxins for Cancer Treatment
Exclusion
Participants who have had chemotherapy, immunotherapy or radiotherapy within 2 weeks prior to the start of study treatment.
Prior therapy with binimetinib.
Participants who are receiving any other investigational agents or have received an investigational agent within 14 days prior to the start of study treatment.
Participants who have undergone major surgery \<= 6 weeks prior to start of study treatment or who have not recovered from side effects of such procedure.
Known hypersensitivity or contraindication to any component of binimetinib or its excipients.
Inability to swallow and retain study drug.
Pregnant women as evaluated by a positive serum or urine beta-human chorionic gonadotropin (beta-hCG) test.
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, cardiac disfunction (details as below), uncontrolled pulmonary infection, pulmonary edema or psychiatric illness/social situations that would limit compliance with study requirements.
Evidence of active Hepatitis B Virus (HBV) or Hepatitis C Virus (HCV) infection.
Active second malignancy requiring treatment other than minor resection of indolent cancers like basal cell and squamous skin cancers.
Human immunodeficiency virus (HIV)-positive participants unless taking appropriate anti- HIV medications with a CD4 count of \> 200. Otherwise, there may be an increased risk of infections.
History of an allogeneic bone marrow or stem cell transplant.
Impaired cardiovascular function or clinically significant cardiovascular disease including, but not limited to, any of the following:
History of acute coronary syndromes (including myocardial infarction, unstable angina, coronary artery bypass grafting, coronary angioplasty or stenting) \< 3 months prior to initiation of study therapy;
Congestive heart failure requiring treatment (New York Heart Association Grade \>= 2);
Left ventricular ejection fraction (LVEF) \< 50% as determined by multigated acquisition scan (MUGA) or transthoracic echocardiogram (TTE);
Uncontrolled hypertension defined as persistent systolic blood pressure \>=160 mmHg or diastolic blood pressure \>= 100 mmHg despite current therapy;
History or presence of clinically significant cardiac arrhythmias (including resting bradycardia, uncontrolled atrial fibrillation or uncontrolled paroxysmal supraventricular tachycardia);
Triplicate average baseline QTcF interval \>= 480 ms.
Impairment of gastrointestinal function or disease which may significantly alter the absorption of study drug (e.g., active ulcerative disease, uncontrolled vomiting or diarrhea, malabsorption syndrome, small bowel resection with decreased intestinal absorption), or recent (\<= 3 months) history of a partial or complete bowel obstruction, or other conditions that will interfere significantly with the absorption of oral drugs.
Concurrent neuromuscular disorder that is associated with elevated creatinine kinase (CK) (e.g., inflammatory myopathies, muscular dystrophy, amyotrophic lateral sclerosis, spinal muscular atrophy).
History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g., uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes); history of maculopathy or retinopathy for which there is an increased risk of
History of thromboembolic or cerebrovascular events \<= 12 weeks prior to the first dose of study treatment. Examples include transient ischemic attacks, cerebrovascular accidents, hemodynamically significant (i.e., massive or sub-massive) deep vein thrombosis or pulmonary emboli.
What this trial measures
- overall response rateevery year
Percentage of participants with the best overall response of CR or PR to therapy