This clinical trial is focused on studying a rare type of cancer called Richter Transformation, which occurs when chronic lymphocytic leukemia (CLL) transforms into a more aggressive form known as diffuse large B-cell lymphoma (DLBCL). The study is investigating the effectiveness and safety of a treatment called brexucabtagene autoleucel, a type of cell therapy that uses genetically modified T cells to target and destroy cancer cells. This treatment is specifically designed for adults who have experienced a relapse or whose disease has not responded to previous treatments.

The purpose of the study is to evaluate how well brexucabtagene autoleucel works in treating patients with Richter Transformation. Participants in the study will receive the treatment through an intravenous infusion, which means the medication is delivered directly into the bloodstream. The study will monitor the participants’ response to the treatment, including whether the cancer shrinks or disappears, and how long the response lasts. The study will also assess the overall survival of participants and the time it takes for the disease to progress or for the next treatment to be needed.

In addition to brexucabtagene autoleucel, the study may involve other medications to support the treatment process. These include carboplatin, mesna, ifosfamide, vincristine, etoposide, gemcitabine, oxaliplatin, methylprednisolone, rituximab, alpelisib, and ibrutinib. Some participants may receive a placebo, which is a substance with no active medication, to compare the effects of the treatment. The study aims to provide valuable information on the potential benefits and risks of using brexucabtagene autoleucel for treating this challenging condition.