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Study to Evaluate Loncastuximab Tesirine With Rituximab Versus Immunochemotherapy in Participants With Relapsed or Refractory Diffuse Large B-Cell Lymphoma (LOTIS-5)

Phase 1
Conditions
Diffuse Large B-Cell Lymphoma (DLBCL)
MedDRA version: 21.0Level: PTClassification code 10012818Term: Diffuse large B-cell lymphomaSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2020-000241-14-HU
Lead Sponsor
ADC Therapeutics SA
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
350
Inclusion Criteria

1. Male or female patient aged 18 years or older
2. Pathologic diagnosis of DLBCL, as defined by the 2016 World Health Organization classification (including patients with DLBCL transformed from indolent lymphoma), or high-grade B cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements
3. Relapsed (disease that has recurred following a response) or refractory (disease that failed to respond to prior therapy) disease following at least one multi-agent systemic treatment regimen
4. Not considered by the investigator to be a candidate for stem cell transplantation based on performance status, advanced age, and/or significant medical comorbidities such as organ dysfunction
5. Measurable disease as defined by the 2014 Lugano Classification as assessed by positron-emission tomography (PET) – computed tomography (CT) or by CT or magnetic resonance imaging (MRI) if tumor is not fluorodeoxyglucose (FDG)-avid on screening PET-CT
6. Availability of formalin-fixed paraffin-embedded (FFPE) tumor tissue block (or minimum 10 freshly cut unstained slides if block is not available)
Note: Any biopsy since initial diagnosis is acceptable, but if several samples are available, the most recent sample is preferred.
7. ECOG performance status 0-2
8. Adequate organ function as defined by screening laboratory values within the following parameters:
a. Absolute neutrophil count =1000/µL (off growth factors at least 72 hours)
b. Platelet count =100000/µL without transfusion within the past 2 weeks
c. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyl transferase (GGT) =2.5 × the upper limit of normal (ULN)
d. Total bilirubin =1.5 × ULN (patients with known Gilbert’s syndrome may have a total bilirubin up to =3 × ULN)
e. Calculated creatinine clearance =30 mL/min by the Cockcroft and Gault equation
Note: A laboratory assessment may be repeated a maximum of two times during the Screening period to confirm eligibility.
9. Negative beta-human chorionic gonadotropin (ß-hCG) pregnancy test within 7 days prior to start of study drug (Cycle 1 Day 1) for women of childbearing potential
10. Women of childbearing potential must agree to use a highly effective method of contraception from the time of giving informed consent until at least 12 months after the last dose of study treatment. Men with female partners who are of childbearing potential must agree to use a condom when sexually active or practice total abstinence from the time of giving informed consent until at least 7 months after the patient receives his last dose of study treatment.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 157
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 193

Exclusion Criteria

1. Previous treatment with loncastuximab tesirine
2. Previous treatment with R-GemOx
3. Known history of hypersensitivity to a CD19 antibody, loncastuximab tesirine (including SG3249) or any of its excipients, or history of or positive serum human ADA to a CD19 antibody
4. Pathologic diagnosis of Burkitt lymphoma
5. Active second primary malignancy other than non-melanoma skin cancers, non-metastatic prostate cancer, in situ cervical cancer, ductal or lobular carcinoma in situ of the breast, or other malignancy that the Sponsor’s medical monitor and Investigator agree and document should not be exclusionary
6. Autologous transplant within 30 days prior to start of study drug (Cycle 1 Day 1)
7. Allogeneic transplant within 60 days prior to start of study drug (Cycle 1 Day 1)
8. Active graft-versus-host disease
9. Post-transplantation lymphoproliferative disorders
10. Active autoimmune disease, including motor neuropathy considered of autoimmune origin and other central nervous system (CNS) autoimmune disease
11. Human immunodeficiency virus (HIV) seropositive with any of the following:
a. CD4+ T-cell (CD4+) counts <350 cells/µL
b. Acquired immunodeficiency syndrome-defining opportunistic infection within 12 months prior to screening
c. Not on anti-retroviral therapy, or on anti-retroviral therapy for <4 weeks at the time of screening
d. HIV viral load =400 copies/mL
12. Serologic evidence of chronic hepatitis B virus (HBV) infection and unable or unwilling to receive standard prophylactic antiviral therapy or with detectable HBV viral load
13. Serologic evidence of hepatitis C virus (HCV) infection without completion of curative treatment or with detectable HCV viral load
14. History of Stevens-Johnson syndrome or toxic epidermal necrolysis
15. Lymphoma with active CNS involvement, including leptomeningeal disease
16. Clinically significant third space fluid accumulation (i.e., ascites requiring drainage or pleural effusion that is either requiring drainage or associated with shortness of breath)
17. Breastfeeding or pregnant
18. Uncontrolled hypertension (blood pressure =160/100 mm Hg repeatedly), unstable angina, congestive heart failure (greater than New York Heart Association class II), electrocardiographic evidence of acute ischemia, coronary angioplasty or myocardial infarction within 6 months prior to screening, uncontrolled atrial or ventricular cardiac arrhythmia, poorly controlled diabetes, severe chronic pulmonary disease, or other serious medical condition which is likely to significantly impair the patient’s ability to tolerate the study treatment
19. Major surgery within 4 weeks prior to start of study drug (Cycle 1 Day 1); radiotherapy, chemotherapy or other antineoplastic therapy within 14 days prior to start of study drug (Cycle 1 Day 1), except shorter if approved by the Sponsor
20. Use of any other experimental medication within 14 days or 5 half-lives prior to start of study drug (Cycle 1 Day 1)
21. Received live vaccine within 4 weeks of Cycle 1 Day 1
22. Failure to recover to =Grade 1 (Common Terminology Criteria for Adverse Events [CTCAE] version 5.0) from acute non hematologic toxicity (except alopecia) due to previous therapy prior to screening
23. Congenital long QT syndrome or a corrected QTcF interval of =480 ms at screening (unless secondary to pacemaker or bundle branch block)
24. Any other significant medical illness, abnormality, or condition that would, in the Investigator’s judgment, make the

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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