non-Hodgkin Lymphoma
Conditions
Interventions
There are 2 treatment groups:
Lonca-R:
Cyclus 1 and 2
loncastuximab tesirine 150 µg/kg + rituximab 375 mg/m2 Q3W
Cyclus 3 - 8
loncastuximab tesirine 75 µg/kg + rituximab 375 mg/m2 Q3W
R-GemOx:
Cyclus 1 - 8
rituximab 375 mg/m 2 + gemcitabine 1000 mg/m 2 +
oxaliplatin 100 mg/m 2 Q2W for up to 8 cycles
An interim analysis for Part 2 of the study will be performed when 88 events
are observed, for analyz
Sponsors
ADC Therapeutics SA
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
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) =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 (β-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.
Exclusion criteria
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 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 =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
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Progression-free survival (PFS) defined as the time between randomization and the first documentation of recurrence or progression by independent central review, or death from any cause | — |
Secondary
| Measure | Time frame |
|---|---|
| • Overall survival (OS) defined as the time between randomization and death from any cause • Overall response rate (ORR) by independent central review according to the 2014 Lugano classification. Overall response rate is defined as the proportion of patients with a best overall response (BOR) of complete response (CR) or partial response (PR) • CR rate by independent central review defined as the proportion of patients with a BOR of CR • Duration of Response (DOR) defined as the time from first documentation of response to recurrence or progression by independent central review, or death from any cause • Frequency and severity of adverse events (AEs) • Changes from baseline of safety laboratory variables, vital signs, physical examinations, eastern cooperative oncology group (ECOG) performance status, and electrocardiograms (ECGs) • Concentrations and PK parameters of loncastuximab tesirine pyrrolobenzodiazepine (PBD)-conjugated antibody, total antibody and SG3199 unconjugated warhead • Anti-drug antibody (ADA) titers to loncastuximab tesirine after treatment with loncastuximab tesirine • Changes in patient-reported outcomes (PROs) (e.g., symptoms, functions, and overall health status) from baseline as evaluated by EORTC QLQ-30, Lymphoma subscale (LymS) of FACT-Lym, GP5 item of FACT-Lym, and EQ-5D-5L | — |
Countries
Netherlands
Outcome results
None listed