Phase 2
N=145
Study to Evaluate the Efficacy and Safety of Loncastuximab Tesirine in Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma
Diffuse Large B-Cell Lymphoma Refractory · Diffuse Large B-cell Lymphoma Recurrent
Bottom Line
View on ClinicalTrials.gov: NCT03589469 ↗Enrolled (actual)
145
Serious AEs
39.3%
Results posted
Jul 2021
Primary outcome: Primary: Overall Response Rate (ORR) — 48.3 percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Loncastuximab tesirine (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- ADC Therapeutics S.A.
- Primary completion
- May 2020
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Overall Response Rate (ORR) |
48.3 | — |
| SECONDARY Duration of Response (DOR) |
13.37 | — |
| SECONDARY Complete Response (CR) Rate |
24.8 | — |
| SECONDARY Relapse-free Survival (RFS) |
NA | — |
| SECONDARY Progression-free Survival (PFS) |
4.93 | — |
| SECONDARY Overall Survival (OS) |
9.53 | — |
| SECONDARY Number of Participants Who Experience Treatment-emergent Adverse Events (TEAEs) |
143; 107; 57 | — |
| SECONDARY Number of Participants With Clinically Significant Changes From Baseline in Clinical Laboratory Tests |
83 | — |
| SECONDARY Number of Participants With Clinically Significant Change From Baseline in Vital Signs |
— | — |
| SECONDARY Eastern Cooperative Oncology Group (ECOG) Performance Status at Baseline and End of Treatment |
58; 78; 9; 0; 0; 0 | — |
| SECONDARY Number of Participants With Clinically Significant Change From Baseline in 12-lead Electrocardiograms (ECGs) |
30; 4; 23; 1 | — |
| SECONDARY Maximum Concentration (Cmax) of Loncastuximab Tesirine Conjugated Antibody, Total Antibody and Warhead SG3199 |
2430; 2734; 1694; 3267; 3756; 2581 | — |
| SECONDARY Area Under the Concentration-time Curve From Time Zero to the Last Quantifiable Concentration (AUC0-last) of Loncastuximab Tesirine Conjugated Antibody, Total Antibody and Warhead SG3199 |
15850; 23913; 22160; 33762; 0.00400; 0.00100 | — |
| SECONDARY Area Under the Concentration-time Curve From Time Zero to Infinity (AUC0-∞) of Loncastuximab Tesirine Conjugated Antibody, Total Antibody and Warhead SG3199 |
19825; 26902; 25778; 37761 | — |
| SECONDARY Apparent Terminal Half-life (Thalf) of Loncastuximab Tesirine Conjugated Antibody, Total Antibody and Warhead SG3199 |
8.85; 15.2; 8.66; 20.9 | — |
| SECONDARY Apparent Clearance (CL) of Loncastuximab Tesirine Conjugated Antibody, Total Antibody and Warhead SG3199 |
0.458; 0.331; 0.418; 0.285 | — |
| SECONDARY Apparent Volume of Distribution at Steady State (Vss) of Loncastuximab Tesirine Conjugated Antibody, Total Antibody and Warhead SG3199 |
4.24; 6.40; 4.10; 7.54 | — |
| SECONDARY Accumulation Index (AI) of Loncastuximab Tesirine Conjugated Antibody, Total Antibody and Warhead SG3199 |
1.65; 2.07 | — |
| SECONDARY Number of Participants With an Anti-drug Antibody (ADA) Response to Loncastuximab Tesirine |
1; 0; 1 | — |
| SECONDARY Change From Baseline Score in the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) Visual Analogue Scale (VAS) |
-0.1; 1.3; 2.8; 2.8; 3.0; 4.0 | — |
| SECONDARY Change From Baseline Score in the Functional Assessment of Cancer Therapy - Lymphoma (FACT-Lym) - Lymphoma Subscale (LymS) |
0.95; 1.34; 2.09; 0.16; 1.16; 1.00 | — |
Summary
The purpose of this Phase 2 study is to evaluate the clinical efficacy and safety of Loncastuximab Tesirine (ADCT-402) in patients with relapsed or refractory Diffuse Large B-Cell Lymphoma.
Eligibility Criteria
Inclusion Criteria
- Male or female patient aged 18 years or older.
- Pathologic diagnosis of DLBCL, as defined by the 2016 WHO classification, to include: DLBCL not otherwise specified; primary mediastinal large B-cell lymphoma; and high-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements
- Relapsed or refractory disease following two or more multi-agent systemic treatment regimens
- Patients who have received previous CD19-directed therapy must have a biopsy that shows CD19 protein expression after completion of the CD19-directed therapy.
- Measurable disease as defined by the 2014 Lugano Classification
- Availability of formalin-fixed paraffin-embedded (FFPE) tumor tissue block or minimum 10 freshly cut unstained slides if block is not available
- ECOG performance status 0-2
- Adequate organ function
- Negative beta-human chorionic gonadotropin (β-HCG) pregnancy test within 7 days prior to start of study drug (C1D1) for women of childbearing potential
- Women of childbearing potential must agree to use a highly effective method of contraception from the time of giving informed consent until at least 16 weeks after the last dose of loncastuximab tesirine. Men with female partners who are of childbearing potential must agree that they will use a highly effective method of contraception from the time of giving informed consent until at least 16 weeks after the patient receives his last dose of loncastuximab tesirine.
Exclusion Criteria
- Previous treatment with loncastuximab tesirine
- Known history of hypersensitivity to or positive serum human ADA to a CD19 antibody
- Pathologic diagnosis of Burkitt lymphoma
- 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
- Autologous stem cell transplant (ASCT) within 30 days prior to start of study drug (C1D1)
- Allogeneic stem cell transplant (AlloSCT) within 60 days prior to start of study drug (C1D1)
- Active graft-versus-host disease
- Post-transplant lymphoproliferative disorders
- Active autoimmune disease, including motor neuropathy considered of autoimmune origin and other central nervous system (CNS) autoimmune disease
- Known seropositive and requiring anti-viral therapy for human immunodeficiency (HIV) virus, hepatitis B virus (HBV), or hepatitis C virus (HCV).
- History of Stevens-Johnson syndrome or toxic epidermal necrolysis
- Lymphoma with active CNS involvement at the time of screening, including leptomeningeal disease
- 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)
- Breastfeeding or pregnant
- Significant medical comorbidities
- Major surgery, radiotherapy, chemotherapy or other anti-neoplastic therapy within 14 days prior to start of study drug (C1D1), except shorter if approved by the Sponsor
- Use of any other experimental medication within 14 days prior to start of study drug (C1D1)
- Planned live vaccine administration after starting study drug (C1D1)
- Failure to recover to Grade ≤1 (Common Terminology Criteria for Adverse Events version 4.0 [CTCAE v4.0]) from acute non-hematologic toxicity (Grade ≤2 neuropathy or alopecia) due to previous therapy prior to screening
- Congenital long QT syndrome or a corrected QTcF interval of >480 ms at screening (unless secondary to pacemaker or bundle branch block)
- Any other significant medical illness, abnormality, or condition that would, in the Investigator's judgment, make the patient inappropriate for study participation or put the patient at risk
Data sourced from ClinicalTrials.gov (NCT03589469). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.