Clinical Trials /

Loncastuximab Tesirine in Combination With Rituximab in Patients With Relapsed or Refractory Follicular Lymphoma

NCT04998669

Description:

The purpose of this research is to see if Loncastuximab Tesirine in combination with Rituximab will result in higher complete response rate when given to treat follicular lymphoma.

Related Conditions:
  • Follicular Lymphoma
Recruiting Status:

Not yet recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Loncastuximab Tesirine in Combination With Rituximab in Patients With Relapsed or Refractory Follicular Lymphoma
  • Official Title: Phase 2, Single-arm, Open-label, Study of Loncastuximab Tesirine in Combination With Rituximab in Patients With Relapsed or Refractory Follicular Lymphoma

Clinical Trial IDs

  • ORG STUDY ID: 20201130
  • NCT ID: NCT04998669

Conditions

  • Follicular Lymphoma

Interventions

DrugSynonymsArms
Loncastuximab tesirineADCT-402Loncastuximab tesirine + Rituximab
RituximabRituxanLoncastuximab tesirine + Rituximab

Purpose

The purpose of this research is to see if Loncastuximab Tesirine in combination with Rituximab will result in higher complete response rate when given to treat follicular lymphoma.

Trial Arms

NameTypeDescriptionInterventions
Loncastuximab tesirine + RituximabExperimentalDuring the 12-week Induction Phase (Cycles 1 to 4), participants will receive loncastuximab tesirine on days 1 of each 3-week cycle for Cycles 1 through 4; and rituximab on days 1, 8, 15 of Cycle 1 and day 1 of Cycle 2. Maintenance Phase 1 (Cycle 5) is 8 weeks: Participants achieving complete response (CR) or partial response (PR) during the Induction Phase will receive loncastuximab tesirine once every 3-weeks; and rituximab once during week 7 or 8. Participants achieving a response of Stable Disease (SD) or Progressive Disease (PD) will be taken off treatment. Maintenance Phase 2 (Cycles 6 and 7) is 16 weeks: Participants achieving CR during Maintenance Phase 1 receive rituximab once during week 7 or 8 of Cycles 6 and 7. Participants achieving PR during Maintenance Phase 1 receive loncastuximab tesirine once every 3-weeks over each 8 week cycle; and rituximab once during week 7 or 8 of Cycles 6 and 7. Participants achieving SD or PD will be taken off treatment.
  • Loncastuximab tesirine
  • Rituximab

Eligibility Criteria

        Inclusion Criteria:

          1. Men and women ≥ 18 years of age.

          2. Patients must have histologic confirmation of Cluster of Differentiation (CD)19 and
             CD20-positive Follicular Lymphoma (FL) (grade 1, 2 and 3A)

          3. Patients with relapsed or refractory FL previously treated with ≥1 line of systemic
             therapy having ≥ 1 Groupe d'Etude des Lymphomes (GELF) criteria for therapy,
             Progression of Diseases within 24 months (POD24), or second relapse.

          4. Baseline FDG-PET/CT scans must demonstrate positive lesions compatible with CT defined
             anatomical tumor sites. Patients should have at least one measurable site of disease
             per Lugano classification.

          5. Patient should have ≥ 1 Groupe d'Etude des Lymphomes (GELF) criteria for treatment
             initiation).

               -  Involvement of ≥3 nodal sites, each with diameter of ≥3 cm

               -  Any nodal or extranodal tumor mass with a diameter of ≥7 cm

               -  B symptoms (fever ≥ 38 degrees Celsius of unclear etiology, night sweats, weight
                  loss > 10% within the prior 6 months).

               -  Risk of local compressive symptoms that may result in organ compromise

               -  Splenomegaly or splenic lesion without splenomegaly

               -  Leukopenia (leukocytes < 1000/mm3)

               -  Leukemia (> 5.000 lymphoma cells/mm3)

               -  Bone lesions detected on FDG-PET/CT; or

          6. Progression or relapsed within 24 months after FL diagnosis in patients previously
             treated with ≥1 line of systemic therapy; or

          7. Second FL relapse/progression after ≥1 line of systemic therapy.

          8. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2.

          9. Life expectancy of greater than 6 weeks.

         10. Patients must have normal organ and marrow function as defined below,

               -  Absolute neutrophil count ≥1000/mm3 (unless due to lymphoma involvement of the
                  bone marrow or spleen).

               -  Platelets ≥100,000/mm3.

               -  Hemoglobin ≥ 10 g/dL or ≥8 g/dL in case of bone marrow involvement by lymphoma.

               -  Total bilirubin < 1.5 x within normal institutional limits (unless due to
                  lymphoma involvement of liver or a known history of Gilbert's disease).

               -  Gamma-Glutamyl Transpeptidase (GGT)/Aspartate Aminotransferase
                  (AST)/(SGOT)/Alanine Aminotransferase (ALT)(SGPT) ≤ 2.5 × institutional upper
                  limit of normal.

               -  Creatinine within normal institutional limits, or creatinine clearance ≥40
                  mL/min/1.73 m2 for patients with creatinine levels above institutional normal
                  (unless due to lymphoma).

        Exclusion Criteria:

          1. FL grade 3B or transformed FL.

          2. Patients with standardized uptake value (SUV) ≥ 14 on FDG-PET/CT and inaccessible
             biopsy site.

          3. > 2 lines of systemic immunochemotherapy for treatment of FL.

          4. Patients with clinically significant pleural effusions and/or ascites requiring
             drainage or associated with shortness of breath.

          5. Patients receiving any other investigational agents.

          6. Patients with known central nervous system involvement of lymphoma.

          7. Uncontrolled intercurrent illness such as: history of Myocardial Infarction (MI) in
             the last 6 months, congestive heart failure New York Heart Association (NYHA) Class
             III-IV, uncontrolled or symptomatic arrhythmia, stroke in last 6 months, liver
             cirrhosis, and autoimmune disorder requiring immunosuppression or long-term
             corticosteroids (>10 mg daily prednisone equivalent).

          8. Breastfeeding or pregnant women.

          9. Serologic status reflecting active hepatitis B or C infection. Patients that are
             positive for hepatitis B core antibody, hepatitis B surface antigen (HBsAg), or
             hepatitis C antibody will need a negative polymerase chain reaction (PCR) prior to
             enrollment. (PCR positive patients will be excluded.) Hepatitis C antibody positive
             patients are eligible if PCR is negative. Hepatitis B core antibody (+) patients
             without evidence of HBsAg or Hep B PCR (+) are eligible with appropriate Hepatitis B
             reactivation prophylaxis.

         10. Human immunodeficiency virus (HIV) infection.

         11. Patients with impaired decision-making capacity.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Number of participants achieving Complete Response (CR)
Time Frame:12 weeks
Safety Issue:
Description:Complete Response rate will be reported as the number of participants achieving complete response (CR) to study therapy. Response to therapy will be assessed using Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET) (FDG-PET)/ Computerized Tomography (CT) following Lugano 2014 criteria by week 12 of treatment.

Secondary Outcome Measures

Measure:Number of participants achieving CR or PR
Time Frame:Week 12
Safety Issue:
Description:Overall response rate (ORR) will be reported as the number of participants achieving complete response (CR) or partial response (PR) by the end of the induction phase, week 12. Response to therapy will be assessed using Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET) (FDG-PET)/ Computerized Tomography (CT) following Lugano 2014 criteria.
Measure:Incidence of Treatment-Related Adverse Events
Time Frame:Up to 13 months
Safety Issue:
Description:Safety of the intervention will be reported as the incidence of treatment-related toxicity, including serious adverse events (SAEs) and adverse events (AEs), in study participants using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0, per physician discretion.
Measure:Progression-free Survival (PFS)
Time Frame:Up to 3 years
Safety Issue:
Description:Progression-Free Survival (PFS) is defined as the elapsed time from the date of starting treatment (Cycle 1 Day 1) until disease progression or death (whichever occur first).
Measure:Overall Survival (OS)
Time Frame:Up to 3 years
Safety Issue:
Description:Overall survival (OS) will be defined as the elapsed time from the date of starting treatment (Cycle 1 Day 1) until death.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Not yet recruiting
Lead Sponsor:Juan P. Alderuccio, MD

Last Updated

August 10, 2021