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NCT03684694

Safety and Efficacy Study of Loncastuximab Tesirine + Ibrutinib in Diffuse Large B-Cell or Mantle Cell Lymphoma

Terminated Phase 1, PHASE2 Results posted Last updated 6 February 2024
What this trial tests

Phase 1, PHASE2 trial testing Loncastuximab Tesirine in Diffuse Large B-Cell Lymphoma in 136 participants. Terminated before completion.

Timeline
1 December 2018
Primary endpoint
8 November 2022
8 November 2022

Quick facts

Lead sponsorADC Therapeutics S.A.
PhasePhase 1, PHASE2
StatusTerminated
Study typeINTERVENTIONAL
Allocationnon randomized
Designsequential
Maskingnone
Primary purposetreatment
Enrollment136
Start date1 December 2018
Primary completion8 November 2022
Estimated completion8 November 2022
Sites35 locations across France, Italy, Belgium, United Kingdom, United States, Spain

Drugs / interventions tested

Conditions studied

Sponsor

ADC Therapeutics S.A. — full company profile →

Who can join

18 and older, any sex, with Diffuse Large B-Cell Lymphoma or Mantle Cell Lymphoma. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Phase 1: Number of Participants With Treatment-emergent Adverse Events (TEAEs) Primary · Day 1 until 30 days after last dose; max duration of treatment was 686 days for Phase 1 (up to approximately 716 days total)

A TEAE was defined as an adverse event (AE) that occurred or worsened in the period extending from the first dose of study drug to 30 days after the last dose of study drug in this study or start of a new anticancer therapy, whichever is earlier. Any clinically significant changes form baseline in safety laboratory values, vital signs, Eastern Cooperative Oncology Group (ECOG) performance status, and 12-lead electrocardiograms (ECGs) which occurred after first dose of study drug were recorded as TEAEs.

GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib37
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib4
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib6
Phase 1: Number of Participants With Serious TEAEs Primary · Day 1 until 30 days after last dose; max duration of treatment was 686 days for Phase 1 (up to approximately 716 days total)

A serious TEAE was defined as any AE which occurred after the first dose of study drug that resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization (hospitalization for elective procedures or for protocol compliance was not considered a serious adverse event), resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, or important medical events that did not meet the preceding criteria but based on appropriate medical judgement may have jeopardized the participant or may have required medic

GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib19
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib0
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib3
Phase 1: Number of Participants With Dose-Limiting Toxicities (DLTs) Primary · 21 days

A DLT was defined as any of the following events which occur during the DLT Period (first 21 days of ibrutinib treatment), except those that are clearly due to underlying disease or extraneous causes: a hematologic DLT (grade ≥3 anaemia, grade 4/febrile neutropenia, grade ≥3 thrombocytopenia), a non-hematologic DLT (including aspartate aminotransferase \[AST\] and/or alanine aminotransferase \[ALT\] \>3× upper limit of normal (ULN) and bilirubin \>2× ULN), any other non-hematologic toxicities ≥ Grade 3, with exceptions.

GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib0
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib0
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib2
Phase 1: Number of Participants With Dose Interruptions Primary · Up to a maximum of 686 days
GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib1
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib0
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib0
Phase 1: Number of Participants With Dose Reductions Primary · Up to a maximum of 686 days
GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib0
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib0
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib0
Phase 2: Complete Response Rate (CRR) Primary · Up to approximately 38 months

CRR according to the 2014 Lugano classifications determined by Independent Review Committee (IRC). CRR was defined as the percentage of participants with a best overall response (BOR) of complete response (CR).

GroupValue95% CI
Phase 2: Loncastuximab Tesirine and Ibrutinib in Non-Germinal Center B-cell (GCB) DLBCL27.115.3 – 41.8
Phase 2: Loncastuximab Tesirine and Ibrutinib in GCB DLBCL26.712.3 – 45.9
Phase 2: Loncastuximab Tesirine and Ibrutinib in MCL90.055.5 – 99.7
Phase 1: Overall Response Rate (ORR) Secondary · Up to approximately 38 months

ORR according to the 2014 Lugano classification, defined as the percentage of participants with a BOR of CR or partial response (PR).

GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib59.542.1 – 75.2
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib50.06.8 – 93.2
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib50.011.8 – 88.2
Phase 1 and Phase 2: Duration of Response (DOR) Secondary · Up to approximately 36 months

DOR was defined as the time from the first documentation of tumor response to disease progression or death.

GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib7.492.46 – 20.50
Phase 1: 75 µg/kg Loncastuximab Tesirine and IbrutinibNANA – NA
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib2.501.94 – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in Non-Germinal Center B-cell (GCB) DLBCL8.252.30 – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in GCB DLBCL7.641.87 – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in MCLNANA – NA
Phase 1 and Phase 2: Relapse-Free Survival (RFS) Secondary · Up to approximately 36 months

RFS was defined as the time from the documentation of CR to disease progression or death.

GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib7.493.61 – 22.28
Phase 1: 75 µg/kg Loncastuximab Tesirine and IbrutinibNANA – NA
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib1.94NA – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in Non-Germinal Center B-cell (GCB) DLBCLNANA – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in GCB DLBCLNANA – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in MCLNANA – NA
Phase 1 and Phase 2: Progression-Free Survival (PFS) Secondary · Up to approximately 37 months

PFS was defined as the time between start of treatment and the first documentation of progression, or death.

GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib3.551.74 – 7.79
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib3.171.22 – NA
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib2.120.69 – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in Non-Germinal Center B-cell (GCB) DLBCL3.201.41 – 4.99
Phase 2: Loncastuximab Tesirine and Ibrutinib in GCB DLBCL3.021.31 – 6.80
Phase 2: Loncastuximab Tesirine and Ibrutinib in MCLNANA – NA
Phase 1 and Phase 2: Overall Survival (OS) Secondary · Up to approximately 38 months

OS was defined as the time between the start of treatment and death from any cause.

GroupValue95% CI
Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib14.237.82 – 25.99
Phase 1: 75 µg/kg Loncastuximab Tesirine and IbrutinibNANA – NA
Phase 1: 90 µg/kg Loncastuximab Tesirine and IbrutinibNANA – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in Non-Germinal Center B-cell (GCB) DLBCL8.544.57 – 20.60
Phase 2: Loncastuximab Tesirine and Ibrutinib in GCB DLBCL16.767.16 – NA
Phase 2: Loncastuximab Tesirine and Ibrutinib in MCLNANA – NA
Phase 1 and Phase 2: Time to Reach Maximum Concentration (Tmax) of Loncastuximab Tesirine (Total Antibody, PBD-Conjugated Antibody and Unconjugated Cytotoxin SG3199) Secondary · C1D1 pre-dose, EOI, 4h PD, C1D8 168h PD, C1D15 336h PD, C2D1 pre-dose, EOI, 4h PD, C2D8 168h PD, C2D15 336h PD (3 week cycles)

Blood samples were collected for analysis of PK data of loncastuximab tesirine (total antibody, PBD-conjugated antibody and unconjugated cytotoxin SG3199)

Cycle 1: PBD-conjugated Antibody
GroupValue95% CI
Phase 1 and Phase 2: 60 µg/kg Loncastuximab Tesirine and Ibrutinib0.0410± 122
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib0.0410± 118
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib0.0330± 108
Cycle 1: Total Antibody
GroupValue95% CI
Phase 1 and Phase 2: 60 µg/kg Loncastuximab Tesirine and Ibrutinib0.0420± 125
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib0.0410± 118
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib0.0250± 21.1
Cycle 1: Unconjugated cytotoxin SG3199
GroupValue95% CI
Phase 1 and Phase 2: 60 µg/kg Loncastuximab Tesirine and Ibrutinib14.9± NA
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib6.94± NA
Cycle 2: PBD-conjugated Antibody
GroupValue95% CI
Phase 1 and Phase 2: 60 µg/kg Loncastuximab Tesirine and Ibrutinib0.0470± 223
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib0.164± 3347
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib0.0280± 37.8
Cycle 2: Total Antibody
GroupValue95% CI
Phase 1 and Phase 2: 60 µg/kg Loncastuximab Tesirine and Ibrutinib0.0570± 232
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib0.0370± 136
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib0.0280± 37.8
Cycle 2: Unconjugated cytotoxin SG3199
GroupValue95% CI
Phase 1 and Phase 2: 60 µg/kg Loncastuximab Tesirine and Ibrutinib0.0220± 19.9

Adverse events — posted to ClinicalTrials.gov

Time frame: All-cause mortality reporting was from enrollment until approximately 4 years. For serious adverse events and other adverse events, from Day 1 until 30 days after last dose; max duration of treatment was 686 days for Phase 1 (up to approximately 716 days total), 711 days for Phase 2 (up to approximately 741 days total).. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Phase 1: 60 µg/kg Loncastuximab Tesirine and Ibrutinib
Serious: 19/37 (51%)
Deaths: 24/37
Phase 1: 75 µg/kg Loncastuximab Tesirine and Ibrutinib
Serious: 0/4 (0%)
Deaths: 0/4
Phase 1: 90 µg/kg Loncastuximab Tesirine and Ibrutinib
Serious: 3/6 (50%)
Deaths: 3/6
Phase 2: Loncastuximab Tesirine and Ibrutinib in Non-Germinal Center B-cell (GCB) DLBCL
Serious: 27/49 (55%)
Deaths: 28/49
Phase 2: Loncastuximab Tesirine and Ibrutinib in GCB DLBCL
Serious: 5/30 (17%)
Deaths: 14/30
Phase 2: Loncastuximab Tesirine and Ibrutinib in MCL
Serious: 5/10 (50%)
Deaths: 3/10

Serious adverse events (66 terms)

ReactionSystemPhase 1: 60 µg/kg Loncastu…Phase 1: 75 µg/kg Loncastu…Phase 1: 90 µg/kg Loncastu…Phase 2: Loncastuximab Tes…Phase 2: Loncastuximab Tes…Phase 2: Loncastuximab Tes…
Pneumonia viralInfections and infestations
General physical health deteriorationGeneral disorders
NeutropeniaBlood and lymphatic system disorders
DeathGeneral disorders
Corona virus infectionInfections and infestations
SepsisInfections and infestations
Urinary tract infectionInfections and infestations
HypercalcaemiaMetabolism and nutrition disorders
Acute kidney injuryRenal and urinary disorders
Febrile neutropeniaBlood and lymphatic system disorders
Lymph node painBlood and lymphatic system disorders
Haemorrhagic disorderBlood and lymphatic system disorders
Atrial fibrillationCardiac disorders
Pericardial effusionCardiac disorders
CardiomyopathyCardiac disorders
Cardiopulmonary failureCardiac disorders
Coronary artery diseaseCardiac disorders
Pericardial diseaseCardiac disorders
PericarditisCardiac disorders
Inappropriate antidiuretic hormone secretionEndocrine disorders
Abdominal pain upperGastrointestinal disorders
AscitesGastrointestinal disorders
Small intestinal obstructionGastrointestinal disorders
StomatitisGastrointestinal disorders
VomitingGastrointestinal disorders
Other adverse events (146 terms — click to expand)

ReactionSystemPhase 1: 60 µg/kg Loncastu…Phase 1: 75 µg/kg Loncastu…Phase 1: 90 µg/kg Loncastu…Phase 2: Loncastuximab Tes…Phase 2: Loncastuximab Tes…Phase 2: Loncastuximab Tes…
ThrombocytopeniaBlood and lymphatic system disorders
NeutropeniaBlood and lymphatic system disorders
FatigueGeneral disorders
AnaemiaBlood and lymphatic system disorders
Oedema peripheralGeneral disorders
PyrexiaGeneral disorders
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
HypophosphataemiaMetabolism and nutrition disorders
RashSkin and subcutaneous tissue disorders
ConstipationGastrointestinal disorders
AstheniaGeneral disorders
ConjunctivitisInfections and infestations
HypokalaemiaMetabolism and nutrition disorders
HypomagnesaemiaMetabolism and nutrition disorders
Muscle spasmsMusculoskeletal and connective tissue disorders
Back painMusculoskeletal and connective tissue disorders
CoughRespiratory, thoracic and mediastinal disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
VomitingGastrointestinal disorders
Aspartate aminotransferase increasedInvestigations
Decreased appetiteMetabolism and nutrition disorders
HypocalcaemiaMetabolism and nutrition disorders
ErythemaSkin and subcutaneous tissue disorders
LeukopeniaBlood and lymphatic system disorders
Atrial fibrillationCardiac disorders
Alanine aminotransferase increasedInvestigations
Gamma-glutamyltransferase increasedInvestigations
Weight increasedInvestigations
Amylase increasedInvestigations
Musculoskeletal painMetabolism and nutrition disorders
HeadacheNervous system disorders
AnxietyPsychiatric disorders
InsomniaPsychiatric disorders
Dermatitis bullousSkin and subcutaneous tissue disorders
PruritusSkin and subcutaneous tissue disorders
HypertensionVascular disorders
VertigoEar and labyrinth disorders
DyspepsiaGastrointestinal disorders
Abdominal painGastrointestinal disorders

Most-reported serious reactions: Pneumonia viral, General physical health deterioration, Neutropenia, Death, Corona virus infection, Sepsis, Urinary tract infection, Hypercalcaemia.

Data from ClinicalTrials.gov NCT03684694 adverse events section.

Sponsor's own description

The purpose of this Phase 1/2 study is to evaluate the safety and efficacy of Loncastuximab Tesirine (ADCT-402) in combination with Ibrutinib in participants with Advanced Diffuse Large B-Cell Lymphoma or Mantle Cell Lymphoma.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. 2021 Update on Diffuse large B cell lymphoma: A review of current data and potential applications on risk stratification and management.
    Susanibar-Adaniya S, Barta SK. · · 2021 · cited 250× · PMID 33661537 · DOI 10.1002/ajh.26151
  2. Final results of a phase 1 study of loncastuximab tesirine in relapsed/refractory B-cell non-Hodgkin lymphoma.
    Hamadani M, Radford J, Carlo-Stella C, Caimi PF, et al · · 2021 · cited 127× · PMID 33211842 · DOI 10.1182/blood.2020007512
  3. New agents and regimens for diffuse large B cell lymphoma.
    Wang L, Li LR, Young KH. · · 2020 · cited 109× · PMID 33317571 · DOI 10.1186/s13045-020-01011-z
  4. Advances in targeted therapy for malignant lymphoma.
    Wang L, Qin W, Huo YJ, Li X, et al · · 2020 · cited 88× · PMID 32296035 · DOI 10.1038/s41392-020-0113-2
  5. Antibody-drug conjugates in clinical trials for lymphoid malignancies and multiple myeloma.
    Yu B, Liu D. · · 2019 · cited 70× · PMID 31500657 · DOI 10.1186/s13045-019-0786-6
  6. The antibody-drug conjugate loncastuximab tesirine for the treatment of diffuse large B-cell lymphoma.
    Calabretta E, Hamadani M, Zinzani PL, Caimi P, et al · · 2022 · cited 44× · PMID 35580172 · DOI 10.1182/blood.2021014663
  7. Dysregulation of Cell Survival in Diffuse Large B Cell Lymphoma: Mechanisms and Therapeutic Targets.
    Miao Y, Medeiros LJ, Xu-Monette ZY, Li J, et al · · 2019 · cited 39× · PMID 30881917 · DOI 10.3389/fonc.2019.00107
  8. Immunotherapy for Diffuse Large B-Cell Lymphoma: Current Landscape and Future Directions.
    Modi D, Potugari B, Uberti J. · · 2021 · cited 29× · PMID 34830980 · DOI 10.3390/cancers13225827

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