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A Study to Evaluate the Pharmacokinetics and Safety of Loncastuximab Tesirine in Participants With Relapsed or Refractory Diffuse Large B-cell Lymphoma or High-grade B-cell Lymphoma With Hepatic Impairment (LOTIS-10)

Primary Purpose

Diffuse Large B-Cell Lymphoma, High-grade B-cell Lymphoma

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Loncastuximab Tesirine
Sponsored by
ADC Therapeutics S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Diffuse Large B-Cell Lymphoma focused on measuring Loncastuximab Tesirine, Lymphoma, DLBCL, HGBCL, Hepatic Impairment

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Male or female participants aged 18 years or older Pathologic diagnosis of relapsed (disease that has recurred following a response) or refractory (disease that failed to respond to prior therapy) DLBCL not otherwise specified, DLBCL arising from low grade lymphoma, and high-grade B-cell lymphoma (2016 World Health Organization classification) who have received at least one systemic treatment regimen Measurable disease as defined by the 2014 Lugano Classification Normal hepatic function or hepatic impairment as defined by the National Cancer Institute Organ Dysfunction Working Group hepatic impairment classification: Arm A Normal hepatic function: bilirubin and aspartate aminotransferase (AST) ≤ upper limit of normal (ULN) Arm B Moderate hepatic impairment: bilirubin > 1.5 × to 3 × ULN (any AST) Arm C Severe hepatic impairment: bilirubin > 3 × ULN (any AST) ECOG performance status 0 to 2 for participants with normal hepatic function. ECOG 0 to 3 for participants with moderate or severe hepatic impairment Adequate organ function Women of childbearing potential (WOCBP)* must agree to use a highly effective method of contraception from the time of giving informed consent until at least 10 months after the last dose of study drug. 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 the first dose until at least 7 months after the last dose of study drug. Exclusion Criteria: Previous therapy with loncastuximab tesirine Allogenic or autologous stem cell transplant within 60 days prior to start of study drug (C1D1) Human immunodeficiency virus (HIV) seropositive 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 Serologic evidence of hepatitis C virus (HCV) infection without completion of curative treatment or with detectable HCV viral load History of Stevens-Johnson syndrome or toxic epidermal necrolysis Lymphoma with active central nervous system involvement at the time of screening, including leptomeningeal disease 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

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    Arm A: Normal Hepatic Function

    Arm B: Moderate Hepatic Impairment

    Arm C: Severe Hepatic Impairment

    Arm Description

    Participants will receive loncastuximab tesirine 0.15 mg/kg once every 3 weeks (Q3W) for two cycles, then 0.075 mg/kg Q3W for subsequent cycles (1 cycle = 21 days). Participants who have a toxicity meeting the criteria for dose reduction will have subsequent doses reduced by 50%. If the toxicity recurs, subsequent doses must be reduced by an additional 50%. A maximum of 2 dose reductions are allowed. Participants who have a toxicity meeting the criteria for dose reduction following Cycle 2 will receive the protocol-specified dose of 50% of initiate dose for Cycle 3, i.e., they will not have an additional dose reduction for Cycle 3.

    Participants will receive loncastuximab tesirine in a standard 3+3 dose-escalation design. Initial dose will be 0.09 mg/kg Q3W for two cycles, then 0.045 mg/kg Q3W for subsequent cycles (1 cycle = 21 days). The highest dose possibly administered will be 0.15 mg/kg Q3W. Participants who have a toxicity meeting the criteria for dose reduction will have subsequent doses reduced by 50%. If the toxicity recurs, subsequent doses must be reduced by an additional 50%. A maximum of 2 dose reductions are allowed. Participants who have a toxicity meeting the criteria for dose reduction following Cycle 2 will receive the protocol-specified dose of 50% of initiate dose for Cycle 3, i.e., they will not have an additional dose reduction for Cycle 3.

    Participants will receive loncastuximab tesirine in a standard 3+3 dose-escalation design. Initial dose will be 0.09 mg/kg Q3W for two cycles, then 0.045 mg/kg Q3W for subsequent cycles (1 cycle = 21 days). The highest dose possibly administered will be 0.15 mg/kg Q3W. Participants who have a toxicity meeting the criteria for dose reduction will have subsequent doses reduced by 50%. If the toxicity recurs, subsequent doses must be reduced by an additional 50%. A maximum of 2 dose reductions are allowed. Participants who have a toxicity meeting the criteria for dose reduction following Cycle 2 will receive the protocol-specified dose of 50% of initiate dose for Cycle 3, i.e., they will not have an additional dose reduction for Cycle 3.

    Outcomes

    Primary Outcome Measures

    Number of Participants with Moderate or Severe Hepatic Impairment Who Experience a Dose-Limiting Toxicity (DLT)

    Secondary Outcome Measures

    Maximum Concentration (Cmax) of Loncastuximab Tesirine and SG3199 in Serum
    Time to Cmax (Tmax) of Loncastuximab Tesirine and SG3199 in Serum
    Area Under the Concentration-time Curve from Time Zero to the Last Quantifiable Concentration (AUClast) of Loncastuximab Tesirine and SG3199 in Serum
    Area Under the Concentration-time Curve from Time Zero to the End of the Dosing Interval (AUCtau) of Loncastuximab Tesirine and SG3199 in Serum
    Area Under the Concentration-time Curve from Time Zero to Infinity (AUCinf) of Loncastuximab Tesirine and SG3199 in Serum
    Apparent Terminal Elimination Half-life (Thalf) of Loncastuximab Tesirine and SG3199 in Serum
    Apparent Clearance (CL) of Loncastuximab Tesirine and SG3199 in Serum
    Apparent Steady-state Volume of Distribution (Vss) of Loncastuximab Tesirine and SG3199 in Serum
    Accumulation Index (AI) of Loncastuximab Tesirine and SG3199 in Serum
    Number of Participants Who Experience an Adverse Event (AE)
    Number of Participants Who Experience a Treatment-emergent Adverse Event (TEAE)
    Number of Participants Who Experience an Adverse Event (AE) Leading to Dose Delay
    Number of Participants Who Experience an Adverse Event (AE) Leading to Dose Interruption
    Number of Participants Who Experience an Adverse Event (AE) Leading to Dose Reduction
    Number of Participants Who Experience a Clinically Significant Change from Baseline in Safety Laboratory Values
    Number of Participants Who Experience a Clinically Significant Change from Baseline in Vital Signs
    Number of Participants Who Experience a Clinically Significant Change from Baseline in Eastern Cooperative Oncology Group (ECOG) Performance Status
    Number of Participants Who Experience a Clinically Significant Change from Baseline in 12-Lead Electrocardiogram (ECG) Measurements
    Overall Response Rate (ORR)
    Duration of Response (DOR)
    Complete Response (CR) Rate
    Progression-Free Survival (PFS)
    Relapse-Free Survival (RFS)
    Overall Survival (OS)
    Number of Participants With Anti-drug Antibody (ADA) Titers to Loncastuximab Tesirine

    Full Information

    First Posted
    December 13, 2022
    Last Updated
    July 24, 2023
    Sponsor
    ADC Therapeutics S.A.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05660395
    Brief Title
    A Study to Evaluate the Pharmacokinetics and Safety of Loncastuximab Tesirine in Participants With Relapsed or Refractory Diffuse Large B-cell Lymphoma or High-grade B-cell Lymphoma With Hepatic Impairment (LOTIS-10)
    Official Title
    A Phase 1b Open-Label Study to Evaluate the Pharmacokinetics and Safety of Loncastuximab Tesirine in Patients With Relapsed or Refractory Diffuse Large B-cell Lymphoma or High-grade B-cell Lymphoma With Hepatic Impairment (LOTIS-10)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    August 14, 2023 (Anticipated)
    Primary Completion Date
    December 2026 (Anticipated)
    Study Completion Date
    April 5, 2027 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    ADC Therapeutics S.A.

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The primary objective of this study is to determine the recommended dosing regimen of loncastuximab tesirine in diffuse large B-cell lymphoma (DLBCL) or high-grade B-cell lymphoma (HGBCL) participants with moderate and severe hepatic impairment.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Diffuse Large B-Cell Lymphoma, High-grade B-cell Lymphoma
    Keywords
    Loncastuximab Tesirine, Lymphoma, DLBCL, HGBCL, Hepatic Impairment

    7. Study Design

    Primary Purpose
    Basic Science
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    56 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Arm A: Normal Hepatic Function
    Arm Type
    Experimental
    Arm Description
    Participants will receive loncastuximab tesirine 0.15 mg/kg once every 3 weeks (Q3W) for two cycles, then 0.075 mg/kg Q3W for subsequent cycles (1 cycle = 21 days). Participants who have a toxicity meeting the criteria for dose reduction will have subsequent doses reduced by 50%. If the toxicity recurs, subsequent doses must be reduced by an additional 50%. A maximum of 2 dose reductions are allowed. Participants who have a toxicity meeting the criteria for dose reduction following Cycle 2 will receive the protocol-specified dose of 50% of initiate dose for Cycle 3, i.e., they will not have an additional dose reduction for Cycle 3.
    Arm Title
    Arm B: Moderate Hepatic Impairment
    Arm Type
    Experimental
    Arm Description
    Participants will receive loncastuximab tesirine in a standard 3+3 dose-escalation design. Initial dose will be 0.09 mg/kg Q3W for two cycles, then 0.045 mg/kg Q3W for subsequent cycles (1 cycle = 21 days). The highest dose possibly administered will be 0.15 mg/kg Q3W. Participants who have a toxicity meeting the criteria for dose reduction will have subsequent doses reduced by 50%. If the toxicity recurs, subsequent doses must be reduced by an additional 50%. A maximum of 2 dose reductions are allowed. Participants who have a toxicity meeting the criteria for dose reduction following Cycle 2 will receive the protocol-specified dose of 50% of initiate dose for Cycle 3, i.e., they will not have an additional dose reduction for Cycle 3.
    Arm Title
    Arm C: Severe Hepatic Impairment
    Arm Type
    Experimental
    Arm Description
    Participants will receive loncastuximab tesirine in a standard 3+3 dose-escalation design. Initial dose will be 0.09 mg/kg Q3W for two cycles, then 0.045 mg/kg Q3W for subsequent cycles (1 cycle = 21 days). The highest dose possibly administered will be 0.15 mg/kg Q3W. Participants who have a toxicity meeting the criteria for dose reduction will have subsequent doses reduced by 50%. If the toxicity recurs, subsequent doses must be reduced by an additional 50%. A maximum of 2 dose reductions are allowed. Participants who have a toxicity meeting the criteria for dose reduction following Cycle 2 will receive the protocol-specified dose of 50% of initiate dose for Cycle 3, i.e., they will not have an additional dose reduction for Cycle 3.
    Intervention Type
    Drug
    Intervention Name(s)
    Loncastuximab Tesirine
    Other Intervention Name(s)
    Zynlonta, ADCT-402
    Intervention Description
    Intravenous (IV) Infusion
    Primary Outcome Measure Information:
    Title
    Number of Participants with Moderate or Severe Hepatic Impairment Who Experience a Dose-Limiting Toxicity (DLT)
    Time Frame
    Day 1 to Day 21 of Cycle 1, where a cycle is 21 days
    Secondary Outcome Measure Information:
    Title
    Maximum Concentration (Cmax) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Time to Cmax (Tmax) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Area Under the Concentration-time Curve from Time Zero to the Last Quantifiable Concentration (AUClast) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Area Under the Concentration-time Curve from Time Zero to the End of the Dosing Interval (AUCtau) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Area Under the Concentration-time Curve from Time Zero to Infinity (AUCinf) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Apparent Terminal Elimination Half-life (Thalf) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Apparent Clearance (CL) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Apparent Steady-state Volume of Distribution (Vss) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Accumulation Index (AI) of Loncastuximab Tesirine and SG3199 in Serum
    Time Frame
    Day 1 up to 1 year
    Title
    Number of Participants Who Experience an Adverse Event (AE)
    Time Frame
    Up to approximately 3 years
    Title
    Number of Participants Who Experience a Treatment-emergent Adverse Event (TEAE)
    Time Frame
    Up to approximately 1 year
    Title
    Number of Participants Who Experience an Adverse Event (AE) Leading to Dose Delay
    Time Frame
    Up to approximately 1 year
    Title
    Number of Participants Who Experience an Adverse Event (AE) Leading to Dose Interruption
    Time Frame
    Up to approximately 1 year
    Title
    Number of Participants Who Experience an Adverse Event (AE) Leading to Dose Reduction
    Time Frame
    Up to approximately 1 year
    Title
    Number of Participants Who Experience a Clinically Significant Change from Baseline in Safety Laboratory Values
    Time Frame
    Baseline up to approximately 1 year
    Title
    Number of Participants Who Experience a Clinically Significant Change from Baseline in Vital Signs
    Time Frame
    Baseline up to approximately 1 year
    Title
    Number of Participants Who Experience a Clinically Significant Change from Baseline in Eastern Cooperative Oncology Group (ECOG) Performance Status
    Time Frame
    Baseline up to approximately 1 year
    Title
    Number of Participants Who Experience a Clinically Significant Change from Baseline in 12-Lead Electrocardiogram (ECG) Measurements
    Time Frame
    Baseline up to approximately 1 year
    Title
    Overall Response Rate (ORR)
    Time Frame
    Up to approximately 3 years
    Title
    Duration of Response (DOR)
    Time Frame
    Up to approximately 3 years
    Title
    Complete Response (CR) Rate
    Time Frame
    Up to approximately 3 years
    Title
    Progression-Free Survival (PFS)
    Time Frame
    Up to approximately 3 years
    Title
    Relapse-Free Survival (RFS)
    Time Frame
    Up to approximately 3 years
    Title
    Overall Survival (OS)
    Time Frame
    Up to approximately 3 years
    Title
    Number of Participants With Anti-drug Antibody (ADA) Titers to Loncastuximab Tesirine
    Time Frame
    Day 1 up to 1 year

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female participants aged 18 years or older Pathologic diagnosis of relapsed (disease that has recurred following a response) or refractory (disease that failed to respond to prior therapy) DLBCL not otherwise specified, DLBCL arising from low grade lymphoma, and high-grade B-cell lymphoma (2016 World Health Organization classification) who have received at least one systemic treatment regimen Measurable disease as defined by the 2014 Lugano Classification Normal hepatic function or hepatic impairment as defined by the National Cancer Institute Organ Dysfunction Working Group hepatic impairment classification: Arm A Normal hepatic function: bilirubin and aspartate aminotransferase (AST) ≤ upper limit of normal (ULN) Arm B Moderate hepatic impairment: bilirubin > 1.5 × to 3 × ULN (any AST) Arm C Severe hepatic impairment: bilirubin > 3 × ULN (any AST) ECOG performance status 0 to 2 for participants with normal hepatic function. ECOG 0 to 3 for participants with moderate or severe hepatic impairment Adequate organ function Women of childbearing potential (WOCBP)* must agree to use a highly effective method of contraception from the time of giving informed consent until at least 10 months after the last dose of study drug. 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 the first dose until at least 7 months after the last dose of study drug. Exclusion Criteria: Previous therapy with loncastuximab tesirine Allogenic or autologous stem cell transplant within 60 days prior to start of study drug (C1D1) Human immunodeficiency virus (HIV) seropositive 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 Serologic evidence of hepatitis C virus (HCV) infection without completion of curative treatment or with detectable HCV viral load History of Stevens-Johnson syndrome or toxic epidermal necrolysis Lymphoma with active central nervous system involvement at the time of screening, including leptomeningeal disease 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
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    ADC Therapeutics
    Phone
    954-903-7994
    Email
    clinical.trials@adctherapeutics.com

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    A Study to Evaluate the Pharmacokinetics and Safety of Loncastuximab Tesirine in Participants With Relapsed or Refractory Diffuse Large B-cell Lymphoma or High-grade B-cell Lymphoma With Hepatic Impairment (LOTIS-10)

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