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Relapsed Follicular LymphomaPhase 2LOTIS-6NCT04699461

Study to Evaluate the Efficacy and Safety of Loncastuximab Tesirine Versus Idelalisib in Participants With Relapsed or Refractory Follicular Lymphoma

A Phase 2 study testing Loncastuximab Tesirine and Idelalisib in people with Relapsed Follicular Lymphoma and Refractory Follicular Lymphoma, run by ADC Therapeutics S.A. at 34 sites in 10 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

This study aims to evaluate the efficacy of single agent loncastuximab tesirine compared to idelalisib in participants with relapsed or refractory follicular lymphoma. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Loncastuximab Tesirine and Idelalisib
Could I receive a placebo?
No, everyone receives an active treatment
How many people
6 participants
Where
34 sitesin 10 countries
Study dates
4 Nov 2021to 25 Nov 2022
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent must be obtained prior to any study procedures.
  • Male or female participants aged 18 years or older, with pathologic diagnosis of follicular lymphoma (FL) (Grade 1, 2, 3A) in the most recent tumor biopsy.
  • Relapsed or refractory disease following two or more treatment regimens, at least one of which must have contained an anti-CD20 therapy.
  • Participants who have received previous CD19-directed therapy must have a biopsy which shows CD19 expression after completion of the CD19-directed therapy.
  • Measurable disease as defined by the 2014 Lugano Classification as assessed by positron emission tomography - computed tomography (PET-CT) or, if not Fluorodeoxyglucose (FDG) avid, CT or magnetic resonance imaging (MRI).
  • 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.
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  • Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2.
  • Adequate organ function as defined by screening laboratory values within the following parameters:
  • Absolute neutrophil count (ANC) ≥1.0 × 10^3/μL (off growth factors at least 72 hours),
  • Platelet count ≥75 × 10^3/μL without transfusion in the past 2 weeks,
  • Alanine aminotransferase, AST, and GGT ≤2.5 × the upper limit of normal (ULN),
  • Total bilirubin ≤1.5 × ULN (participants with known Gilbert's syndrome may have a total bilirubin up to ≤3 × ULN),
  • Calculated creatinine clearance ≥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
  • Women of childbearing potential (WOCBP)(1) must agree to use a highly effective method(2) of contraception from the time of giving informed consent until at least 9 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 6 months after the participant receives his last dose of study treatment.
  • WOCBP are defined as sexually mature women who have not undergone bilateral tubal ligation, bilateral oophorectomy, or hysterectomy; or who have not been postmenopausal. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone (FSH) level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy. However, in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient.
  • Highly effective forms of birth control are methods that achieve a failure rate of less than 1% per year when used consistently and correctly. Highly effective forms of birth control include hormonal contraceptives associated with inhibition of ovulation (oral, injectable, patch, intrauterine devices), male partner sterilization, or total abstinence from heterosexual intercourse, when this is the preferred and usual lifestyle of the participant.
  • Note: The double-barrier method (e.g., synthetic condoms, diaphragm, or cervical cap with spermicidal foam, cream, or gel), periodic abstinence (such as calendar, symptothermal, post ovulation), withdrawal (coitus interruptus), lactational amenorrhea method, and spermicide-only are not acceptable as highly effective methods of contraception.

Who cannot join

  • Previous treatment with loncastuximab tesirine.
  • Previous treatment with idelalisib.
  • History of hypersensitivity to any of the excipients of loncastuximab tesirine or idelalisib.
  • Follicular lymphoma which has transformed to diffuse large B-cell lymphoma (DLBCL) or other aggressive lymphomas.
  • Requires treatment or prophylaxis with a strong cytochrome P450 (CYP) 3A inhibitor, inducer, or sensitive substrate.
  • History of or ongoing drug-induced pneumonitis.
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  • History of or ongoing inflammatory bowel disease.
  • Any condition that could interfere with the absorption or metabolism of idelalisib including malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel.
  • Active second primary malignancy other than non-melanoma skin cancers, nonmetastatic 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 transplant within 30 days prior to start of study treatment (C1D1).
  • Allogenic transplant within 60 days prior to start of study treatment (C1D1).
  • Active graft-versus-host disease.
  • Post-transplantation lymphoproliferative disorders.
  • Human immunodeficiency virus (HIV) seropositive with any of the following:
  • CD4+ T-cell counts <350 cells/μL.
  • Acquired immuno-deficiency syndrome (AIDS)-defining opportunistic infection within 12 months prior to screening.
  • Not on anti-retroviral therapy, or on anti-retroviral therapy for < 4 weeks at the time of screening.
  • HIV viral load ≥400 copies/mL.
  • Serologic evidence of chronic hepatitis B infection and unable or unwilling to receive standard prophylactic anti-viral therapy or with detectable hepatitis B virus (HBV) viral load.
  • Serologic evidence of hepatitis C infection without completion of curative treatment or with detectable hepatitis C virus (HCV) viral load.
  • History of Stevens-Johnson syndrome or toxic epidermal necrolysis.
  • Lymphoma with active central nervous system involvement, 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, including but not limited to, uncontrolled hypertension (BP ≥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, or severe chronic pulmonary disease.
  • Any Grade ≥3 active infection which requires IV antibiotics, IV antiviral, or IV antifungal treatment.
  • Major surgery, radiotherapy, chemotherapy or other anti-neoplastic therapy within 14 days prior to start of study treatment (C1D1), except shorter if approved by the Sponsor.
  • Use of any other experimental medication within 30 days prior to start of study treatment (C1D1).
  • Live vaccine administration within 4 weeks prior to Cycle(C) 1 Day (D) 1.
  • Failure to recover to ≤ Grade 1 (Common Terminology Criteria for Adverse Events [CTCAE] version 5.0) from acute non-hematologic toxicity (except ≤Grade 2 neuropathy or alopecia) due to previous therapy prior to screening.
  • Any other significant medical illness, abnormality, or condition that would, in the Investigator's judgment, make the participant inappropriate for study participation or put the participant at risk.

Trial locations and contacts

34 sites in 10 countries.

34 sites in 10 countries

Spain8 sites
  • Institut Català d'Oncologia - Hospital Duran i Reynals (ICO L'Hospitalet)

    L'Hospitalet de Llobregat, 08908

  • Hospital Universitari Arnau de Vilanova

    Lleida, 25198

  • Hospital Universitario Ramón y Cajal

    Madrid, 08908

  • Hospital General Universitario Gregorio Marañón

    Madrid, 28007

  • Hospital Universitario Fundación Jiménez Díaz

    Madrid, 28040

  • Hospital Universitario La Paz

    Madrid, 28046

  • Hospital Universitario Quirónsalud Madrid

    Pozuelo de Alarcón, 28223

  • Hospital Universitario Virgen del Rocío

    Seville, 41013

Other trials in Spain

United States5 sites
  • Hollings Cancer Center

    Charleston, South Carolina, 29425

  • Summit Medical Group - Florham Park Campus

    Florham Park, New Jersey, 07932

  • Summit Medical Group

    Florham Park, New Jersey, 07932

  • Comprehensive Cancer Centers of Nevada - Central Valley

    Las Vegas, Nevada, 89074

  • Comprehensive Cancer Centers of Nevada

    Las Vegas, Nevada, 89169

Other trials in United States

Israel5 sites
  • Soroka Medical Center

    Beersheba, 8410101

  • Carmel Medical Center

    Haifa, 3436212

  • Rabin Medical Center - Beilinson Hospital

    Petah Tikva, 4941492

  • The Chaim Sheba Medical Center

    Tel Aviv, 52621

  • Tel Aviv Sourasky Medical Center

    Tel Aviv, 6423906

Other trials in Israel

France4 sites
  • Centre Hospitalier de Dunkerque

    Dunkirk, 59385

  • Centre Hospitalier de La Rochelle

    La Rochelle, 17000

  • Centre de Lutte Contre le Cancer - Centre Henri-Becquerel

    Rouen, 76038

  • Hôpital Bretonneau

    Tours, 37044

Other trials in France

Hungary3 sites
  • Semmelweis Egyetem

    Budapest, 1088

  • Országos Onkológiai Intézet

    Budapest, 1122

  • Pécsi Tudományegyetem Klinikai Központ

    Pécs, 7624

Other trials in Hungary

Poland3 sites
  • Szpitale Pomorskie Spółka Z Ograniczoną Odpowiedzialnością

    Gdynia, 81-519

  • Pratia Onkologia Katowice

    Katowice, 40-519

  • Pratia Poznań

    Skorzewo, 60-185

Other trials in Poland

Belgium2 sites
  • Universitair Ziekenhuis Gent

    Ghent, 9000

  • Centre Hospitalier Universitaire Universite Catholique de Louvain

    Yvoir, B-5530

Other trials in Belgium

United Kingdom2 sites
  • NHS Greater Glasgow and Clyde

    Glasgow, G51 4TF

  • Account University College London Hospitals NHS Foundation Trust

    London, NW1 2PG

Other trials in United Kingdom

Italy1 site
  • Azienda Ospedaliero - Universitaria Careggi

    Florence, 50134

Other trials in Italy

Switzerland1 site
  • Inselspital Universitätsspital Bern

    Bern, 3010

Other trials in Switzerland

About this study

Official title: A Phase 2 Randomized Study of Loncastuximab Tesirine Versus Idelalisib in Patients With Relapsed or Refractory Follicular Lymphoma (LOTIS-6)

This study aims to evaluate the efficacy of single agent loncastuximab tesirine compared to idelalisib in participants with relapsed or refractory follicular lymphoma.

Being tested
Loncastuximab Tesirine, Idelalisib
Keywords
Relapsed Follicular Lymphoma, Refractory Follicular Lymphoma, Loncastuximab Tesirine, Follicular Lymphoma, Lymphoma
Medical subject headings
Lymphoma, Follicular, Lymphoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Loncastuximab TesirineDrug

    Also called Zynlonta, ADCT-402

    IV infusion

  • IdelalisibDrug

    Oral tablet

Study groups in NCT04699461
Study groupRoleWhat they receive
Loncastuximab TesirineExperimentalParticipants will be administered loncastuximab tesirine as an intravenous (IV) infusion on Day 1 of each cycle, where 1 cycle is 3 weeks. Loncastuximab tesirine will be administered at a dose of 150 μg/kg for 2 cycles, then at a dose of 75 μg/kg for subsequent cycles.
Receives: Drug: Loncastuximab Tesirine
IdelalisibActive comparatorParticipants will be administered 150 mg idelalisib, orally, twice a day throughout each cycle, where 1 cycle is 4 weeks.
Receives: Drug: Idelalisib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Complete Response Rate (CRR)

    CRR was defined as the percentage of participants who experienced a best overall response (BOR) of complete response (CR) assessed prior to any subsequent anticancer treatment.

    Measured: Up to the end of treatment, maximum time on treatment was 333 days

Secondary outcomes (14)
  1. Overall Response Rate (ORR)

    ORR was defined as the percentage of participants with a BOR of CR or partial response (PR) assessed prior to any subsequent anticancer treatment.

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  2. Progression-Free Survival (PFS)

    PFS was defined as the time between the randomization date and the first documentation of recurrence, progression, or death.

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  3. Overall Survival (OS)

    OS was defined as the time between the randomization date and death from any cause.

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  4. Duration of Response (DOR)

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

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  5. Number of Participants Who Experienced at Least One Treatment-Emergent Adverse Event (TEAE)

    TEAEs were defined as an AE that occurs or worsens in the period extending from the first dose of study treatment until 30 days after the last dose of study treatment or start of new anti-cancer therapy, whichever is earlier.

    Any clinically significant changes from baseline in the safety laboratory values, vital signs, 12-lead electrocardiogram (ECG), and Eastern Cooperative Oncology Group (ECOG) performance status were reported as TEAEs.

    Measured: Day 1 to 30 days after end of treatment, maximum time on treatment was 333 days

  6. Average Concentration of Loncastuximab Tesirine Before Infusion

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  7. Average Concentration of Loncastuximab Tesirine at the End of Infusion

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  8. Clearance Rate of Loncastuximab Tesirine

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  9. Volume of Distribution of Loncastuximab Tesirine

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  10. Number of Participants With Anti-Drug Antibody (ADA) Titers to Loncastuximab Tesirine

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  11. Change From Baseline in Health-Related Quality of Life (HRQoL) as Measured by the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L)

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  12. Change From Baseline in Health-Related Quality of Life (HRQoL) as Measured by the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym)

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  13. Number of Participants With Specific Symptomatic Adverse Event Symptoms As Selected From Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

    The specific symptomatic adverse events includes fatigue, swelling, rash, nausea, diarrhea, abdominal pain, and cough.

    Measured: Up to end of treatment, maximum time on treatment was 333 days

  14. Treatment-Related Symptoms as Assessed by Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

    The specific symptoms assessed include fatigue, swelling, rash, nausea, diarrhea, abdominal pain, and cough. The severity is assessed from "None" to "Very severe" and the interference level is assessed from "Not at all" to "Very much."

    Measured: Up to end of treatment, maximum time on treatment was 333 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Jan 2021
  2. Study start4 Nov 2021
  3. Primary completion25 Nov 2022
  4. Study completion25 Nov 2022

Why it stopped: Administrative decision (not due to safety reason)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
6 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04699461
Sponsor's protocol ID
ADCT 402-202
Other IDs
2020-003695-40
Acronym
LOTIS-6
Status last verified
Sep 2023
First submitted
5 Jan 2021
Last updated
23 Oct 2023
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Loncastuximab Tesirine and Idelalisib in people with Relapsed Follicular Lymphoma and Refractory Follicular Lymphoma, run by ADC Therapeutics S.A. at 34 sites in 10 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 17 inclusion and 31 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 23 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 34 sites in Spain, United States, Israel, France, Hungary and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 23 Oct 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Complete Response Rate (CRR) (time frame: Up to the end of treatment, maximum time on treatment was 333 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Oct 2023.

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