Aggressive Diffuse Large B-cell LymphomaPhase 2CLEARNCT07197307
Combining Loncastuximab Tesirine and Epcoritamab in Relapsed/Refractory Diffuse Large B-cell Lymphoma (DLBCL)
A Phase 2 study testing Loncastuximab Tesirine and Epcoritamab in people with Aggressive Diffuse Large B-cell Lymphoma and High-grade B-cell Lymphoma (HGBL), run by Universität Münster at 34 sites in Germany.
Trial summary
This is a phase II study designed to evaluate the toxicity and efficacy of the combination of loncastuximab tesirine and epcoritamab in patients with relapsed/refractory aggressive B-cell lymphoma. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Aggressive Diffuse Large B-cell Lymphoma, High-grade B-cell Lymphoma (HGBL), Follicular Lymphoma (FL) Grade 3B
- What is being tested?
- Loncastuximab Tesirine and Epcoritamab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 120 participants
- Where
- 34 sitesGermany
- Study dates
- 31 Oct 2025to 30 Apr 2030
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
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
- Disease:
- Subjects with histologically confirmed relapsed/refractory DLBCL based on pathology report (WHO 2022 criteria)
- DLBCL (de novo or transformed)
- High-grade B-cell lymphoma with MYC and BCL2 rearrangements
- High-grade B-cell lymphoma, not otherwise specified (NOS)
- Follicular lymphoma grade 3B
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- Diagnostic biopsy performed at the time of relapse/progressive disease no longer than 3 months before study entry must be available, with sufficient material for central review and complimentary scientific analyses. CD20 expression (or a high likelihood of CD20 expression) based on immunohistochemistry should be documented prior enrollment into the study.
- Refractory disease is defined as no remission to the last therapy. Subjects intolerant to previous therapy are excluded. Two groups of patients are eligible:
- Progressive disease (PD) or stable disease (SD) as best response to previous therapy.
- Complete (CR) or partial response (PR) as the best response after previous therapy, with biopsy-proven relapse occurring < 6 months after end of treatment.
- Relapsed disease is defined as subjects achieving complete or partial remission to previous therapy, followed by biopsy-proven relapse ≥6 months after treatment completion.
- Subjects with refractory and early relapsed (≤12 months) disease after first line anti-CD20-/anthracycline-containing therapy are eligible. Subjects with late relapsed (>12 months) disease after first line anti-CD20-/anthracycline-containing therapy can be enrolled in the study only if deemed ineligible to high dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT)) or if refuse to undergo HDCT/ASCT. Subjects relapsed/refractory to second line CAR-T cell therapy are eligible.
- Subject must be 18 years or older.
- Subject must be eligible to receive and in need of treatment initiation based on symptoms and/or disease burden, as assessed by the investigator.
- Eastern Cooperative Oncology Group Performance (ECOG) status 0-2.
- Subject must have one or more measurable disease sites defined as follows:
- A positron emission tomography/computed tomography (PET/CT) scan demonstrating PET- positive lesion(s) AND
- At least one measurable nodal lesion (long axis > 1.5 cm and short axis > 1.0 cm) or ≥ one measurable extra-nodal lesion (long axis > 1.0 cm) on CT scan or MRI.
- Ability to understand and willingness to sign written informed consent. Signed informed consent must be obtained before any study specific procedure.
- Contraception:
- Women of childbearing potential and sexually active men must practice a highly effective method of birth control during and after the study, consistent with local regulations regarding the use of birth control methods for subjects participating in clinical trials. 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 7 months after the patient receives his last dose of study treatment. Men must agree not to donate sperm from the time of giving informed consent until at least 7 months after the patient receives his last dose of study treatment. For female subjects, they apply for 12 months after the last dose of the study drug. A woman is considered to be of childbearing potential until becoming post-menopausal or permanently sterile. Permanent sterilization methods include hysterectomy, bilateral salpingectomy, and bilateral oophorectomy. Post-menopausal status is defined as no menstrual periods for a continuous 12-month period without an alternative medical cause. A post-menopausal state can be confirmed by a high follicle-stimulating hormone (FSH) level within the postmenopausal range, especially in women not using hormonal contraception or replacement therapy. The investigator or a designated associate will provide guidance to patients on achieving highly effective contraception (with a failure rate of less than 1%), such as intrauterine devices, intrauterine hormone-releasing systems, bilateral tubal occlusion, having a vasectomized partner, or sexual abstinence. Male patients are required to use condoms unless their female partner is permanently sterile.
- Women of childbearing potential participating in the study will be required to undergo a pregnancy test using either urine or serum beta-human chorionic gonadotropin (beta-hCG) at the screening visit. A negative result is necessary for inclusion in the study.
- Adequate baseline organ function tests collected no more than 7 days before starting study treatment:
- Total bilirubin ≤ 1.5 times the upper limit of normal (ULN), except for patients with Gilbert syndrome, cholestasis due to hepatic hilum adenopathies or liver involvement, or biliary obstruction due to lymphoma, who may have a total bilirubin ≤ 3 times the ULN.
- Alanine transaminase (ALT) and aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) ≤ 2.5 times the ULN, or ≤ 5 times the ULN for patients with liver involvement by lymphoma.
- Glomerular filtration rate (GFR) ≥ 45 mL/min/1.73 m² according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. If not initially within target range, this evaluation may be repeated after at least 24 hours, either using the CKD-EPI formula or by 24-hour sampling. If the subsequent result is within the acceptable range, it may be used to fulfill the inclusion criteria.
- Prothrombin time/international normalized ratio (INR)/activated partial thromboplastin time (aPTT) ≤ 1.5 times the ULN, unless the patient is receiving anticoagulation (although the INR should not exceed 4.0).
- Platelet count ≥ 75,000/mm³ without transfusion in the prior 7 days.
- Hemoglobin ≥ 8 g/dL.
- Absolute neutrophil count ≥ 1,000/mm3 (off growth factors at least 72 hours).
- Left ventricular ejection fraction > 45%.
- Concomitant Medications:
- Subjects should not be taking any active medication known to decrease T-cell numbers or activity, or any other concurrent immunosuppressive medication, except for up to 10 mg of prednisone daily or an equivalent dose, unless it is necessary for disease control during the screening period, premedication and/or cytokine release syndrome (CRS)/ immune effector cell-associated neurotoxicity syndrome (ICANS) management within the study.
- Subjects must not have been treated with any investigational drug within 30 days or 5 half-lives of the drug (whichever is longer) prior to the first dose of the study drug. They should not be currently enrolled in another interventional clinical study or have been previously enrolled in this study, unless the agent being used has been approved under emergency authorization (e.g., anti-severe acute respiratory syndrome coronavirus (SARS-CoV-2) monoclonal antibodies).
- Acute toxicity (except alopecia, fatigue) of any prior lymphoma therapy should be resolved to Grade ≤ 1 (with the exception of prior CRS or ICANS that should be fully resolved) at study screening.
- The subject should not have received vaccination with live-attenuated vaccines within 28 days prior to screening, and they should not be expected to require any live-attenuated vaccination during their participation in the study, including at least 3 months following the last dose of study treatment. However, vaccination with coronavirus messenger ribonucleic acid (mRNA) and adenovirus-based vaccines, which are not live-attenuated vaccines, is permitted.
Who cannot join
- Patients who meet any of the following criteria at the time of screening will be excluded:
- Any prior lymphoma-directed treatment, except for first-line anti-CD20-/anthracycline-containing chemoimmunotherapy or second line CAR-T cell therapy. Particularly, patients previously treated with loncastuximab tesirine and any CD3xCD20 bispecific antibody therapy are not eligible.
- Patients with late relapse (>12 months) after first-line immunochemotherapy considered HDCT/ASCT eligible as assessed by the local investigator.
- Known central nervous system (CNS) involvement.
- Diagnosed or treated for any malignancy other than r/r DLBCL, HGBL or FL grade 3B within the last 3 years, except for adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease, non-invasive basal cell or squamous cell skin carcinoma, adequately treated carcinoma in situ without evidence of disease, localized prostate cancer, post-radical prostatectomy with non-rising prostate-specific antigen levels < 0.1 ng/mL, cervical carcinoma of stage 1B or less, non-invasive, superficial bladder cancer or any curable cancer with a CR of > 2 years duration.
- Known history of human immunodeficiency virus (HIV) or active hepatitis C virus (HCV) or active hepatitis B virus (HBV) infection or any known active systemic bacterial, viral, fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds). Patients with serologic markers of HBV immunization due to vaccination (HBsAg negative, Anti-HBc negative, and Anti-HBs positive) will be eligible. Subjects who are positive for hepatitis B core antibody, hepatitis B surface antigen, or hepatitis C antibody must have a negative polymerase chain reaction (PCR) result before enrollment. Those who are PCR positive will be excluded.
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- Cytomegalovirus (CMV)-PCR positive at baseline.
- Any life-threatening illness, medical condition, or organ system dysfunction that, in the investigator's opinion, could compromise the subject's safety or interfere with the feasibility to administer study drugs including active hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS), history of cutaneous collagenous vasculopathy and capillary leak syndrome.
- Concurrent treatment with another investigational agent or radiation therapy.
- Any psychological, cognitive, familial, or social condition that, in the investigator's opinion, compromises the patient's ability to understand the patient information, give informed consent, or comply with the study protocol.
- Participation in another clinical trial.
- Known history of hypersensitivity and/or positive serum human anti-drug antibody (ADA) against any component of the study products or of the concomitant medication or an anti-CD19 antibody.
- History of Stevens-Johnson syndrome or toxic epidermal necrolysis.
- 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; history of pericardial effusion).
- Pregnancy or breastfeeding.
- Use of any other experimental medication within 30 days or 5 half-lives prior to the start of the study drug (Cycle 1 Day 1).
- Close affiliation with the investigational site, such as being a close relative of the investigator or dependent person (e.g., employee or student of the investigational site).
- Excluded medical conditions:
- Congestive heart failure > New York Heart Association (NYHA) class 2.
- Unstable angina (angina symptoms at rest) or new-onset angina (begun within the last 3 months).
- Uncontrolled atrial or ventricular cardiac arrhythmia.
- Left ventricular ejection fraction ≤ 45%.
- Electrocardiographic evidence of acute ischemia, coronary angioplasty, or myocardial infarction within 6 months prior to screening.
- Arterial or venous thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), deep vein thrombosis, or pulmonary embolism within 3 months before the start of study medication.
- Congenital long QT syndrome or a QT corrected by Fridericia's formula (QTcF) interval of > 480 ms at screening (unless secondary to pacemaker or bundle branch block).
- Severe chronic pulmonary disease.
- Known clinically significant liver disease, including hepatitis, current alcohol abuse, or cirrhosis.
- Autoimmune disease requiring immunosuppressive therapy, except for up to 10 mg prednisone daily (or equivalent).
- Seizure disorder requiring therapy within the past 12 months. Subjects with a history of seizure disorder beyond must have a complete CNS workup.
- Major surgery within 4 weeks of the first dose of study drugs, except for lymphoma reasons.
- Any other co-existing medical or psychological condition that will preclude participation in the study or compromise the ability to give informed consent.
Trial locations and contacts
34 sites in 1 country. Contact the study team or a site near you to ask about taking part.
34 sites in 1 country
Germany34 sites, 34 recruiting
- Recruiting
Universitaetsklinikum Aachen
Aachen, 52074
- Recruiting
Universitaetsklinikum Augsburg
Augsburg, 86156
- Recruiting
Vivantes Netzwerk fuer Gesundheit
Berlin, 10967
- Recruiting
Charite Universitaetsmedizin Berlin
Berlin, 12203
- Recruiting
HELIOS Klinikum Berlin-Buch
Berlin, 13125
- Recruiting
Evangelisches Klinikum Bethel
Bielefeld, 33611
- Recruiting
Klinikum Chemnitz
Chemnitz, 09116
- Recruiting
Universitaetsklinikum Duesseldorf
Düsseldorf, 40225
- Recruiting
Universitaetsklinikum Erlangen
Erlangen, 91054
- Not yet recruiting
Universitaetsklinikum Essen
Essen, 45147
- Recruiting
Universitaetsklinikum Frankfurt
Frankfurt, 60590
- Recruiting
Medical Center - University Of Freiburg
Freiburg im Breisgau, 79106
- Recruiting
Universitaetsmedizin Greifswald
Greifswald, 17489
- Recruiting
Universitaetsklinikum Halle (Saale)
Halle, 06120
- Not yet recruiting
University Medical Center Hamburg-Eppendorf
Hamburg, 20246
- Recruiting
St. Barbara-Klinik Hamm
Hamm, 59073
- Recruiting
Universitaetsklinikum Heidelberg
Heidelberg, 69120
- Recruiting
Universitaet Des Saarlandes
Homburg, 66421
- Recruiting
Universitaetsklinikum Jena
Jena, 07747
- Recruiting
Staedtisches Klinikum Karlsruhe
Karlsruhe, 76133
- Recruiting
Universitaetsklinikum Schleswig-Holstein
Kiel, 24105
- Recruiting
Universitaetsklinikum Schleswig-Holstein
Lübeck, 23538
- Recruiting
Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz
Mainz, 55131
- Recruiting
Philipps-Universitaet Marburg
Marburg, 35043
- Recruiting
Muehlenkreiskliniken
Minden, 32429
- Not yet recruiting
Klinikum der Universitaet Muenchen
München, 81377
- Recruiting
Universitätsklinikum Münster, Medizinische Klinik A
Münster, 48149
Evgenii Shumilov, PD, MD, +492518357106, Evgenii.Shumilov@ukmuenster.de
Evgenii Shumilov, PD, MD
- Recruiting
Kliniken Ostalb gemeinnuetzige kommunale Anstalt des oeffentlichen Rechts
Mutlangen, 73557
- Recruiting
Ortenau Klinikum
Offenburg, 77654
- Recruiting
Klinikum Oldenburg
Oldenburg, 26133
- Recruiting
Medizinisches Versorgungszentrum des Bruederkrankenhauses St. Josef Paderborn
Paderborn, 33098
- Recruiting
Universitaetsklinikum Regensburg
Regensburg, 93053
- Not yet recruiting
Diakonie-Klinikum Stuttgart Diakonissenkrankenhaus und Paulinenhilfe
Stuttgart, 70176
- Recruiting
Universitaetsklinikum Ulm
Ulm, 89081
About this study
This is a phase II study designed to evaluate the toxicity and efficacy of the combination of loncastuximab tesirine and epcoritamab in patients with relapsed/refractory aggressive B-cell lymphoma. Chimeric antigen receptor (CAR)-T cell naive patients who have failed first-line therapy and patients who have received CAR-T cells as second-line therapy and experienced CAR-T failure will be eligible for inclusion.
Read the detailed description
A total of 120 patients will be included. 60 days after 20 patients have started the therapy, a safety analysis will be performed to identify early and unexpected side effects of the combination therapy. An interim analysis will be conducted 6 months after recruitment of the 50th patient to check the effectiveness of the therapy. For patients not pretreated with CAR-T cells, an additional and separate efficacy analysis will be performed after the 20th CAR-T naive patient started treatment with loncastuximab tesirine and epcoritamab and had a second response assessment (12 weeks after treatment initiation) by FDG-PET/CT (-/MRI).
- Conditions
- Aggressive Diffuse Large B-cell Lymphoma, High-grade B-cell Lymphoma (HGBL), Follicular Lymphoma (FL) Grade 3B
- Being tested
- Loncastuximab Tesirine and Epcoritamab
- Keywords
- Loncastuximab Tesirine, Epcoritamab, Diffuse Large B-cell Lymphoma
- Medical subject headings
- Lymphoma, Follicular, Lymphoma, Large B-Cell, Diffuse
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Loncastuximab Tesirine and EpcoritamabDrug
Loncastuximab tesirine:
Loncastuximab tesirine 150 µg/kg iv for 2 cycles followed by 75 µg/kg iv on day 1 of each 21-day cycle in responding patients for 4 cycles subsequently (max. 6 cycles).
Epcoritamab:
Step-up dosing for epcoritamab sc will be performed, consisting of a 0.16 mg sc priming dose on day 1 of cycle 1 (day 8 of cycle 1 for loncastuximab tesirine), followed by a 0.8 mg sc dose on day 8, and full dosing with 48 mg sc on day 15. Starting from day 15, epcoritamab will be administered weekly during cycle 2-3, then once every 2 weeks during cycle 4-9, and once every 4 weeks from cycle 10 until cycle 13 (max. 13 cycles).
| Study group | Role | What they receive |
|---|---|---|
| Loncastuximab Tesirine and Epcoritamab | Experimental | Combination of loncastuximab tesirine and epcoritamab in patients with relapsed/refractory aggressive B-cell lymphoma (DLBCL, HGBL or FL grade 3B) Receives: Drug: Loncastuximab Tesirine and Epcoritamab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Best overall response rate (BORR)
BORR defined as the proportion of patients with r/r DLBCL, HGBL and FL grade 3B who achieve a complete or partial remission as best response up to 12-months of study treatment according to the 2014 Lugano criteria.
Measured: 12 months after the start of study therapy
Secondary outcomes (14)
Progression-free survival (PFS)
2-year progression-free survival (PFS) with a 95% confidence interval. PFS is defined as time from the first dose of study drug until one of the following events occurs, whichever is first: Disease progression, Relapse or Death due to any cause. Patients who have not experienced an event at the time of analysis will be censored at the most recent date of disease assessment.
Measured: 2 years after the start of study therapy
Overall survival (OS)
2-year overall survival (OS) defined as the time from the first dose of study drug to death of any cause. Patients who have not experienced an event at the time of analysis will be censored at the last date known to be alive.
Measured: 2 years after the start of study therapy
Complete response (CR) rate
Complete response (CR) rate measured as the number of complete remissions as best response (achieved up to 12 months) divided by the number of patients treated with at least one dose of study drug.
Measured: 12 months after the start of study therapy
Partial response (PR) rate
Partial response (PR) rate measured as the number of partial remissions as best response (achieved up to 12 months) divided by the number of patients treated with at least one dose of study drug.
Measured: 12 months after the start of study therapy
Time to complete response
Time to complete response measured as the time from the start of therapy to documentation of complete remission.
Measured: from the start of therapy to documentation of complete remission
Time to best response
Time to best response (achieved up to 12 months) measured as the time from the start of therapy to documentation of the best tumor response according to type of response.
Measured: 12 months after the start of study therapy
Duration of response
Duration of response measured as the time from documentation of tumor response (complete or partial remission) to relapse or progressive disease.
Measured: from documentation of tumor response (complete or partial remission) to relapse or progressive disease
Progression rate
Progression rate measured as the number of progressions (observed up to 12 months) divided by the number of patients treated with at least one dose of study drug.
Measured: 12 months after the start of study therapy
Rate of relapse
Relapse rate measured as the number of relapses divided by the number of patients included with complete or partial remission.
Measured: From date of complete or partial remission until the date of relapse, assessed until the end of the study
Biological characteristics of the lymphoma
Outcomes of the study will be evaluated according to biological characteristics of the lymphoma.
Measured: Screening visit (day -28 to day -1); during therapy cycles of loncastuximab tesirine and epcoritamab; end of trial, or in case of relapse/progression, or subject discontinuation, whichever comes first.
Adverse Events (AEs)
AEs that occurred in the study.
Measured: AEs will be assessed at each study visit from start of the study until 150 days after the last administration of loncastuximab tesirine and/or epcoritamab (whichever is administered last).
Serious Adverse Events (SAEs)
SAEs that occurred in the study.
Measured: SAEs will be assessed at each study visit from start of the study until 150 days after the last administration of loncastuximab tesirine and/or epcoritamab (whichever is administered last).
Rate of treatment-related deaths
Rate of treatment-related deaths defined as the number of treatment-related deaths during therapy or up to 2 months after the end of therapy divided by the number of patients treated with at least one dose of study drug.
Measured: from start of the therapy to 2 months after the end of therapy
Number and duration of treatment cycles and cumulative doses of loncastuximab tesirine and epcoritamab
Number of treatment cycles received, duration of treatment cycles and cumulative doses of loncastuximab tesirine and epcoritamab.
Measured: At each therapy cycle from start of the study therapy until the last administration of loncastuximab tesirine and/or epcoritamab (whichever is administered last).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Sep 2025
- Study start31 Oct 2025
- Primary completion30 Apr 2030 (estimated)
- Study completion30 Apr 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Aggressive Diffuse Large B-cell LymphomaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 120 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Universität Münster
- Sponsor type
- University, hospital or other
- Collaborators
- AbbVie, Sobi, Inc.
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07197307
- Sponsor's protocol ID
- WWU23_0006
- Other IDs
- 2023-509861-19-01, 2023
- Acronym
- CLEAR
- Status last verified
- Jul 2026
- First submitted
- 3 Sep 2025
- Last updated
- 30 Jul 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 30 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Combining Loncastuximab Tesirine and Epcoritamab in Relapsed/Refractory Diffuse Large B-cell Lymphoma (DLBCL)
- ClinicalTrials.gov ID
- NCT07197307
- Acronym / sponsor ID
- CLEAR / WWU23_0006
- Conditions
- Aggressive Diffuse Large B-cell Lymphoma, High-grade B-cell Lymphoma (HGBL), Follicular Lymphoma (FL) Grade 3B
- Keywords
- Loncastuximab Tesirine, Epcoritamab, Diffuse Large B-cell Lymphoma
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 120 participants (estimated)
- Lead sponsor
- Universität MünsterUniversity, hospital or other
- Collaborators
- AbbVie, Sobi, Inc.
- Study start
- 31 Oct 2025 (actual)
- Primary completion
- 30 Apr 2030 (estimated)
- Study completion
- 30 Apr 2030 (estimated)
- First posted
- 29 Sep 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a phase II study designed to evaluate the toxicity and efficacy of the combination of loncastuximab tesirine and epcoritamab in patients with relapsed/refractory aggressive B-cell lymphoma. Chimeric antigen receptor (CAR)-T cell naive patients who have failed first-line therapy and patients who have received CAR-T cells as second-line therapy and experienced CAR-T failure will be eligible for inclusion.
Detailed description
A total of 120 patients will be included. 60 days after 20 patients have started the therapy, a safety analysis will be performed to identify early and unexpected side effects of the combination therapy. An interim analysis will be conducted 6 months after recruitment of the 50th patient to check the effectiveness of the therapy. For patients not pretreated with CAR-T cells, an additional and separate efficacy analysis will be performed after the 20th CAR-T naive patient started treatment with loncastuximab tesirine and epcoritamab and had a second response assessment (12 weeks after treatment initiation) by FDG-PET/CT (-/MRI).
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Loncastuximab Tesirine and Epcoritamab | Experimental | Drug: Loncastuximab Tesirine and EpcoritamabCombination of loncastuximab tesirine and epcoritamab in patients with relapsed/refractory aggressive B-cell lymphoma (DLBCL, HGBL or FL grade 3B) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (36 listed)
- Subjects with histologically confirmed relapsed/refractory DLBCL based on pathology report (WHO 2022 criteria)
- Diagnostic biopsy performed at the time of relapse/progressive disease no longer than 3 months before study entry must be available, with sufficient material for central review and complimentary scientific analyses. CD20 expression (or a high likelihood of CD20 expression) based on immunohistochemistry should be documented prior enrollment into the study.
- Refractory disease is defined as no remission to the last therapy. Subjects intolerant to previous therapy are excluded. Two groups of patients are eligible:
- Relapsed disease is defined as subjects achieving complete or partial remission to previous therapy, followed by biopsy-proven relapse ≥6 months after treatment completion.
- Subjects with refractory and early relapsed (≤12 months) disease after first line anti-CD20-/anthracycline-containing therapy are eligible. Subjects with late relapsed (>12 months) disease after first line anti-CD20-/anthracycline-containing therapy can be enrolled in the study only if deemed ineligible to high dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT)) or if refuse to undergo HDCT/ASCT. Subjects relapsed/refractory to second line CAR-T cell therapy are eligible.
Key exclusion criteria (31 listed)
- Patients who meet any of the following criteria at the time of screening will be excluded:
- Any prior lymphoma-directed treatment, except for first-line anti-CD20-/anthracycline-containing chemoimmunotherapy or second line CAR-T cell therapy. Particularly, patients previously treated with loncastuximab tesirine and any CD3xCD20 bispecific antibody therapy are not eligible.
- Patients with late relapse (>12 months) after first-line immunochemotherapy considered HDCT/ASCT eligible as assessed by the local investigator.
- Known central nervous system (CNS) involvement.
- Diagnosed or treated for any malignancy other than r/r DLBCL, HGBL or FL grade 3B within the last 3 years, except for adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease, non-invasive basal cell or squamous cell skin carcinoma, adequately treated carcinoma in situ without evidence of disease, localized prostate cancer, post-radical prostatectomy with non-rising prostate-specific antigen levels < 0.1 ng/mL, cervical carcinoma of stage 1B or less, non-invasive, superficial bladder cancer or any curable cancer with a CR of > 2 years duration.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Loncastuximab Tesirine and EpcoritamabLoncastuximab tesirine: Loncastuximab tesirine 150 µg/kg iv for 2 cycles followed by 75 µg/kg iv on day 1 of each 21-day cycle in responding patients for 4 cycles subsequently (max. 6 cycles). Epcoritamab: Step-up dosing for epcoritamab sc will be performed, consisting of a 0.16 mg sc priming dose on day 1 of cycle 1 (day 8 of cycle 1 for loncastuximab tesirine), followed by a 0.8 mg sc dose on day 8, and full dosing with 48 mg sc on day 15. Starting from day 15, epcoritamab will be administered weekly during cycle 2-3, then once every 2 weeks during cycle 4-9, and once every 4 weeks from cycle 10 until cycle 13 (max. 13 cycles). | Drug | Loncastuximab Tesirine and Epcoritamab |
Primary outcome
Best overall response rate (BORR)
Time frame: 12 months after the start of study therapy
BORR defined as the proportion of patients with r/r DLBCL, HGBL and FL grade 3B who achieve a complete or partial remission as best response up to 12-months of study treatment according to the 2014 Lugano criteria.
14 secondary outcomes
Progression-free survival (PFS)
Time frame: 2 years after the start of study therapy
Overall survival (OS)
Time frame: 2 years after the start of study therapy
Complete response (CR) rate
Time frame: 12 months after the start of study therapy
Partial response (PR) rate
Time frame: 12 months after the start of study therapy
Time to complete response
Time frame: from the start of therapy to documentation of complete remission
Time to best response
Time frame: 12 months after the start of study therapy
Duration of response
Time frame: from documentation of tumor response (complete or partial remission) to relapse or progressive disease
Progression rate
Time frame: 12 months after the start of study therapy
Rate of relapse
Time frame: From date of complete or partial remission until the date of relapse, assessed until the end of the study
Biological characteristics of the lymphoma
Time frame: Screening visit (day -28 to day -1); during therapy cycles of loncastuximab tesirine and epcoritamab; end of trial, or in case of relapse/progression, or subject discontinuation, whichever comes first.
Adverse Events (AEs)
Time frame: AEs will be assessed at each study visit from start of the study until 150 days after the last administration of loncastuximab tesirine and/or epcoritamab (whichever is administered last).
Serious Adverse Events (SAEs)
Time frame: SAEs will be assessed at each study visit from start of the study until 150 days after the last administration of loncastuximab tesirine and/or epcoritamab (whichever is administered last).
Rate of treatment-related deaths
Time frame: from start of the therapy to 2 months after the end of therapy
Number and duration of treatment cycles and cumulative doses of loncastuximab tesirine and epcoritamab
Time frame: At each therapy cycle from start of the study therapy until the last administration of loncastuximab tesirine and/or epcoritamab (whichever is administered last).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jul 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
34 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Loncastuximab Tesirine and Epcoritamab in people with Aggressive Diffuse Large B-cell Lymphoma and High-grade B-cell Lymphoma (HGBL), run by Universität Münster at 34 sites in Germany.
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 36 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: looking for participants now, as of the sponsor's last update on 30 Jul 2026. 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 Germany. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Georg Lenz, Prof. (+492518347587, lenzsekr@ukmuenster.de), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Best overall response rate (BORR) (time frame: 12 months after the start of study therapy). 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 30 Jul 2026.