Phase 1b open-label study of loncastuximab tesirine in combination with other anticancer agents in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (LOTIS-7).

Authors

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Brian T. Hess

Division of Hematology and Medical Oncology, Department of Medicine, Medical University of South Carolina, Charleston, SC

Brian T. Hess , Melhem M. Solh , Mitul Gandhi , Ying Wang , Yajuan Qin , Eric Yu , Pier Luigi Zinzani , Graham P. Collins

Organizations

Division of Hematology and Medical Oncology, Department of Medicine, Medical University of South Carolina, Charleston, SC, Blood and Marrow Transplant Group of Georgia, Atlanta, GA, Virginia Cancer Specialists, Fairfax, VA, ADC Therapeutics America, Inc., Murray Hill, NJ, Institute of Hematology “Seràgnoli”, University of Bologna, Bologna, Italy, Oxford University Hospitals, NHS Trust, Oxford, United Kingdom

Research Funding

Pharmaceutical/Biotech Company
ADC Therapeutics SA

Background: Combining agents with different mechanisms of action may enhance treatment (Tx) efficacy in patients (pts) with relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma (B-NHL). Loncastuximab tesirine (loncastuximab tesirine-lpyl; Lonca), an FDA-approved, CD19-directed, antibody-drug conjugate indicated for R/R diffuse large B-cell lymphoma (DLBCL), showed significant efficacy and manageable toxicity in a phase 2 trial in pts with R/R DLBCL. In preclinical models, Lonca + polatuzumab vedotin (Pola) showed improved efficacy. CD20×CD3 T-cell engaging antibodies and Lonca target different antigens; combining these is expected to increase efficacy. The safety and activity of Lonca combined with other agents in pts with R/R B-NHL will be evaluated in LOTIS-7. Methods: LOTIS-7, a phase 1b, open-label, multicenter, multiarm study (NCT04970901), will enroll ~200 pts with B-NHL in part 1 (dose escalation, 60 pts) and part 2 (dose expansion, 140 pts). Part 2 may include specific subpopulation(s) of B-NHL informed by part 1. Primary endpoints are frequency and severity of adverse events (AE), serious AE, dose-limiting toxicities, and frequency of AE-related dose modifications. Secondary endpoints are overall response rate; duration of response; complete response rate; progression-free, relapse-free, and overall survival; Lonca concentrations; and antidrug antibody titers. Planned arms include Lonca + Pola (arm C), glofitamab (arm E), or mosunetuzumab (arm F). Arm C enrollment is open: pts are treated with Lonca + Pola as an outpatient infusion. In part 1, arm C pts receive Lonca at escalating doses (90-150 µg/kg) and Pola (1.8 mg/kg) on day 1 of each 3-week cycle; pts in arms E and F will receive Lonca 150 µg/kg for 2 cycles, then 75 µg/kg for subsequent cycles + glofitamab (2.5 mg on cycle [C]1 day [D]8, 10 mg on C1D15, 10 or 30 mg for C2-12 D1, arm E) or mosunetuzumab SC (5 mg on C1D1, 15 or 45 mg for C1D8, and 45 mg for C1D15 and C2-8 D1, arm F) after initial step-up dosing. Lonca Tx may continue for up to 1 year or until disease progression, unacceptable toxicity, or other discontinuation criteria. Key eligibility criteria include age ≥18 years, pathologic diagnosis of R/R B-NHL (2016 WHO classification), measurable disease (2014 Lugano classification), Tx failure/intolerance, ≥2 lines of prior therapy (LOT) for part 1 (≥1 LOT for part 2), and ECOG performance status of 0-2. Pts previously receiving a study drug could not enroll in that respective study arm. Pts who received a stem-cell transplant within 60 days (100 days for arms E/F) before study Tx; received allogenic stem cell or solid organ transplant (arms E/F); have lymphoma with active CNS involvement, ascites, edema, or effusion; or have significant comorbidities are excluded. The study opened in December 2021; 12 pts have been enrolled and 9 treated in the Lonca + Pola arm. Clinical trial information: NCT04970901.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies

Sub Track

Chronic Lymphocytic Leukemia (CLL) and Hairy Cell

Clinical Trial Registration Number

NCT04970901

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr TPS7581)

DOI

10.1200/JCO.2023.41.16_suppl.TPS7581

Abstract #

TPS7581

Poster Bd #

130b

Abstract Disclosures