This phase I trial studies the side effects and best dose of loncastuximab tesirine in combination with carmustine, etoposide, cytarabine, and melphalan (BEAM) chemotherapy regimen in treating patients with diffuse large B-cell lymphoma that has come back (recurrent) or has not responded to treatment (refractory). Loncastuximab tesirine is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. Chemotherapy drugs, such as carmustine, etoposide, cytarabine, and melphalan, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving chemotherapy with loncastuximab tesirine may kill more cancer cells.
OUTLINE: This is a dose-escalation study of loncastuximab tesirine. PART I (CONDITIONING): Patients receive loncastuximab tesirine intravenously (IV) on day -7, carmustine IV over 2 hours on day -7, etoposide IV over 1-2 hours twice daily (BID) days -6, -5, -4, and -3, cytarabine IV over 1 hour BID on days -6, -5, -4, and -3, and melphalan IV over 15-20 minutes on day -2. Patients undergo peripheral blood ASCT per standard practice on day 0. PART II (MAINTENANCE): Beginning 30-90 days after ASCT, patients receive loncastuximab tesirine IV once every 3 weeks (Q3W) for up to 9 cycles in the absence of disease progression or unacceptable toxicity. After completion of the study treatment, patients are followed for 2 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Undergo peripheral blood ASCT
Given IV
Given IV
Given IV
Given IV
Given IV
Fred Hutch/University of Washington Cancer Consortium
Seattle, Washington, United States
Incidence of dose-limiting toxicity (Part 1)
Will be descriptive based on the appropriate analysis set and may include summary statistics such as means/median, standard deviations, range for continuous variables, and count/percentage for categorical variables, if applicable.
Time frame: Up to 30 days
Incidence of toxicity requiring dose delay or modification (Part 2)
Will be descriptive based on the appropriate analysis set and may include summary statistics such as means/median, standard deviations, range for continuous variables, and count/percentage for categorical variables, if applicable.
Time frame: Up to 30 days
Progression-free survival
Kaplan-Meier curves and median time-to-event estimation with 95% confidence intervals will be presented for time to-event endpoints, if appropriate.
Time frame: Time from receiving loncastuximab tesirine to the first observation of disease progression or death from any cause, whichever occurs first, assessed at 2 years post-autologous stem cell transplantation (ASCT)
Overall survival
Kaplan-Meier curves and median time-to-event estimation with 95% confidence intervals will be presented for time to-event endpoints, if appropriate.
Time frame: Time from receiving loncastuximab tesirine to death from any cause, assessed at 2 years post-ASCT
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