This phase II trial evaluates whether loncastuximab tesirine and rituximab followed by dose-adjusted doxorubicin, etoposide, vincristine, cyclophosphamide, and prednisone works to treat patients with high risk diffuse large B-cell lymphoma. Loncastuximab tesirine is a monoclonal antibody called loncastuximab, linked to a drug called tesirine. It is a form of targeted therapy because it attaches to specific molecules (receptors) on the surface of cancer cells, known as CD19 receptors, and delivers tesirine to kill them. Rituximab is a monoclonal antibody. It binds to a protein called CD20, which is found on B cells (a type of white blood cell) and some types of cancer cells. This may help the immune system kill cancer cells. Chemotherapy drugs such as doxorubicin, vincristine, and cyclophosphamide 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. Etoposide is in a class of medications known as podophyllotoxin derivatives. It blocks a certain enzyme needed for cell division and DNA repair and may kill cancer cells. Prednisone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Giving loncastuximab tesirine and rituximab in combination with dose-adjusted doxorubicin, etoposide, vincristine, cyclophosphamide, and prednisone may be more effective at treating high risk diffuse large B-cell lymphoma patients than standard treatments.
PRIMARY OBJECTIVE: I. To obtain a preliminary estimate of the anti-tumor activity of loncastuximab tesirine and rituximab (lonca-R) in newly diagnosed double-expressor lymphoma (DEL) and double-hit lymphoma (DHL). SECONDARY OBJECTIVES: I. To obtain additional efficacy measures of lonca-R in newly diagnosed DEL and DHL. II. To assess safety and tolerability of lonca-R followed by dose-adjusted doxorubicin, etoposide, vincristine, cyclophosphamide, and prednisone (DA-EPOCH-R) as coded by Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0. OUTLINE: Patients receive rituximab intravenously (IV), loncastuximab tesirine IV, etoposide IV, doxorubicin IV, vincristine IV, prednisone orally (PO), and cyclophosphamide IV on study. Patients also undergo collection of blood samples and bone marrow aspiration and biopsy at screening and computed tomography (CT) or positron emission tomography (PET)/CT at screening, throughout the study, and during follow up.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Given IV
Given IV
Given IV
Given IV
Given PO
Given IV
Given IV
University of California Davis Comprehensive Cancer Center
Sacramento, California, United States
RECRUITINGUC San Diego Moores Cancer Center
San Diego, California, United States
RECRUITINGComplete response rate
Evaluated per 2014 Lugano criteria. An exact 95% confidence interval will be calculated.
Time frame: First dose through cycle 2 (1 cycle = 3 weeks)
Overall survival rate
Will be estimated using the product-limit of Kaplan and Meier.
Time frame: First dose to off study, assessed up to 3 years
Relapse/progression free survival
Will be estimated using the product-limit of Kaplan and Meier.
Time frame: First dose (cycle 1 day 6 rituximab dose) until relapse/progression or off study, whichever occurs first, assessed up to 3 years
Overall response rate (complete response + partial response)
Defined as the proportion of participants who have partial or complete response from the start of study treatment through completion of 2 cycles. Evaluated per 2014 Lugano criteria. An exact 95% confidence interval will be calculated.
Time frame: First dose through cycle 2 (1 cycle = 3 weeks)
Incidence of adverse events
Will evaluate the number of participants experiencing treatment-related adverse events, classified by severity and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Observed toxicities will be summarized by type (organ affected or laboratory determination), severity, date of onset, duration, and attribution.
Time frame: First dose through 30 days post last dose
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.