A Study to Evaluate the Safety and Anti-cancer Activity of Loncastuximab Tesirine in Combination With Other Anti-cancer Agents in Participants With Relapsed or Refractory B-cell Non-Hodgkin Lymphoma (LOTIS-7)

Last updated: November 12, 2025
Sponsor: ADC Therapeutics S.A.
Overall Status: Active - Recruiting

Phase

1

Condition

Lymphoma, B-cell

Lymphoma

Treatment

Polatuzumab Vedotin

Mosunetuzumab

Glofitamab

Clinical Study ID

NCT04970901
ADCT-402-105
2021-001071-16
  • Ages > 18
  • All Genders

Study Summary

The primary objective of this study is to characterize the safety and tolerability of loncastuximab tesirine in combination with polatuzumab vedotin, glofitamab, or mosunetuzumab, and to identify the maximum tolerated dose (MTD) and/or recommended dose for expansion (RDE) for the combinations.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Male or female participant aged 18 years or older

  • Pathologic diagnosis of relapsed (disease that has recurred following a response) orrefractory (disease that failed to respond to prior therapy) B-NHL (2016 WorldHealth Organization classification) who have failed, or been intolerant to anyapproved therapy and had received at least two systemic treatment regimens in Part 1; and at least one systemic treatment regimen in Part 2

  • LBCL:

Part 2 Arm E enrollment focused on LBCL only

  • DLBCL, not otherwise specified (NOS)

  • Germinal Center B-cell type

  • Activated B-cell type

  • Transformed FL (note: patients with transformed FL must have received at least oneline of systemic therapy post-transformation to be eligible)

  • HGBCL, with MYC and BCL2 and/or BCL6 rearrangements

  • HGBCL, NOS

  • FL Grade 3b

  • Arm F and Part 1 Arm E:

  • All LBCL histologies listed above

  • FL (Grade 1-3a)

  • MZL

  • For Arm C only:

  • All histologies listed above

  • DLBCL (including transformed diseases)

  • MCL

  • BL

  • Life expectancy of at least 24 weeks according to Investigator's judgement

  • Need of systemic treatment for any of the listed indications as assessed by theinvestigator, including indolent B-NHLs (e.g. FL and MZL)

  • Measurable disease as defined by the 2014 Lugano Classification

  • Availability of formalin-fixed paraffin-embedded tumor tissue block

  • ECOG performance status 0 to 2

  • Adequate organ function

  • Women of childbearing potential (WOCBP) must agree to use a highly effectivemethod of contraception from the time of giving informed consent until at least 10 months after the last dose of loncastuximab tesirine. Men with femalepartners who are of childbearing potential must agree to use a condom whensexually active or practice total abstinence from the time of giving informedconsent the first dose until at least 7 months after the last dose ofloncastuximab tesirine. Men must refrain from donating sperm during this sameperiod. Arm E: WOCBP must agree to use contraceptive methods that result in afailure of less than 1% per year or remain abstinent (refrain from heterosexualintercourse) during the treatment period and for at least 18 months afterpretreatment with obinutuzumab. Arm F: WOCBP must agree to use contraceptivemethods that result in a failure of less than 1% per year or remain abstinent (refrain from heterosexual intercourse) during the treatment period and for atleast 3 months after the final dose of mosunetuzumab and tocilizumab (ifapplicable)

  • Patients 80 years of age and older at the time of signing the informed consentmust be deemed fit by Cumulative Illness Rating Scale - Geriatric (CIRS-Gscale), defined as no score of 3-4 in any category AND < 5 categories with ascore of 2 excluding hematologic criteria

Exclusion

Exclusion Criteria:

  • Known history of hypersensitivity resulting in treatment discontinuation to orpositive serum human ADA to a CD19 antibody

  • Previous therapy with loncastuximab tesirine

  • Previous treatment with polatuzumab vedotin, glofitamab or mosunetuzumab (applied torelevant arm and/or cohort of the specific drug administered)

  • Participants who received previous treatment of polatuzumab vedotin containingregimen will be excluded from Arm C

  • Participants who received previous treatment of glofitamab containing regimenwill be excluded from Arm E

  • Participants who received previous treatment of mosunetuzumab containingregimen will be excluded from Arm F

  • Human immunodeficiency virus (HIV) seropositive

  • Serologic evidence of chronic hepatitis B virus (HBV) infection and unable orunwilling to receive standard prophylactic antiviral therapy or with detectable HBVviral load

  • Serologic evidence of hepatitis C virus (HCV) infection without completion ofcurative treatment or with detectable HCV viral load

  • History of confirmed progressive multifocal leukoencephalopathy

  • History of Stevens-Johnson syndrome, toxic epidermal necrolysis, or macrophageactivation syndrome (MAS)/hemophagocytic lymphohistiocytosis (HLH)

  • Clinically significant third space fluid accumulation (i.e., ascites requiringdrainage or pleural effusion that is either requiring drainage or associated withshortness of breath)

  • Breastfeeding or pregnant

  • Significant medical comorbidities

  • Major surgery, radiotherapy, chemotherapy, or other anti-neoplastic therapy, within 14 days prior to start of study drugs (C1 D1), unless approved by the Sponsor

  • Live vaccine within 4 weeks prior to C1D1

  • Failure to recover to Grade ≤1 (Common Terminology Criteria for Adverse Events [CTCAE] version 5.0) from acute non-hematologic toxicity (excluding alopecia) due toprevious therapy prior to screening

  • Active second primary malignancy other than non-melanoma skin cancers,non-metastatic prostate cancer, in situ cervical cancer, ductal or lobular carcinomain situ of the breast, or other malignancy that the Sponsor's medical monitor andInvestigator agree and document should not be exclusionary

Extra Exclusion Criteria for Arms E (includes glofitamab) and F (includes mosunetuzumab) Note: as applicable, the arm-specific exclusion criteria may supersede the general ones, such as stem cell transplant.

  • Prior allogeneic stem cell transplant and solid organ transplant

  • Autologous stem cell transplant within 100 days prior to C1D1

  • History of central nervous system (CNS) lymphoma or leptomeningeal infiltration

  • Current or history of CNS disease, such as stroke, epilepsy, CNS vasculitis, orneurodegenerative disease

  • Known active infection, reactivation of a latent infection, whether bacterial,viral, fungal, mycobacterial, or other pathogens (excluding fungal infections ofnail beds), or any major episode of infection requiring hospitalization or treatmentwith intravenous (IV) antibiotics within four weeks prior to C1D1

  • Active or history of autoimmune disease or immune deficiency, motor neuropathyconsidered of autoimmune origin and other CNS autoimmune diseases, including but notlimited to, myasthenia gravis, myositis, autoimmune hepatitis, systemic lupuserythematosus, rheumatoid arthritis, inflammatory bowel disease, antiphospholipidantibody syndrome, Wegener granulomatosis, Sjögren syndrome, Guillain-Barrésyndrome, or multiple sclerosis, with, with certain exceptions

  • Prior treatment with anti-cancer/lymphoma targeted therapies (e.g., tyrosine kinaseinhibitors, systemic immunotherapeutic/immunostimulating agents, including, but notlimited to, cluster of differentiation 137 agonists or immune checkpoint blockadetherapies, including anti-cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4),anti-programmed cell death protein 1 (PD1), and anti-programmed death ligand 1 (PDL1) therapeutic antibodies, radio-immunoconjugates, ADCs, immune/cytokines andmonoclonal antibodies) or treatment with systemic immunosuppressive medication (including, but not limited to, cyclophosphamide, azathioprine, methotrexate,thalidomide, and anti-tumor necrosis factor agents) within 4 weeks or fivehalf-lives of the drug, whichever is shorter, prior to C1D1, or anticipation of needfor systemic immunosuppressive medication during study treatment, with certainexceptions

  • Prior treatment with CAR-T-cell therapy within 100 days prior to C1D1; primaryrefractory patients (progressive or persistent disease within 30 days) to CAR-T-celltherapy are not eligible

  • Toxicities from prior anti-cancer therapy including immunotherapy that did notresolve to ≤ Grade 1 with the exception of alopecia, endocrinopathy managed withreplacement therapy and stable vitiligo

  • Any history of immune-related Grade ≥3 AE with the exception of endocrinopathymanaged with replacement therapy

  • Ongoing corticosteroid use greater than 25 mg/day of prednisone or equivalent within 4 weeks prior and during study treatment

  • Administration of a live attenuated vaccine within 4 weeks prior to the first doseof study treatment or anticipation that such a live attenuated vaccine will berequired during the study or within 5 months after last dose of study treatment

  • Arm E only: Known history of hypersensitivity to obinutuzumab

Study Design

Total Participants: 200
Treatment Group(s): 5
Primary Treatment: Polatuzumab Vedotin
Phase: 1
Study Start date:
June 17, 2022
Estimated Completion Date:
October 29, 2027

Study Description

This is a Phase 1b, multi-center, open-label, multi-arm study to evaluate the safety and anti-cancer activity of loncastuximab tesirine in combination with polatuzumab vedotin, glofitamab, or mosunetuzumab in participants with relapsed or refractory B-cell Non-Hodgkin Lymphoma (R/R B-NHL). The study will enroll approximately 200 participants.

Loncastuximab tesirine (ADCT-402; Zynlonta) is an antibody drug conjugate (ADC), composed of a humanized monoclonal antibody directed against human cluster of differentiation 19 (CD19) conjugated through a cathepsin-cleavable linker to a pyrrolobenzodiazepine (PBD) dimer cytotoxin. Loncastuximab tesirine has been granted by Food and Drug Administration (FDA) as accelerated approval for adult participants with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, DLBCL arising from low grade lymphoma, and high-grade B-cell lymphoma (HGBCL). In the European Union (EU), the European Commission (EC) granted conditional approval for the treatment of adult patients with relapsed or refractory DLBCL and HGBCL, after two or more lines of systemic therapy.

The study includes multiple arms in two parts, Dose Escalation part (Part 1) and Dose Expansion part (Part 2). In Part 1, for the arm of loncastuximab tesirine in combination with polatuzumab vedotin includes DLBCL, HGBCL, follicular lymphoma (FL), mantle cell lymphoma (MCL), marginal zone lymphoma (MZL), and Burkitt lymphoma (BL); for the arms of loncastuximab tesirine in combination with glofitamab or mosunetuzumab include DLBCL, HGBCL, FL, and MZL. In Part 2, participants will be treated at the dose level(s) determined from Part 1. The Sponsor will conduct the safety monitoring and the overall supervision of the study in consultation with the Dose-Escalation Steering Committee (DESC)/Data Safety Monitoring Committee (DSMC).

For each participant, the study will include a Screening Period (of up to 28 days), a Treatment Period (cycles of 21 days), and a Follow-up Period (approximately every 12 week visits for up to two years for Arm C and three years for Arms E and F). Participants may continue treatment for up to one year or until disease progression, unacceptable toxicity, or other discontinuation criteria, whichever occurs first.

Treatment with gemcitabine (Arm A), lenalidomide (Arm B), and umbralisib (Arm D) were removed.

Connect with a study center

  • Universitair Ziekenhuis Gent

    Gent, 9000
    Belgium

    Site Not Available

  • Universitair Ziekenhuis Gent

    Ghent 2797656, 9000
    Belgium

    Active - Recruiting

  • Centre Hospitalier Universitaire Universite Catholique de Louvain - Site Godinne

    Yvoir, B-5530
    Belgium

    Site Not Available

  • Centre Hospitalier Universitaire Universite Catholique de Louvain - Site Godinne

    Yvoir 2783385, B-5530
    Belgium

    Active - Recruiting

  • Fakultni Nemocnice Brno

    Brno, South Moravian 625 00
    Czechia

    Site Not Available

  • Fakultni Nemocnice Brno

    Brno 3078610, South Moravian 3339536 625 00
    Czechia

    Active - Recruiting

  • Fakultni nemocnice Ostrava

    Ostrava, 708 52
    Czechia

    Site Not Available

  • Fakultni nemocnice Ostrava

    Ostrava 3068799, 708 52
    Czechia

    Active - Recruiting

  • Fakultni nemocnice v Motole

    Prague, 150 06
    Czechia

    Site Not Available

  • Fakultní Nemocnice Královské Vinohrady

    Prague, 100 34
    Czechia

    Active - Recruiting

  • Fakultni nemocnice v Motole

    Prague 3067696, 150 06
    Czechia

    Active - Recruiting

  • Fakultní Nemocnice Královské Vinohrady

    Prague 3067696, 100 34
    Czechia

    Active - Recruiting

  • Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII

    Bergamo, 24127
    Italy

    Site Not Available

  • Azienda Socio Sanitaria Territoriale (ASST) Papa Giovanni XXIII

    Bergamo 3182164, 24127
    Italy

    Active - Recruiting

  • Centro di Ricerche Cliniche - IRCCS Azienda Ospedaliero Universitaria di Bologna

    Bologna, 40138
    Italy

    Site Not Available

  • Centro di Ricerche Cliniche - IRCCS Azienda Ospedaliero Universitaria di Bologna

    Bologna 3181928, 40138
    Italy

    Active - Recruiting

  • Azienda Socio Sanitaria Territoriale (ASST) degli Spedali Civili di Brescia

    Brescia, 25123
    Italy

    Site Not Available

  • Azienda Socio Sanitaria Territoriale (ASST) degli Spedali Civili di Brescia

    Brescia 3181554, 25123
    Italy

    Active - Recruiting

  • Istituto Europeo di Oncologia

    Milan 6951411, 20141
    Italy

    Active - Recruiting

  • Istituto Europeo di Oncologia

    Milano, 20141
    Italy

    Site Not Available

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

    Barcelona, 08908
    Spain

    Site Not Available

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

    Barcelona 3128760, 08908
    Spain

    Active - Recruiting

  • Hospital General Universitario Gregorio Marañón

    Madrid, 28007
    Spain

    Active - Recruiting

  • Hospital Universitario Ramón y Cajal

    Madrid, 28034
    Spain

    Site Not Available

  • Hospital General Universitario Gregorio Marañón

    Madrid 3117735, 28007
    Spain

    Active - Recruiting

  • Hospital Universitario Ramón y Cajal

    Madrid 3117735, 28034
    Spain

    Active - Recruiting

  • Complejo Asistencial Universitario de Salamanca - Hospital Clínico

    Salamanca, 37007
    Spain

    Site Not Available

  • Complejo Asistencial Universitario de Salamanca - Hospital Clínico

    Salamanca 3111108, 37007
    Spain

    Active - Recruiting

  • Hospital Universitari i Politècnic La Fe

    Valencia, 46026
    Spain

    Site Not Available

  • Hospital Universitari i Politècnic La Fe

    Valencia 2509954, 46026
    Spain

    Active - Recruiting

  • University College London Hospitals NHS Foundation Trust

    London, NW1 2PG
    United Kingdom

    Site Not Available

  • University College London Hospitals NHS Foundation Trust

    London 2643743, NW1 2PG
    United Kingdom

    Completed

  • Oxford University Hospitals NHS Foundation Trust

    Oxford, OX3 7LE
    United Kingdom

    Site Not Available

  • Oxford University Hospitals NHS Foundation Trust

    Oxford 2640729, OX3 7LE
    United Kingdom

    Completed

  • University of California San Francisco - Fresno Center for Medical Education and Research

    Clovis, California 93611
    United States

    Site Not Available

  • Scripps Health - Prebys Cancer Center

    San Diego, California 92103
    United States

    Site Not Available

  • University of California San Francisco - Fresno Center for Medical Education and Research

    Clovis 5338122, California 5332921 93611
    United States

    Active - Recruiting

  • Scripps Health - Prebys Cancer Center

    San Diego 5391811, California 5332921 92103
    United States

    Active - Recruiting

  • Miami Cancer Institute

    Miami, Florida 33176
    United States

    Active - Recruiting

  • Sylvester Comprehensive Cancer Center

    Miami, Florida 33136
    United States

    Site Not Available

  • Memorial Cancer Institute - Memorial Hospital West

    Pembroke Pines, Florida 33028
    United States

    Site Not Available

  • Miami Cancer Institute

    Miami 4164138, Florida 4155751 33176
    United States

    Active - Recruiting

  • Sylvester Comprehensive Cancer Center

    Miami 4164138, Florida 4155751 33136
    United States

    Active - Recruiting

  • Memorial Cancer Institute - Memorial Hospital West

    Pembroke Pines 4168139, Florida 4155751 33028
    United States

    Active - Recruiting

  • The Blood and Marrow Transplant Group of Georgia

    Atlanta, Georgia 30342
    United States

    Active - Recruiting

  • Winship Cancer Institute of Emory University

    Atlanta, Georgia 30322
    United States

    Site Not Available

  • The Blood and Marrow Transplant Group of Georgia

    Atlanta 4180439, Georgia 4197000 30342
    United States

    Active - Recruiting

  • Winship Cancer Institute of Emory University

    Atlanta 4180439, Georgia 4197000 30322
    United States

    Active - Recruiting

  • Mission Cancer + Blood - Mission Cancer Foundation

    Des Moines, Iowa 50309
    United States

    Site Not Available

  • Mission Cancer + Blood - Mission Cancer Foundation

    Des Moines 4853828, Iowa 4862182 50309
    United States

    Active - Recruiting

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts 02215
    United States

    Site Not Available

  • Dana-Farber Cancer Institute

    Boston, Massachusetts 02215
    United States

    Active - Recruiting

  • Beth Israel Deaconess Medical Center

    Boston 4930956, Massachusetts 6254926 02215
    United States

    Active - Recruiting

  • Dana-Farber Cancer Institute

    Boston 4930956, Massachusetts 6254926 02215
    United States

    Active - Recruiting

  • University of Minnesota

    Minneapolis, Minnesota 55455
    United States

    Site Not Available

  • University of Minnesota

    Minneapolis 5037649, Minnesota 5037779 55455
    United States

    Active - Recruiting

  • Columbia University Irving Medical Center

    New York, New York 10027
    United States

    Site Not Available

  • Columbia University Irving Medical Center

    New York 5128581, New York 5128638 10027
    United States

    Active - Recruiting

  • Cleveland Clinic Main Campus

    Cleveland, Ohio 44195
    United States

    Site Not Available

  • Cleveland Clinic Main Campus

    Cleveland 5150529, Ohio 5165418 44195
    United States

    Active - Recruiting

  • Oregon Health and Science University

    Portland, Oregon 97239
    United States

    Site Not Available

  • Oregon Health and Science University

    Portland 5746545, Oregon 5744337 97239
    United States

    Active - Recruiting

  • Penn Medicine - Perelman Center for Advanced Medicine

    Philadelphia, Pennsylvania 19104
    United States

    Site Not Available

  • Allegheny Health Network - West Penn Hospital

    Pittsburgh, Pennsylvania 15224
    United States

    Site Not Available

  • Penn Medicine - Perelman Center for Advanced Medicine

    Philadelphia 4560349, Pennsylvania 6254927 19104
    United States

    Active - Recruiting

  • Allegheny Health Network - West Penn Hospital

    Pittsburgh 5206379, Pennsylvania 6254927 15224
    United States

    Active - Recruiting

  • Brown University Health - Rhode Island Hospital

    Providence, Rhode Island 02903
    United States

    Site Not Available

  • Brown University Health - Rhode Island Hospital

    Providence 5224151, Rhode Island 5224323 02903
    United States

    Active - Recruiting

  • Hollings Cancer Center

    Charleston, South Carolina 29425
    United States

    Site Not Available

  • Hollings Cancer Center

    Charleston 4574324, South Carolina 4597040 29425
    United States

    Completed

  • Avera Cancer Institute

    Sioux Falls, South Dakota 57105
    United States

    Site Not Available

  • Avera Cancer Institute

    Sioux Falls 5231851, South Dakota 5769223 57105
    United States

    Site Not Available

  • Greco-Hainsworth Tennessee Oncology Centers for Research (GHCR)

    Nashville, Tennessee 37203
    United States

    Site Not Available

  • Greco-Hainsworth Tennessee Oncology Centers for Research (GHCR)

    Nashville 4644585, Tennessee 4662168 37203
    United States

    Active - Recruiting

  • Baylor University Medical Center

    Dallas, Texas 75246
    United States

    Site Not Available

  • Baylor University Medical Center

    Dallas 4684888, Texas 4736286 75246
    United States

    Active - Recruiting

  • Huntsman Cancer Institute

    Salt Lake City, Utah 84112
    United States

    Site Not Available

  • Huntsman Cancer Institute

    Salt Lake City 5780993, Utah 5549030 84112
    United States

    Active - Recruiting

  • Emily Couric Clinical Cancer Center

    Charlottesville, Virginia 22903
    United States

    Site Not Available

  • NEXT Virginia (Virginia Cancer Specialists)

    Fairfax, Virginia 22031
    United States

    Site Not Available

  • Emily Couric Clinical Cancer Center

    Charlottesville 4752031, Virginia 6254928 22903
    United States

    Active - Recruiting

  • NEXT Virginia (Virginia Cancer Specialists)

    Fairfax 4758023, Virginia 6254928 22031
    United States

    Completed

  • Froedtert & Medical College of Wisconsin

    Milwaukee, Wisconsin 53226
    United States

    Site Not Available

  • Froedtert & Medical College of Wisconsin

    Milwaukee 5263045, Wisconsin 5279468 53226
    United States

    Active - Recruiting

Map preview placeholder

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.