Clinical Trial Results:
A Phase 2 Randomized Study of Loncastuximab Tesirine Versus Idelalisib in Patients with Relapsed or Refractory Follicular Lymphoma (LOTIS 6)
Summary
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EudraCT number |
2020-003695-40 |
Trial protocol |
BE PL HU IT ES |
Global end of trial date |
25 Nov 2022
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Results information
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Results version number |
v1 |
This version publication date |
09 Sep 2023
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First version publication date |
09 Sep 2023
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Other versions |
v2 |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
ADCT-402-202
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT04699461 | ||
WHO universal trial number (UTN) |
- | ||
Other trial identifiers |
IND Number: 126138 | ||
Sponsors
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Sponsor organisation name |
ADC Therapeutics SA
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Sponsor organisation address |
Route de la Corniche, 3B, Epalinges, Switzerland, 1066
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Public contact |
Clinical Trials Information, ADC Therapeutics SA, clinicaltrials@adctherapeutics.com
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Scientific contact |
Clinical Trials Information, ADC Therapeutics SA, clinicaltrials@adctherapeutics.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
25 Nov 2022
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
25 Nov 2022
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Was the trial ended prematurely? |
Yes
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General information about the trial
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Main objective of the trial |
To evaluate the efficacy of single agent loncastuximab tesirine compared to idelalisib in participants with relapsed or refractory follicular lymphoma.
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Protection of trial subjects |
The study was performed in accordance with the protocol and with the Consensus ethical principles derived from international guidelines including the Declaration of Helsinki and Council for International Organizations of Medical Sciences (CIOMS) International Ethical Guidelines, applicable International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) Good Clinical Practice (GCP) Guidelines, and applicable laws and regulations.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
04 Nov 2021
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Spain: 2
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Country: Number of subjects enrolled |
Hungary: 2
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Country: Number of subjects enrolled |
Poland: 2
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Worldwide total number of subjects |
6
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EEA total number of subjects |
6
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
5
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From 65 to 84 years |
1
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85 years and over |
0
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Recruitment
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Recruitment details |
Participants were enrolled at research centers in Spain, Hungary and Poland from November 2021 to November 2022. Only 6 participants were enrolled and the study was terminated early (administrative decision). | ||||||||||||||||||||||||
Pre-assignment
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Screening details |
Eligible participants were randomly assigned in a 2:1 ratio to treatment with loncastuximab tesirine or idelalisib. | ||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Period
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Not blinded | ||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Loncastuximab Tesirine | ||||||||||||||||||||||||
Arm description |
Participants were administered loncastuximab tesirine as an intravenous (IV) infusion on Day 1 of each cycle, where 1 cycle is 3 weeks. Loncastuximab tesirine was administered at a dose of 150 μg/kg for 2 cycles, then at a dose of 75 μg/kg for subsequent cycles. The median number of treatment cycles was 5.5 (min: 5; max: 12). The median treatment duration was 122.5 days (min: 54; max: 231 days). | ||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||
Investigational medicinal product name |
Loncastuximab Tesirine
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
IV infusion on Day 1 of each cycle. Loncastuximab tesirine was administered at 150 μg/kg for 2 cycles, then at a dose of 75 μg/kg for subsequent cycles.
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Arm title
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Idelalisib | ||||||||||||||||||||||||
Arm description |
Participants were administered 150 mg idelalisib, orally, twice a day throughout each cycle, where 1 cycle is 4 weeks. 1 participant received 6 cycles and the other participant received 13 cycles of treatment. The treatment duration was 140 days and 333 days, respectively. | ||||||||||||||||||||||||
Arm type |
Active comparator | ||||||||||||||||||||||||
Investigational medicinal product name |
Idelalisib
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
150 mg orally, twice a day on Day 1 of each cycle.
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Baseline characteristics reporting groups
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Reporting group title |
Overall Period
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Reporting group description |
- | ||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Loncastuximab Tesirine
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Reporting group description |
Participants were administered loncastuximab tesirine as an intravenous (IV) infusion on Day 1 of each cycle, where 1 cycle is 3 weeks. Loncastuximab tesirine was administered at a dose of 150 μg/kg for 2 cycles, then at a dose of 75 μg/kg for subsequent cycles. The median number of treatment cycles was 5.5 (min: 5; max: 12). The median treatment duration was 122.5 days (min: 54; max: 231 days). | ||
Reporting group title |
Idelalisib
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Reporting group description |
Participants were administered 150 mg idelalisib, orally, twice a day throughout each cycle, where 1 cycle is 4 weeks. 1 participant received 6 cycles and the other participant received 13 cycles of treatment. The treatment duration was 140 days and 333 days, respectively. |
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End point title |
Complete Response Rate (CRR) [1] | ||||||||||||
End point description |
CRR was defined as the percentage of participants who experienced a best overall response (BOR) of complete response (CR) assessed prior to any subsequent anticancer treatment.
Due to the limited number of participants enrolled and completing the study, no summary statistics could be calculated.
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End point type |
Primary
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End point timeframe |
Up to the end of treatment, maximum time on treatment was 333 days
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Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: No formal statistical analysis was planned. |
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Notes [2] - Insufficient number of participants experienced CR, so CRR could not be calculated. [3] - Insufficient number of participants experienced CR, so CRR could not be calculated. |
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No statistical analyses for this end point |
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End point title |
Overall Response Rate (ORR) | ||||||||||||
End point description |
ORR was defined as the percentage of participants with a BOR of CR or partial response (PR) assessed prior to any subsequent anticancer treatment.
Due to the limited number of participants enrolled and completing the study, no summary statistics could be calculated.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [4] - Insufficient number of participants experienced CR or PR, so ORR could not be calculated. [5] - Insufficient number of participants experienced CR or PR, so ORR could not be calculated. |
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No statistical analyses for this end point |
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End point title |
Progression-Free Survival (PFS) | ||||||||||||
End point description |
PFS was defined as the time between the randomization date and the first documentation of recurrence, progression, or death.
Due to the limited number of participants enrolled and completing the study, no summary statistics could be calculated.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [6] - Insufficient number of participants had recurrence, progression, or death, PFS could not calculated. [7] - Insufficient number of participants had recurrence, progression, or death, PFS could not calculated. |
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No statistical analyses for this end point |
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End point title |
Overall Survival (OS) | ||||||||||||
End point description |
OS was defined as the time between the randomization date and death from any cause.
Due to the limited number of participants enrolled and completing the study, no summary statistics could be calculated.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [8] - Insufficient number of participants experienced death, so OS could not be calculated. [9] - Insufficient number of participants experienced death, so OS could not be calculated. |
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No statistical analyses for this end point |
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End point title |
Duration of Response (DOR) | ||||||||||||
End point description |
DOR was defined as the time from the documentation of tumor response to disease progression or death.
Due to the limited number of participants enrolled and completing the study, no summary statistics could be calculated.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [10] - Insufficient number of participants had progression or death, so DOR could not be calculated. [11] - Insufficient number of participants had progression or death, so DOR could not be calculated. |
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No statistical analyses for this end point |
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End point title |
Number of Participants Who Experience at Least One Treatment-Emergent Adverse Event (TEAE) | |||||||||||||||
End point description |
TEAEs were defined as an AE that occurs or worsens in the period extending from the first dose of study treatment until 30 days after the last dose of study treatment or start of new anti-cancer therapy, whichever is earlier.
Any clinically significant changes from baseline in the safety laboratory values, vital signs, 12-lead electrocardiogram (ECG), and Eastern Cooperative Oncology Group (ECOG) performance status were reported as TEAEs.
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End point type |
Secondary
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End point timeframe |
Day 1 to 30 days after end of treatment, maximum time on treatment was 333 days
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No statistical analyses for this end point |
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End point title |
Average Concentration of Loncastuximab Tesirine Before Infusion | ||||||||||||
End point description |
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [12] - No summary statistics could be collected. [13] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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End point title |
Average Concentration of Loncastuximab Tesirine at the End of Infusion | ||||||||||||
End point description |
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [14] - No summary statistics could be collected. [15] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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End point title |
Clearance Rate of Loncastuximab Tesirine | ||||||||||||
End point description |
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [16] - No summary statistics could be collected. [17] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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End point title |
Volume of Distribution of Loncastuximab Tesirine | ||||||||||||
End point description |
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [18] - No summary statistics could be collected. [19] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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End point title |
Number of Participants With Anti-Drug Antibody (ADA) Titers to Loncastuximab Tesirine | |||||||||
End point description |
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [20] - No summary statistics could be collected. [21] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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End point title |
Change From Baseline in Health-Related Quality of Life (HRQoL) as Measured by the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) | ||||||||||||
End point description |
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [22] - No summary statistics could be collected. [23] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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End point title |
Change From Baseline in Health-Related Quality of Life (HRQoL) as Measured by the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) | ||||||||||||
End point description |
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [24] - No summary statistics could be collected. [25] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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End point title |
Number of Participants With Specific Symptomatic Adverse Event Symptoms As Selected From Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) | |||||||||
End point description |
The specific symptomatic adverse events includes fatigue, swelling, rash, nausea, diarrhea, abdominal pain, and cough.
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [26] - No summary statistics could be collected. [27] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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End point title |
Treatment-Related Symptoms as Assessed by Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) | |||||||||
End point description |
The specific symptoms assessed include fatigue, swelling, rash, nausea, diarrhea, abdominal pain, and cough. The severity is assessed from "None" to "Very severe" and the interference level is assessed from "Not at all" to "Very much."
Due to the limited number of participants enrolled and completing the study, no data for summary statistics could be collected.
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End point type |
Secondary
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End point timeframe |
Up to end of treatment, maximum time on treatment was 333 days
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Notes [28] - No summary statistics could be collected. [29] - No summary statistics could be collected. |
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Up to end of treatment, maximum time on treatment was 333 days
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Assessment type |
Non-systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
23.1
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Reporting groups
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Reporting group title |
Loncastuximab Tesirine
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Reporting group description |
Participants were administered loncastuximab tesirine as an intravenous (IV) infusion on Day 1 of each cycle, where 1 cycle is 3 weeks. Loncastuximab tesirine was administered at a dose of 150 μg/kg for 2 cycles, then at a dose of 75 μg/kg for subsequent cycles. The median number of treatment cycles was 5.5 (min: 5; max: 12). The median treatment duration was 122.5 days (min: 54; max: 231 days). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Idelalisib
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Reporting group description |
Participants were administered 150 mg idelalisib, orally, twice a day throughout each cycle, where 1 cycle is 4 weeks. 1 participant received 6 cycles and the other participant received 13 cycles of treatment. The treatment duration was 140 days and 333 days, respectively. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 0% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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25 Nov 2020 |
The primary reason for Protocol Amendment 1 was to incorporate the changes in response to the US FDA feedback. This amendment combines changes regarding safety monitoring, study stratification, and statistical analysis. In addition, updates include removal of QTcF eligibility criteria and dexamethasone equivalent as premedication, assigning ORR as key secondary endpoint, as well as modifications on PRO schedules. |
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19 Feb 2021 |
The primary reason for Protocol Amendment 2 was to extend the contraception duration post loncastuximab tesirine for female participants with childbearing potential from 6 to 9 months to align with current regulatory guidance. |
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07 Apr 2021 |
The primary reason for Protocol Amendment 3 is to align the frequency of laboratory evaluations for participants treated with idelalisib with the idelalisib Summary of Product Characteristics (SmPC); to exclude participants with history of hypersensitivity to any of the excipients of study drugs; to align contraception guidance for women of childbearing potential (WOCBP) receiving idelalisib treatment with the idelalisib SmPC; and to extend SAE reporting duration to at least 5 half-lives after the last loncastuximab tesirine dose based on regulatory authority request. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
The study was terminated due to administrative decision (not due to safety reason) by the sponsor following the withdrawal of idelalisib from the US market for the relapsed FL indication (i.e., not due to any safety reasons emerging from this study). |