ClinicalTrials.gg
RecruitingNCT05296070Updated Sep 21, 2026

Open-label of Loncastuximab Tesirine (ADCT-402) in Relapsed/Refractory Marginal Zone Lymphoma

A Phase 2 interventional study of Loncastuximab tesirine 150 µg/Kg and Loncastuximab tesirine 75µg/Kg in Marginal Zone Lymphoma, sponsored by University of Miami. Recruiting at 4 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-21.

Sponsored by University of Miami · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2022; still recruiting 4 years 4 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
50
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this research study is to see if loncastuximab tesirine has any benefits at dose levels researchers found acceptable in earlier studies in patients with related forms of immune cell cancers. The researchers want to find out the effects (good and bad) that loncastuximab tesirine has on the participant and the participant's condition.

02

Conditions studied

  • Marginal Zone Lymphoma
03

In context

Lymphoma, B-Cell, Marginal Zone

875 studies on the registry are indexed under Lymphoma, B-Cell, Marginal Zone; 111 are open to participants now.

This study's planned enrollment of 50 is above the median of 40 across 681 interventional studies indexed under Lymphoma, B-Cell, Marginal Zone.

Browse Lymphoma, B-Cell, Marginal Zone studies →

Lead sponsor

University of Miami is the lead sponsor of 840 studies on the registry; 164 are open to participants now.

Of its 115 completed or terminated interventional studies of FDA-regulated products, 97 (84%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Men and women, aged 18 years or older.
  2. confirmed MZL, including extranodal, nodal, and splenic subtypes.
  3. Previously received 1 or more , including at least 1 anti-CD20 antibody (cluster of differentiation antigen 20) (either as monotherapy or in combination as chemoimmunotherapy), with documented progression or documented failure to achieve CR or PR after the most recent systemic treatment regimen. Subjects with H. pylori-positive gastric extranodal MZL who received an initial treatment with currently accepted antibiotics may be considered eligible if, after antibiotic regimen, subject has histologically confirmed MZL and was subsequently treated with at least 1 line of systemic therapy.
  4. Radiographically measurable lymphadenopathy or extranodal lymphoid (defined as the presence of ≥ 1 lesion that measures > 1.5 cm in the LDi and ≥ 1.0 cm in the longest perpendicular diameter as assessed by CT or MRI per response criteria for lymphomas.68 Imaging must be conducted within 6 weeks prior to the start of therapy.

    1. Subjects with splenic MZL who do not meet the radiographically criteria described herein are eligible for participation provided that bone marrow infiltration of MZL is histologically confirmed.
    2. Subjects with skin EMZL (extranodal marginal zone lymphoma) who do not meet the radiographically measurable disease criteria described herein are eligible for participation provided that skin lesion measures ≥ 1.5 cm in diameter by tape measure and is documented by photo or there are multiple skin lesions measuring >1cm in diameter on the body that cannot be incorporated in one radiation field and at least one of them is histologically confirmed as MZL.
    3. Subjects with gastric extranodal MZL histologically confirmed and need therapy but do not have measurable disease and in which response to treatment can be assess by multiple random gastric .
    4. Subjects with conjunctival EMZL who do not meet the radiographically measurable disease criteria described herein are eligible for participation provided that conjunctival lesion measures ≥ 1 cm in diameter by tape measure and is documented by photo or there are multiple conjunctival lesions measuring together >1 5cm that cannot be treated by radiation because of previous radiation therapy, to radiation and patient refusal to receive radiation therapy. At least one of these lesions needs be histologically confirmed as MZL.
  5. Subjects must be willing to provide a lymph node or tissue biopsy from the most recent available archival tissue or undergo an incisional or excisional lymph node or tissue biopsy.

    a. Subjects with splenic MZL who do not have a tumor to biopsy or an archival tumor tissue sample are eligible for participation provided subject is willing to undergo a bone marrow biopsy or provide an archival bone marrow biopsy that was obtained before the date of the first dose of study treatment; bone marrow sample must show histologically confirmed infiltration of MZL.

  6. Patient should have at least one of the following criteria for treatment initiation):

    • Involvement of ≥3 nodal sites, each with diameter of ≥3 cm
    • Any nodal or extranodal tumor mass with a diameter of ≥5 cm
    • B symptoms (fever ≥ 38 degrees Celsius of unclear etiology, night sweats, weight loss > 10% within the prior 6 months) or other symptoms attributed to disease or specific organ involvement associated with the relapse.
    • Risk of local compressive symptoms that may result in organ compromise
    • Splenomegaly or splenic lesion without splenomegaly
    • Leukopenia attributed to MZL (leukocytes \< 1000/mm3)
    • Leukemia (> 5.000 lymphoma cells/mm3)
    • Threatened organ function, especially for extranodal MZL
    • Requirement for transfusion or growth factor support attributed to lymphoma
    • Involvement of 2 or more extranodal sites, with tumor/lesion in each extranodal site ≥1 cm
    • Progression or within 24 months after MZL diagnosis in patients previously treated with ≥1 line of systemic therapy
  7. > 3 months.
  8. (Eastern Cooperative Oncology Group ) performance status 0 to 2 (Refer to Appendix A).69
  9. Adequate hematologic, hepatic, and renal function tested within 6 weeks prior to the start of therapy (values must not be achieved with growth factors):

    1. (absolute neutrophil count ) ≥ 1.0 × 109/L.
    2. ≥ 8.0 g/dL.
    3. count ≥ 50 × 109/L.
    4. Total ≤ 1.5 × (upper limit of normal ). Subjects with documented history of Gilbert's syndrome and in whom total bilirubin elevations are accompanied by elevated indirect bilirubin are eligible.
    5. (alanine aminotransferase) /AST (aspartate aminotransferase ) ≤ 3.0 ULN or ≤ 5 × ULN in the presence of liver involvement by lymphoma.
    6. Calculated ≥ 45 mL/min by the Cockcroft-Gault Equation70 or the estimated ≥ 45 mL/min/1.73 m2 using the Modification of Diet in Renal Disease formula.
  10. Willingness to avoid pregnancy or fathering children based on the criteria below:

    1. Woman of nonchildbearing potential (ie, surgically sterile with a hysterectomy and/or bilateral oophorectomy OR ≥ 12 months of amenorrhea and at least 45 years of age).
    2. Woman of who has a negative serum pregnancy test at screening and who agrees to take appropriate precautions to avoid pregnancy (with at least 99% certainty) from screening through safety follow-up at least 9 months after the last dose of loncastuximab tesirine. Permitted methods that are at least 99% effective in preventing pregnancy should be communicated to the subject and their understanding confirmed.
  11. Man, who agrees to take appropriate precautions to avoid fathering children (with at least 99% certainty) from screening through at least 6 months after the last dose of study treatment. Permitted methods that are at least 99% effective in preventing pregnancy should be communicated to the subject and their understanding confirmed.

Exclusion criteria

Exclusion Criteria:

  1. Evidence of DLBCL transformation. a. Subjects with presumptive evidence of transformation based on clinical assessment of factors such as, but not limited to, increasing lactate dehydrogenase, rapidly worsening disease, or frequent B-symptoms, must be ruled out for a transformation to a more aggressive disease, such as DLBCL.
  2. History of central nervous system lymphoma (either primary or ) or .
  3. Concurrent anticancer therapy (eg, chemotherapy, radiation therapy, surgery, immunotherapy, biologic therapy, hormonal therapy, therapy, or tumor embolization).
  4. stem cell transplant within the last 6 months, or autologous stem cell transplant within the last 3 months before the date of the first dose of study treatment.
  5. Active .
  6. Receipt of anticancer medications or investigational drugs within the following intervals before the date of the first dose of study treatment:

    1. \< 10 weeks from completion of any radio- or toxin-immunoconjugates.
    2. \< 4 weeks for immunotherapy
    3. \<. 3 weeks for radiotherapy.
    4. \< 2 weeks for any investigational agent or other anticancer medications.
    5. that are used for treatment of allergy or other underlying condition are permittable, but not steroids started to treat lymphoma. Subjects receiving corticosteroids must be at a dose level ≤ 10 mg/day within 7 days of the study treatment administration.
  7. Inadequate recovery from toxicity and/or complications from a major surgery before starting therapy.
  8. Prior treatment-related toxicities have not resolved to v5.071 ≤ Grade 1 before the date of the first dose of study treatment, except for stable chronic toxicities (≤ Grade 2) not expected to resolve (eg, stable Grade 2 peripheral neurotoxicity).
  9. Previous treatment with anti CD19 (cluster of differentiation antigen 19 ) approaches
  10. Current or previous other within 3 years of study entry, except cured basal or squamous cell skin cancer, superficial bladder cancer, prostate intraepithelial neoplasm, carcinoma in situ of the cervix, or other noninvasive or indolent malignancy.
  11. Significant concurrent, uncontrolled medical condition, including, but not limited to, renal, hepatic, hematological, GI, endocrine, pulmonary, neurological, cerebral, or psychiatric disease. Patients with pleural effusion, pericardial effusion or ascites should not be enrolled in this study, unless effusions are caused by lymphoma.
  12. Chronic or current active infectious disease requiring systemic antibiotics, antifungal, or antiviral treatment or exposure to a within 30 days of dosing.
  13. Known infection or positivity on immunoassay. Note: HIV screening test is optional
  14. Liver disease: (hepatitis B virus) or (hepatitis C virus) infection: Subjects positive for HBsAg or hepatitis B core antibody will be eligible if they are negative for HBV-DNA; these subjects should be considered for prophylactic antiviral therapy. Subjects positive for anti-HCV antibody will be eligible if they are negative for HCV-RNA.
  15. Current Class II to IV congestive heart failure or uncontrolled arrhythmia.
  16. Uncontrolled or symptomatic arrhythmia, stroke in last 6 months, liver cirrhosis, and disorder requiring or long-term corticosteroids (>10 mg daily prednisone equivalent)
  17. Currently pregnant or breastfeeding.
  18. Any condition that would, in the investigator's judgment, interfere with full participation in the study, including administration of study treatment and attending required study visits; pose a significant risk to the subject; or interfere with interpretation of study data.
  19. Patients with impaired decision-making capacity
Terms in these criteria, in plain language(32)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

GVHD (graft-versus-host disease)

After a transplant from a donor, the donor’s immune cells attack the recipient’s body, often the skin, gut or liver.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
50 participants (estimated)

Study arms

  • Experimental
    Loncastuximab tesirine Cycles 1-6

    Patients will be treated with loncastuximab tesirine for a total of 6 cycles on Day 1 (+/-3) of each 21 day (3 week) cycle. The total duration of treatment is approximately 18 weeks (4.5 months)

    Drug: Loncastuximab tesirine 150 µg/Kg · Drug: Loncastuximab tesirine 75µg/Kg

Interventions

  • DrugLoncastuximab tesirine 150 µg/Kg

    Drug page: Loncastuximab tesirine

    Participants will be treated with loncastuximab tesirine at a dose of 150 µg/Kg given as an intravenous infusion (given as per treatment guidelines for 30 minutes or longer) on Day 1 (+/- 3 days) of each 21 day cycle for Cycle 1 - 2.

  • DrugLoncastuximab tesirine 75µg/Kg

    Drug page: Loncastuximab tesirine

    Participants will be treated with loncastuximab tesirine at a dose of 75 µg/Kg given as an intravenous infusion (given as per treatment guidelines for 30 minutes or longer) on Day 1 (+/- 3 days) of each 21 day cycle for Cycle 3 - 6.

06

What researchers measure

Primary outcomes

  1. Complete Response (CR) rate of Loncastuximab tesirine in relapsed/refractory at 6 months

    CR rate is defined as the Complete Response (CR)/n, where n is the number of participants. The proportion of patients with best overall response of complete response (CR), per Cheson criteria if disease is not PET (Positron emission tomography)-avid in initial screening and by revised Lugano criteria if screening PET-CT demonstrated PET-avid disease.CR will be defined by a Deauville score of ≤ 3.

    Time frame: 6 months.

  2. Complete Response (CR) rate of Loncastuximab tesirine in relapsed/refractory at 12 months

    CR rate is defined as the Complete Response (CR)/n, where n is the number of participants. The proportion of patients with best overall response of complete response (CR), per Cheson criteria if disease is not PET-avid in initial screening and by revised Lugano criteria if screening PET-CT demonstrated PET-avid disease.CR will be defined by a Deauville score of ≤ 3.

    Time frame: 12 months.

Secondary outcomes

  1. Partial Response rate at 6 months

    PR rate Partial Response rate: (PR)/n, where n is the number of participants.The proportion of patients with best overall response of partial response (PR), per Cheson or revised Lugano criteria (based on PET avidity), among evaluable patients

    Time frame: 6 months

  2. Partial Response rate at 12 months

    PR rate Partial Response rate: (PR)/n, where n is the number of participants.The proportion of patients with best overall response of partial response (PR), per Cheson or revised Lugano criteria (based on PET avidity), among evaluable patients

    Time frame: 12 months

  3. Overall response rate (ORR) at 6 months

    Overall response rate (ORR): (CR+PR)/n, where n is the number of participants. The proportion of patients with best overall response of complete or partial responses, per Cheson or revised Lugano criteria (based on PET avidity) modified for MZL (marginal zone lymphoma), among evaluable patients

    Time frame: 6 months

  4. Overall response rate (ORR) at 12 months

    Overall response rate (ORR): (CR+PR)/n, where n is the number of participants. The proportion of patients with best overall response of complete or partial responses, per Cheson or revised Lugano criteria (based on PET avidity) modified for MZL, among evaluable patients.

    Time frame: 12 months

  5. Progression-free survival (PFS)

    Progression-free survival (PFS),which is defined as the elapsed time from start of treatment to documented progressive disease or death from any cause. For patients alive and progression-free, follow-up will be censored at the last date of document progression-free status.

    Time frame: 2 years

  6. Overall survival (OS)

    Overall survival (OS), defined as the elapsed time from start of treatment to death from any cause. Alive patients will censored at last date known to be alive.

    Time frame: 2 years

  7. Duration of Response (DOR)

    Duration of Response (DOR), defined as elapsed time from achievement of objective response (Complete Response or Partial Response) to progression, relapse, or death from any cause.

    Time frame: 2 years

  8. Number of Treatment Related Toxicities

    Defined as Adverse Events and Serious Adverse Events that are definitely, probably, or possibly related to treatment as assessed by treating physician.

    Time frame: 7 months

07

Study locations

4 of 4 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05296070
Collaborators
ADC Therapeutics S.A.
Responsible party
Sponsor
First posted
Mar 25, 2022
Start date
Jun 21, 2022
Primary completion
Jun 30, 2028 (estimated)
Completion
Jun 30, 2029 (estimated)
Last update
Sep 21, 2026

Study contacts

Philip Arlen, PhD
Contact
paa107@miami.edu
3052435247
Izidore Lossos, MD
principal investigator · University of Miami

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Loncastuximab tesirine

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