Loncastuximab tesirine in relapsed or refractory diffuse large B-cell lymphoma: a profile of its use in the USA
Funding The preparation of this review was not supported by any external funding.
Authorship and Conflict of interest A. Markham is a salaried employee of Adis International Ltd/Springer Nature and declares no relevant conflicts of interest. Z.T. Al-Salama, a salaried employee of Adis International Ltd/Springer Nature and an editor of Drugs & Therapy Perspectives, was not involved in any publishing decisions for the manuscript and declares no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.
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The antibody-drug conjugate (ADC) loncastuximab tesirine (loncastuximab tesirine-lpyl, Zynlonta®), is a useful option for third-line and subsequent treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Loncastuximab tesirine comprises a humanized anti-CD19 antibody linked to a pyrrolobenzodiazepine (PBD) dimer cytotoxic alkylating agent. It is the first CD19-targeted ADC approved for third-line and subsequent treatment of relapsed or refractory large B-cell lymphoma, DLBCL not otherwise specified, DLBCL arising from low-grade lymphoma, and high-grade B-cell lymphoma. In the pivotal phase II LOTIS-2 trial, loncastuximab tesirine as monotherapy produced an overall response rate (ORR) of 48% in heavily pre-treated patients with relapsed or refractory DLBCL, some of whom had previously received chimeric antigen receptor (CAR)-T cell therapy or hematopoietic stem cell transplantation (HSCT). The adverse event profile of loncastuximab was consistent with that seen with other PBD-based treatments, characterized by fluid overload and elevated γ-glutamyl transferase levels.
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