Loncastuximab Shows Favorable Tolerability in Relapsed/Refractory DLBCL

EP: 1.Part 1: Treatment Options and Relevant Data for Patients With DLBCL

EP: 2.Part 2: Shah Discusses Challenges in Using Lenalidomide Plus Tafasitamab for Patients With DLBCL

EP: 3.Part 3: Polatuzumab Vedotin Plus Bendamustine and Rituximab Shows Promise in Patients With DLBCL

EP: 4.Part 1: Kline Discusses Challenges of CAR T-Cell Therapy in R/R DLBCL

EP: 5.Part 2: Loncastuximab Provides Potential Bridge Therapy for R/R DLBCL

EP: 6.Part 3: Kline Discusses the Use of Tafasitamab in Certain Patients with R/R DLBCL

EP: 7.Part 1: Decision-Making for Third-Line Treatment of Transplant-Ineligible DLBCL

EP: 8.Part 2: Real-World Challenges with CAR T-Cell Therapy in DLBCL

EP: 9.Part 3: Third-Line Use of Loncastuximab for Relapsed/Refractory DLBCL

EP: 10.Part 1: Choosing a Third-Line Treatment for Refractory DLBCL

EP: 11.Part 2: Loncastuximab as a Third-Line Therapy for Relapsed/Refractory DLBCL

EP: 12.Part 3: Barriers to Loncastuximab Before CAR T-Cell Therapy in DLBCL

EP: 13.Part 1: Selecting Third-Line Options for DLBCL With CAR T-Cell Therapy

EP: 14.Part 2: Sequencing Loncastuximab and CAR T-Cell Therapy in DLBCL

EP: 15.Part 1: Tafasitamab/Lenalidomide Shows Durable Responses in R/R DLBCL

EP: 16.Part 2: LOTIS-2 Trial Includes High-Risk Patients and CAR T Sequencing in R/R DLBCL

EP: 17.Part 1: Real-World Barriers to CAR T-Cell Therapy in Advanced DLBCL

EP: 18.Part 2: Selecting a Non-CAR T-Cell Treatment in Third-Line R/R DLBCL

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EP: 19.Loncastuximab Shows Favorable Tolerability in Relapsed/Refractory DLBCL

EP: 20.Loncastuximab Shows Durable Response in Higher-Risk R/R DLBCL Population

EP: 21.Efficacy Data Support Loncastuximab as Third-Line DLBCL Treatment

EP: 22.Physicians Discuss Roles of Later-Line Therapies in DLBCL

EP: 23.Considerations for Third-Line Therapy for Relapsed/Refractory DLBCL

EP: 24.Evaluating the Role of Loncastuximab in Relapsed/Refractory DLBCL

EP: 25.Reviewing Options After CAR T-Cell Therapy Progression in R/R DLBCL

EP: 26.Bispecific T-Cell Engagers Emerge as Later-Line Therapies for DLBCL

EP: 27.Physicians Consider Loncastuximab for Older Patients With R/R DLBCL

EP: 28.Bispecific Agents Vs Loncastuximab as Third-Line Therapy for R/R DLBCL

EP: 29.ADC Loncastuximab Shows Signs of Durable Response in R/R DLBCL

EP: 30.Assessing the Durability, Tolerability of Loncastuximab in R/R DLBCL

EP: 31.Fitting Loncastuximab Into the Current Landscape of R/R DLBCL

EP: 32.Comparing Results with Loncastuximab in the Clinic and Real-World Settings in DLBCL

EP: 33.Experience and Sequencing Guide Third-Line DLBCL Therapy Selection

EP: 34.Different Options Discussed for DLBCL in Later-Lines of Treatment

EP: 35.Takeaways on Tolerability Challenges With Loncastuximab in DLBCL

EP: 36.Loncastuximab Leads to Responses in DLBCL After Prior CD19 CAR T

Matthew S. McKinney, MD, assistant professor of medicine at Duke University School of Medicine, discusses the tolerability observed in the LOTIS-2 trial (NCT03589469) of loncastuximab tesirine (Zynlonta) of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).

According to McKinney, loncastuximab was generally well tolerated in the study, with the most common grade 3 or higher treatment-emergent adverse events (AEs) being cytopenias including neutropenia in 26% of patients and thrombocytopenia in 18% of patients, which he says is expected with treatment for this population. The next highest grade 3 or higher treatment-emergent AE was increased gamma-glutamyltransferase (GGT) in 17%, which was a common reason for treatment discontinuation in the study, though it is not commonly monitored in patients with DLBCL. However, McKinney says it did not appear to be dangerous to patients.

Other notable AEs included volume overload such as edema and serous infusion, which were improved after diuresis, and skin rash related to sun exposure, which can be managed with steroid premedication. Patients need to be cautioned to report these events to their physicians.

Overall, these AEs with loncastuximab can be managed, and the study results suggest that loncastuximab has favorable efficacy and tolerability, according to McKinney.

TRANSCRIPTION:

0:08 | In terms of adverse responses, in general, loncastuximab was well tolerated. One interesting thing that read out from the study is one of the more common toxicities or reasons that the study administration was stopped in individual patients was GGT elevations. That's not something that we routinely check in the [United States] and it was not something seemingly dangerous for the patients. So for the most part in real-world use, that's not going to be an issue that limits administration of loncastuximab.

0:42 | There were important safety readouts and things around monitoring and premedication that came off of LOTIS-2. One of which was that there [were] cytopenias, which is expected in this population, even with the antibody-drug conjugate [ADC] mode of administration. Interestingly enough, there was a small number of patients that had volume overload: things like edema or serous effusions. Those generally improved with diuresis. And it was also found that the novel ADC in the setting of sun exposure could cause a particular type of skin rash, and so there's precautions around steroid [premedication] before the infusions to prevent that. Patients are cautioned to watch for volume overload and notify their physicians if they have any signs of that, or if they develop rash because there can be things like steroids that can be administered to resolve that.

1:41 | Aside from those things, loncastuximab was generally well tolerated overall. And I think paired with the ease of administration and the overall encouraging efficacy, [this] makes it another exciting compound to have an armamentarium for relapsed/refractory DLBCL.