Loncastuximab tesirine, a CD19-directed antibody and alkylating agent, has been under the spotlight for its effectiveness in treating refractory or relapsed large B-cell lymphoma in adults. Recently, phase 2 trials have expanded its potential use to high-risk follicular lymphoma and marginal zone lymphoma, with significant results.
At the 2024 American Society of Hematology (ASH) Annual Meeting & Exposition, ADC Therapeutics announced positive outcomes from two separate trials. The first trial, led by Dr. Juan Pablo Alderuccio, involved 39 patients with relapsed or refractory follicular lymphoma. Participants treated with loncastuximab tesirine and rituximab achieved an overall response rate of 97%, a complete response rate of 80%, and a 12-month progression-free survival rate of 94%. Notably, patients with POD24 (disease progression within 24 months of starting treatment) showed a 100% overall response rate and an 80% complete response rate.
The second trial, an ongoing multicenter study led by Dr. Izidore S. Lossos, focused on 22 patients with refractory or relapsed marginal zone lymphoma, a rare type of blood cancer. As of July 1, 2024, results indicated an overall response rate of 85% and a complete response rate of 75%, with POD24 patients achieving a 77% complete response rate.
Adverse events in the follicular lymphoma trial included neutropenia and elevated liver enzyme levels, while the marginal zone lymphoma trial reported photosensitivity, skin rash, and elevated liver enzyme levels as common side effects.
The trials' authors concluded that loncastuximab tesirine offers clinically significant outcomes for high-risk patients with follicular lymphoma and those with marginal zone lymphoma, supporting its use for these indications. Further research is underway, including a multicenter expansion cohort study of loncastuximab tesirine with rituximab for follicular lymphoma, as the marginal zone lymphoma trial continues.
