Anti-CD19 Monoclonal Antibodies for Treating Patients With R/R DLBCL

Loncastuximab tesirine and tafasitamab are “welcome additions” to the treatment paradigm for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL), though more data is needed for prescribers to fully understand the sequencing of these agents, researchers said.¹

Loncastuximab tesirine and tafasitamab are the first anti-CD19 monoclonal antibodies recently approved for patients with R/R DLBCL by the US Food and Drug Administration. Investigators conducted a review to summarize existing data and indicated use of these agents.

“Treatment options are limited for patients that have relapsed after or are ineligible for autologous stem cell transplant or chimeric antigen receptor (CAR) T-cell therapy,” wrote James A Davis, PharmD, BCOP, clinical pharmacy specialist in malignant hematology, MUSC Hollings Cancer Center, and coauthors. “Recent novel therapy approvals have started to change management strategies and outcomes for these patients.”

Both agents were granted accelerated approval for adult patients with R/R DLBCL. Tafasitamab (Monjuvi) was approved on July 31, 2020, following the phase 2 L-MIND trial, an open label, multicenter, single-arm trial involving 81 patients.² It is approved for use in combination with lenalidomide after 1 or more lines of therapy.

Loncastuximab tesirine (Zynlonta) was granted accelerated approval on April 23, 2021, after the phase 2 LOTIS-2 trial, which was an open-label, single-arm trial that enrolled 145 patients.³ This agent is indicated for use after 2 or more lines of therapy.

“Tafasitamab and loncastuximab tesirine are…welcome additions to the limited therapy options for these patients. Further data is needed to elucidate sequencing and the impact these agents may have on CAR T-cell therapy,” Dr Davis and coauthors said.

Both agents are currently being investigated further to determine their efficacy in combination with other agents, “which may further expand treatment options for patients with B-cell lymphomas.”

References:

1. Davis JA, Shockley A, Glode AE. Newly approved anti-CD19 monoclonal antibodies for the treatment of relapsed or refractory diffuse large B-cell lymphoma. J Oncol Pharm Pract. 2022;28(3):686-690. doi:10.1177/10781552211073575
2. FDA grants accelerated approval to tafasitamab-cxix for diffuse large B-cell lymphoma. News release. US Food and Drug Administration; August 3, 2020. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-tafasitamab-cxix-diffuse-large-b-cell-lymphoma
3. FDA grants accelerated approval to loncastuximab tesirine-lpyl for large B-cell lymphoma. News release. US Food and Drug Administration; April 23, 2021. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-loncastuximab-tesirine-lpyl-large-b-cell-lymphoma