New potential treatment option for relapsed or refractory DLBCL

The LOTIS-2 trial looked at whether a new drug called lonastuximab tesirine was effective in people with large B-cell lymphomas that had come back or not responded after at least two previous courses of treatment.

Loncastuximab tesirine is a type of targeted treatment called an antibody–drug conjugate: an antibody joined to a toxic drug. The antibody sticks to a protein called CD19 found on the surface of some lymphoma cells, and carries the drug straight to them. The drug is released inside the cells and kills them. Loncastuximab tesirine is given through a drip into a vein once every 3 weeks.

The trial included 145 people with diffuse large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBL), double-hit lymphoma, triple-hit lymphoma, or transformed follicular lymphoma. On average, people in the trial had had three previous courses of treatment, including 24 people who had had a stem cell transplant and 13 people who had had CAR T-cell therapy.

Almost half of these difficult-to-treat people responded to loncastuximab tesirine treatment. On average, responses to treatment lasted over 10 months. At the time the results were analysed, 20 people remained in complete response. After having loncastuximab tesirine treatment, 24 people went on to have a stem cell transplant or CAR T-cell therapy to try to make their remission last as long as possible.

These results are hopeful for people who otherwise have very limited treatment options.

The most common side effects of loncastuximab tesirine were low blood counts and abnormal liver function tests.

The durable clinical antitumour activity of single-agent loncastuximab tesirine compared with recently approved therapies, including activity in difficult-to-treat subgroups, suggest it could change practice as a potential treatment option for patients with relapsed or refractory DLBCL who have received two or more previous systemic therapies.

Study authors

LOTIS-2 was a phase 2 trial and further trials of loncastuximab tesirine are ongoing.

To find out more about clinical trials for lymphoma, or to search for a trial that might be suitable for you, visit Lymphoma TrialsLink.

24 May 2021