Loncastuximab in high‑risk and heavily pre‑treated relapsed/refractory diffuse large B‑cell lymphoma: a real‑world analysis from 21 US centers

Rákkutatás · Diffuse large B-cell lymphoma

In a large real‑world cohort of relapsed/refractory diffuse large B‑cell lymphoma patients, loncastuximab‑teserine demonstrated a complete response rate of 14 % and overall response rate of 32 %, lower than rates reported in the pivotal LOTIS‑2 clinical trial, highlighting an efficacy–effectiveness gap in this high‑risk population.

Outcomes in patients with relapsed/refractory (R/R) diffuse large B‑cell lymphoma (DLBCL) are poor. Loncastuximab‑teserine (Lonca) is an antibody‑drug conjugate which was approved by the FDA for treatment of patients with R/R DLBCL after at least two prior lines of therapy, based on the LOTIS‑2 trial. This retrospective study included 21 US centers and evaluated outcomes of 187 patients with R/R DLBCL treated with Lonca. Patients had higher‑risk baseline features compared to LOTIS‑2, including higher proportion of bulky disease (17 % vs 0 %), high‑grade B‑cell histology (22 % vs 8 %), and increased number of prior lines (median 4 vs 3). The complete response rate was 14 % and overall response rate 32 %. Median event‑free survival and overall survival were 2.1 and 4.6 months, respectively. Those with bulky disease and high‑grade B‑cell histology had significantly worse outcomes, whereas non‑GCB subtype and CR to last therapy were associated with superior outcomes. Real‑world outcomes were lower than LOTIS‑2, likely reflecting higher risk and more heavily pre‑treated patients.

This study demonstrates that real‑world effectiveness of loncastuximab‑teserine is lower than that seen in clinical trials, underscoring the need for careful patient selection and the persistence of an efficacy–effectiveness gap in aggressive relapsed/refractory diffuse large B‑cell lymphoma.

Bizonyítékszint: Állatkísérletes. Állatmodellben vizsgálták.

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