Loncastuximab Tesirine Versus Polatuzumab Vedotin Plus Bendamustine and Rituximab in Relapsed/Refractory DLBCL After ≥ 2 Lines of Therapy: Matching-Adjusted Indirect Comparison

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2025-03-28 DOI:10.1007/s12325-025-03169-9

Koo Wilson, Francesca Chiodi, Abby Paine, Zalmai Hakimi, Victoria Ward, Tom Macmillan, Daniel Eriksson, Silvia Mappa

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引用次数: 0

Abstract

Introduction

Despite recent approvals of new treatments, relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) remains challenging to treat, with limited durable responses and a high proportion of patients relapsing after two or more lines of therapy. Loncastuximab tesirine (Lonca) is a highly potent CD19-targeted antibody drug conjugate with convenient dosing for patients with third-line R/R DLBCL.

Methods

In the absence of head-to-head trials, unanchored matching-adjusted indirect comparisons (MAICs) were conducted to compare the relative efficacy and safety of Lonca with polatuzumab vedotin + bendamustine and rituximab (Pola + BR).

Results

Four studies included in the MAICs were identified via systematic review and hand-searching. Lonca (LOTIS-2) was compared with three comparator studies for Pola + BR (GO29365 extension study, COTA database, Dal et al. 2023). Overall, there was no evidence of a difference in overall response and complete response (CR) rates. Despite Pola + BR demonstrating a higher CR rate in the GO29365 extension study, this did not translate into significant improvements in progression-free or overall survival. Survival analyses indicated similar efficacy between treatments across studies, with most comparisons/meta-analyses showing no statistically significant differences. Lonca had significantly lower odds of Grade 3–4 infections, any serious adverse event (SAE), and specific SAEs including febrile neutropenia, pneumonia and pyrexia. Of the safety endpoints analyzed, none indicated significant differences in favor of Pola + BR.

Conclusion

These results suggest no evidence of a difference in efficacy between the two treatments and potentially more favorable safety profile for Lonca compared with Pola + BR in patients with R/R DLBCL after two or more lines of treatment.

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Loncastuximab Tesirine与Polatuzumab Vedotin +苯达莫司汀和利妥昔单抗治疗复发/难治性DLBCL≥2线治疗后：匹配调整的间接比较

尽管最近批准了新的治疗方法，但复发/难治性（R/R）弥漫性大b细胞淋巴瘤（DLBCL）的治疗仍然具有挑战性，其持久反应有限，并且在两种或两种以上治疗后复发的患者比例很高。Loncastuximab tesirine （Lonca）是一种高效cd19靶向抗体药物偶联物，用于三线R/R DLBCL患者，给药方便。方法：在没有头对头试验的情况下，进行了非锚定匹配调整间接比较（MAICs），比较Lonca与polatuzumab vedotin +苯达莫司汀和利妥昔单抗（Pola + BR）的相对疗效和安全性。结果：通过系统回顾和手工检索，确定了4项纳入MAICs的研究。Lonca （LOTIS-2）与Pola + BR的三个比较研究（GO29365扩展研究，COTA数据库，Dal et al. 2023）进行比较。总体而言，没有证据表明总缓解率和完全缓解率（CR）有差异。尽管Pola + BR在GO29365扩展研究中显示出更高的CR率，但这并没有转化为无进展生存期或总生存期的显著改善。生存分析表明，不同研究的治疗之间的疗效相似，大多数比较/荟萃分析显示没有统计学上的显著差异。Lonca的3-4级感染、严重不良事件（SAE）和特异性不良事件（包括发热性中性粒细胞减少症、肺炎和发热）的发生率明显较低。在分析的安全终点中，没有显示Pola + BR有显著差异。结论：这些结果表明，没有证据表明两种治疗方法之间的疗效差异，并且在两种或多种治疗后，Lonca与Pola + BR相比，在R/R DLBCL患者中可能更有利的安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.