Management of Adverse Reactions to Loncastuximab in Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma

Diffuse large B-cell lymphoma (DLBCL) is the most common B-cell non-Hodgkin lymphoma in the world. Treatment options for relapsed DLBCL in the third line and beyond include chimeric antigen receptor T-cell therapy, T-cell–engaging bispecific antibodies, and loncastuximab tesirine (loncastuximab tesirine-lpyl [Lonca]), each with unique toxicity profiles. There is still an unmet need for guidance on managing Lonca-associated adverse events (AEs), particularly for oncologists who have limited experience with this antibody–drug conjugate. Here, an online survey among lymphoma specialists in the US between June and August 2024 assessed practice patterns and experiences, including Lonca treatment patterns, AE management, patient concerns, and physician perceptions. Based on these responses, an algorithm was developed to help manage Lonca-associated AEs. The most commonly reported AEs were edema and rash/photosensitivity, typically occurring within the first 4 doses, whereas fatigue was the most common patient concern. Lonca-associated AEs were managed by delaying or discontinuing Lonca or by prescribing diuretics, steroids, or antihistamines, depending on the AE observed. The survey results align with findings from prior clinical trials and support the manageability of Lonca-associated AEs in a wide variety of settings. The included algorithm provides guidance for managing AEs, such as edema, myelosuppression, and cutaneous reactions.