Loncastuximab tesirine in relapsed/refractory diffuse large B-cell lymphoma: drug profile and expert opinion on the prevention and management of adverse events

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma in the United States and Western Europe and patients with relapsed or refractory (R/R) DLBCL who do not respond to salvage therapies have a poor prognosis. Loncastuximab tesirine (loncastuximab), a CD19-directed antibody-drug (pyrrolobenzodiazepine, PBD) conjugate approved as single agent for the third-line treatment of adult patients with R/R DLBCL and high-grade B-cell lymphoma, has shown durable clinical antitumor activity, including in difficult-to-treat subgroups. While loncastuximab has an overall manageable safety profile, it may cause drug-specific adverse events (AEs) different from other R/R DLBCL treatments. After summarizing the profile of loncastuximab, here we discuss PBD-specific AEs such as phototoxicity & cutaneous reactions, edema & effusions, and liver enzyme elevation; and use available clinical trial data, real-world evidence and clinical scenarios to provide expert opinion and practical advice on how to prevent and manage these non-hematological, PBD-specific AEs.