Epperla Narendranath, Olszewski Adam J, Ayers Emily C, Ahmed Sairah
Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
Division of Hematology and Oncology, Brown University Health, Providence, Rhode Island, USA.
Hematol Oncol. 2025 Sep;43(5):e70128. doi: 10.1002/hon.70128.
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.
弥漫性大B细胞淋巴瘤（DLBCL）是全球最常见的B细胞非霍奇金淋巴瘤。三线及以上复发DLBCL的治疗选择包括嵌合抗原受体T细胞疗法、T细胞接合双特异性抗体和loncastuximab tesirine（loncastuximab tesirine-lpyl [Lonca]），每种疗法都有独特的毒性特征。对于管理与Lonca相关的不良事件（AE），尤其是对于使用这种抗体药物偶联物经验有限的肿瘤学家而言，仍然存在未满足的指导需求。在此，2024年6月至8月间在美国淋巴瘤专家中开展的一项在线调查评估了实践模式和经验，包括Lonca治疗模式、AE管理、患者担忧以及医生认知。基于这些回复，开发了一种算法以帮助管理与Lonca相关的AE。最常报告的AE是水肿和皮疹/光敏反应，通常在前4剂给药期间出现，而疲劳是患者最常见的担忧。根据观察到的AE，通过延迟或停用Lonca或开具利尿剂、类固醇或抗组胺药来管理与Lonca相关的AE。调查结果与先前临床试验的结果一致，并支持在各种情况下对与Lonca相关的AE进行管理。所纳入的算法为管理AE（如水肿、骨髓抑制和皮肤反应）提供了指导。
