The following is a summary of “Loncastuximab tesirine with rituximab in patients with relapsed or refractory follicular lymphoma: a single-centre, single-arm, phase 2 trial,” published in the December 2024 issue of Hematology by Alderuccio et al. 

Preliminary data indicate promising activity of loncastuximab tesirine in follicular lymphoma (FL), with synergistic effects when combined with rituximab. 

Researchers conducted a retrospective study to evaluate loncastuximab tesirine combined with rituximab for second line (2L) and later treatment of FL. 

They conducted a single-arm, phase 2 trial at Sylvester Comprehensive Cancer Center, enrolling patients aged 18 or older with histologically confirmed relapsed or refractory FL (grade 1–3A). Treatment included loncastuximab tesirine at 0.15 mg/kg for the first 2 cycles, followed by 0.075 mg/kg for subsequent cycles, and rituximab at 375 mg/m² for 4 weekly doses, then every 8 weeks for cycles 5, 6, and 7. The primary endpoint was the complete response rate (CRR) at week 12, assessed by the Lugano 2014 criteria in patients who received at least 3 doses of loncastuximab tesirine. The safety analysis included all patients who received at least 1 dose of loncastuximab tesirine.  

The results showed that between Jan 28, 2022, and June 3, 2024, 39 patients were enrolled (median age 68 years [IQR 58–77]; 21 [54%] male, 18 [46%] female). At baseline, 36 patients (92%) had 1 or more GELF criteria, and 20 (51%) had POD24 after the first line (1L) of treatment. As of Sept 13, 2024, the median follow-up was 18.2 months (95% CI 12.0–19.3). The Week 12 complete response rate was 67% (26 of 39 patients). The most common grade 3 or worse treatment-emergent adverse events were lymphopenia (8 [21%]) and neutropenia (5 [13%]; 1 with serious febrile neutropenia). Generalized and peripheral oedema was mostly grade 1–2, treatable with diuretics. Serious treatment-related adverse events (TRAEs) occurred in 4 (10%) patients. No fatal AEs occurred. 

Investigators found that loncastuximab tesirine with rituximab demonstrated clinically meaningful activity in relapsed or refractory FL. The treatment had a manageable safety profile. 

Source: thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00345-4/abstract