Loncastuximab Tesirine in Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Evidence and Practical Guidance From Italian Clinical Experience.

Patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) who progress to the third-line setting face a lack of standardized treatment, despite the presence of multiple available therapies. In this context, antibody-drug conjugates represent a relatively new class of anticancer agents; among them, loncastuximab tesirine is a second-in-class agent approved for the treatment of patients with R/R DLBCL after ≥ 2 lines of systemic therapy. Because many patients with R/R DLBCL are ineligible for intensive therapies due to advanced age and comorbidities, the availability of any new agent is particularly important. We present an overview of the clinical evidence for loncastuximab tesirine and offer practical guidance on its use in R/R DLBCL. Additionally, three clinical cases are described to illustrate its efficacy in transformed DLBCL, the management of treatment and safety when used as a bridge to allogeneic stem cell transplantation, and its role in the sequencing of therapies for R/R DLBCL. Findings from our Italian experience may be informative on the clinical application of loncastuximab tesirine in other countries where it is approved and available.