Loncastuximab

Class: Antineoplastic Agents
- Antibody-drug Conjugates
- ADCs
Chemical Name: Immunoglobulin G1, (anti-human CD19 (antigen)) (humanized clone RB4v1.2 κ1-chain), disulfide with humanized clone RB4v1.2 κ-chain, dimer, bis(thioether) with N-[31-(2,5-dihydro-2,5-dioxo-1H-pyrrol-1-yl)-1,29-dioxo4,7,10,13,16,19,22,25-octaoxa-28-azahentriacont-1-yl]-L-valyl-N-[4- [[[[(11S,11aS)-8-[[5-[[(11aS)-5,11a-dihydro-7-methoxy-2-methyl-5-oxo-1Hpyrrolo[2,1-c][1,4]benzodiazepin-8-yl]oxy]pentyl]oxy]-11,11a-dihydro-11- hydroxy-7-methoxy-2-methyl-5-oxo-1H-pyrrolo[2,1-c][1,4]benzodiazepin10(5H)-yl]carbonyl]oxy]methyl]phenyl]-L-alaninamide
Molecular Formula: C₆₅₄₄H₁₀₀₄₈N₁₇₁₈O₂₀₆₄S₅₂
CAS Number: 1879918-31-6
Brands: Zynlonta

Medically reviewed by Drugs.com on Dec 13, 2021. Written by ASHP.

Introduction

Antineoplastic agent; a CD19-directed antibody-drug conjugate consisting of a humanized monoclonal IgG₁ kappa antibody linked to an alkylating agent (SG3199).

Uses for Loncastuximab

B-cell Lymphoma

Treatment of relapsed or refractory large B-cell lymphoma, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, DLBCL arising from low-grade lymphoma, and high-grade B-cell lymphoma, previously treated with ≥2 systemic therapies (designated an orphan drug by FDA for this use).

Efficacy based on overall response rate; clinical benefit (e.g., improvement in survival, amelioration of disease-related symptoms) not established.

Loncastuximab Dosage and Administration

General

Pretreatment Screening

• Verify pregnancy status of females of reproductive potential.

Patient Monitoring

• Monitor for extravasation and subcutaneous infiltration during administration of loncastuximab tesirine.

• Monitor for new or worsening effusions or edema.

• Evaluate for new or worsening signs or symptoms of infection.

• Monitor CBC during therapy.

• Monitor for new or worsening cutaneous reactions, including photosensitivity reactions.

Premedication and Prophylaxis

• Unless contraindicated, administer dexamethasone 4 mg orally or IV twice daily for 3 days beginning the day prior to day 1 of each cycle. If dexamethasone cannot be administered the day prior to day 1 of each cycle, administer dexamethasone at least 2 hours prior to administration of loncastuximab tesirine.

• Consider prophylaxis with a granulocyte colony-stimulating factor (G-CSF) as appropriate to reduce the risk of hematologic toxicity associated with loncastuximab tesirine therapy.

Dispensing and Administration Precautions

Handling and Disposal

• Loncastuximab tesirine is a hazardous drug; follow procedures for proper handling (e.g., use of gloves or protective clothing) and disposal of antineoplastic agents.

Administration

IV Administration

Administer via IV infusion. Loncastuximab tesirine lyophilized powder for injection must be reconstituted and diluted prior to administration.

Compatible wi