What are the side effects of Loncastuximab tesirine?

Loncastuximab tesirine, also known by its brand name Zynlonta, is a novel antibody-drug conjugate (ADC) used in the treatment of relapsed or refractory large B-cell lymphoma. While it marks a significant advancement in the treatment of this aggressive form of cancer, it is crucial for patients and healthcare providers to understand its side effects to manage and mitigate them effectively.

The side effects of Loncastuximab tesirine can range from mild to severe. One of the most common side effects observed is fatigue. Patients often report a significant decrease in energy levels, which can affect their daily activities. This fatigue can be persistent and may require patients to adjust their routines accordingly.

Another frequent side effect is neutropenia, which is a reduction in the number of neutrophils, a type of white blood cell essential for fighting infections. Neutropenia can increase the risk of bacterial, fungal, and viral infections, making it important for patients to monitor for signs of infection such as fever, chills, or sore throat and seek medical attention promptly.

Patients might also experience thrombocytopenia, a condition characterized by a low platelet count. This can lead to an increased risk of bleeding and bruising. It is recommended to avoid activities that could result in cuts or bruises and to use caution with sharp objects.

Anemia, or a decrease in red blood cells, is another side effect that can cause symptoms like shortness of breath, dizziness, and a rapid heart rate. Managing anemia often involves regular monitoring of blood counts and may require treatments like blood transfusions or medications to stimulate red blood cell production.

Gastrointestinal side effects such as nausea, vomiting, and diarrhea are also common. These symptoms can usually be managed with dietary adjustments and medications prescribed by a healthcare provider. Staying well-hydrated and eating small, frequent meals can help mitigate these effects.

Skin reactions, including rash and itching, have been reported in some patients. These reactions can range from mild to severe and may require topical treatments or systemic medications to alleviate discomfort. Patients should report any skin changes to their healthcare provider for appropriate management.

Infusion-related reactions are another potential side effect, occurring during or shortly after the administration of the drug. Symptoms can include fever, chills, rash, or difficulty breathing. Premedications like antihistamines and corticosteroids are often given to minimize these reactions, and the infusion rate can be adjusted to reduce symptoms.

Some patients may experience peripheral edema, which is swelling of the extremities due to fluid retention. This can cause discomfort and may require the use of diuretics to reduce fluid buildup.

Liver enzyme elevations have been observed, indicating potential liver toxicity. Regular monitoring of liver function tests is essential to detect any changes early, and dose adjustments may be necessary if significant liver abnormalities are found.

Finally, more severe but less common side effects include interstitial lung disease and tumor lysis syndrome. Interstitial lung disease can present as new or worsening respiratory symptoms and requires prompt evaluation and treatment. Tumor lysis syndrome is a rapid release of cancer cell contents into the bloodstream, which can lead to kidney failure and other complications, necessitating immediate medical intervention.

In conclusion, while Loncastuximab tesirine offers a promising treatment option for relapsed or refractory large B-cell lymphoma, it is associated with a range of side effects that require careful monitoring and management. Patients should maintain open communication with their healthcare team to address any side effects promptly and ensure the best possible outcomes.