- In an interview with Medscape, Ann S. LaCasce, MD, a lymphoma specialist, talks about tafasitamab-cxix (Monjuvi) in combination with lenalidomide, recently approved by the US Food and Drug Administration (FDA) for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).
- Almost 40% of patients with DLBCL will have relapsed or refractory disease.
- The pace of DLBCL can be highly variable, with some patients responding to multiple lines of therapy, whereas others experience rapidly progressive refractory disease.
- More than half of patients do not fit the eligibility criteria for autologous stem cell transplant (ASCT).
- Tafasitamab-cxix is an appropriate option for patients who are ineligible for potentially curative approaches, including ASCT and chimeric antigen receptor (CAR) T-cell therapy.
- Tafasitamab-cxix was approved on the basis of the phase 2 L-MIND study of tafasitamab plus lenalidomide in patients who were ineligible for ASCT and had received 1-3 prior regimens.
- The overall and complete response rates were 60% and 43%, respectively, and median PFS was approximately 1 year.
- The most common adverse events were infusion reactions and myelosuppression.
- Tafasitamab plus lenalidomide regimen requires frequent visits, particularly during the first 3 months and then every other week until progression.
- Because tafasitamab therapy needs to be continued until progression, the cumulative cost is likely to be very high; however, all other therapies are also costly.
- Other drugs under development or trials for relapsed or refractory DLBCL include novel CAR T-cell therapies such as lisocabtagene maraleucel, bispecific antibodies such as REGN1979 and mosunetuzumab, combinations with CD47 antibodies, and loncastuximab tesirine.