An antibody-chemotherapy treatment for some lymphomas
Loncastuximab tesirine
An antibody-chemotherapy treatment used for some types of lymphoma, given into a vein.
What is Loncastuximab tesirine?
Loncastuximab tesirine is a specialist cancer treatment used for some adults with lymphoma (a cancer of the lymph system) that has come back or not responded to earlier treatment. It is an antibody joined to a powerful chemotherapy drug: the antibody homes in on a marker called CD19 on the lymphoma cells and delivers the chemotherapy into them. It is given as a drip into a vein in hospital. The main risks are fluid build-up such as swelling and effusions (fluid around the lungs or heart), a drop in blood cells with a risk of infection, serious infections, sensitivity to sunlight, and skin reactions. It is used only under close specialist supervision.
Education and reference only. This is a plain-language guide to Loncastuximab tesirine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Loncastuximab tesirine is a type of treatment called an antibody-drug conjugate, used for some adults with lymphoma, a cancer affecting the body's lymph system. It is used mainly when the lymphoma has returned or has not responded to earlier treatments. It is made of an antibody that recognises a marker called CD19, found on lymphoma cells, linked to a strong chemotherapy agent. It is given as an infusion into a vein in a specialist cancer unit and is prescribed and supervised by a haematology team.
How it works
The antibody part of loncastuximab tesirine attaches to CD19, a marker on the surface of lymphoma cells. Once attached, the package is taken inside the cell, where the powerful chemotherapy it carries is released and damages the cell's DNA, killing it. The aim is to concentrate the chemotherapy on the cancer cells. Because the chemotherapy is very potent and the treatment affects healthy cells too, side effects such as fluid build-up, low blood counts and skin reactions can occur, and careful monitoring is needed.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist treatment used in UK cancer centres for some adults with lymphoma that has come back or not responded to earlier treatment.
Practical use
How to take Loncastuximab tesirine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as a drip into a vein in a specialist cancer unit, on a schedule planned by your haematology team.
- Tell your team about new swelling, breathlessness or chest discomfort, as fluid can build up around the lungs or heart.
- Contact your team urgently if you develop a fever or other signs of infection, as your blood counts can fall.
- Protect your skin from sunlight by covering up and using sun protection, as the treatment increases sun sensitivity.
- Use reliable contraception during treatment and for as long as your team advises, as it can harm an unborn baby.
Weighing it up
Advantages & disadvantages of Loncastuximab tesirine
Advantages
- Targets a marker on lymphoma cells to deliver chemotherapy where it is needed.
- An option for some adults whose lymphoma has come back or not responded to earlier treatment.
- Given as a planned hospital infusion under close specialist care.
Disadvantages
- Can cause fluid build-up, such as swelling and effusions around the lungs or heart.
- Lowers blood counts and can lead to serious infections.
- Increases sensitivity to sunlight and can cause skin reactions.
Practical use
Good to know
A few effects stand out with loncastuximab tesirine. It can cause fluid to build up in the body, leading to swelling (oedema) and effusions, which is fluid collecting around the lungs or the heart, causing breathlessness or discomfort; this should be reported so it can be managed. It lowers blood counts, so infections, bruising and bleeding are risks, and serious infections can occur, meaning any fever must be reported straight away. The treatment can make the skin much more sensitive to sunlight, so covering up and using sun protection is important during treatment and for a time afterwards, and other skin reactions such as rash can happen. Like other cancer treatments, it can harm an unborn baby, so reliable contraception is essential during treatment and for a time afterwards. Your team will explain what to watch for and when to seek help.
Who should not take it / use with caution
- People who have had a serious allergic reaction to loncastuximab tesirine should not have it.
- It is generally avoided in pregnancy and while breastfeeding because it can harm the baby.
- It is used with caution in people with active infections or significant fluid build-up, under specialist judgement.
Monitoring
- Regular blood tests to check blood counts, liver function and for signs of infection.
- Watching for fluid build-up such as swelling and effusions.
- Reviewing the skin and how the lymphoma is responding to treatment.
Side effects
- Fluid build-up, such as swelling (oedema) and effusions around the lungs or heart, causing breathlessness.
- A fall in blood cells, leading to infections, tiredness, bruising or bleeding, and sometimes serious infections.
- Increased sensitivity to sunlight and other skin reactions such as rash.
- Nausea, tiredness and changes in liver blood tests in some people.
Key interactions
- Other treatments that lower blood counts or weaken the immune system can add to the risk of infection.
- Live vaccines are generally avoided around this treatment, so check before any vaccination.
- Tell your team about all your medicines, including anything from a pharmacy or herbal products.
Available as: A powder made up into a solution and given as an infusion into a vein.
Answers
Loncastuximab tesirine: frequently asked questions
What is loncastuximab tesirine used for?
It is used for some adults with lymphoma that has come back or not responded to treatment, by targeting a marker called CD19 to deliver chemotherapy into the cancer cells.
Why might I get swelling or breathlessness?
It can cause fluid to build up in the body, including swelling and effusions around the lungs or heart, so report any new swelling, breathlessness or chest discomfort to your team.
Why do I need to protect my skin from the sun?
The treatment makes your skin much more sensitive to sunlight, so covering up and using sun protection is important during treatment and for a time afterwards.
Why am I more likely to get infections?
It lowers your blood counts, including infection-fighting cells, and serious infections can occur, so any fever must be reported to your team straight away.
Can I have it during pregnancy?
No. It can harm an unborn baby, so it is avoided in pregnancy and reliable contraception is needed during treatment and for a time afterwards.
Authoritative sources
- BNF
- NICE CKS
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