Loncastuximab tesirin (1) – Zynlonta®

Diffuse large B-cell lymphoma (DLBCL) and highly malignant B-cell lymphoma (HGBL), ≥ 2 prior therapies)

Characteristics

Start date 15.05.2023 – Marketing authorisation: 20.12.2022
Resolution 02.11.2023
INN Loncastuximab tesirin
Brand name Zynlonta®
Pharm. company Swedish Orphan Biovitrum GmbH
G-BA Procedure ID D-936
ATC code L01FX22 Other monoclonal antibodies and antibody drug conjugates (L01FX)
ICD-10 codes (AIS) C83.3Diffuse large B-cell lymphoma, C85.1Unspecified B-cell lymphoma
Alpha-ID codes (AIS) I110892Highly malignant B-cell lymphoma, I114432Diffuse large B-cell lymphoma
Therapeutic area Oncological diseases B-cell lymphoma (DLBCL / PMBCL)
Reason for procedure Initial assessment
Regulatory status Conditional Approval
Specialty ACT change

Therapeutic indication of the resolution

Zynlonta is used as monotherapy in adults for the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and highly malignant B-cell lymphoma (HGBL) after two or more lines of systemic treatment.

Subpopulation Indication Comparator
a) Adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL) after two or more lines of systemic therapy who are eligible for CAR-T cell therapy or stem cell transplantation Therapy according to the doctor's instructions, taking into account - Tisagenlecleucel, - Axicabtagene-Ciloleucel, - induction therapy with MINE (mesna, ifosfamide, mitoxantrone, etoposide) followed by high-dose therapy with autologous stem cell transplantation in the event of a response to induction therapy - induction therapy with MINE (mesna, ifosfamide, mitoxantrone, etoposide) followed by high-dose therapy with allogeneic stem cell transplantation in the event of a response to induction therapy
b) Adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL) after two or more lines of systemic therapy who are not eligible for CAR-T cell therapy or stem cell transplantation Therapy according to the doctor's instructions, taking into account - CEOP (cyclophosphamide, etoposide, vincristine, prednisone), - dose-adjusted EPOCH (etoposide, vincristine, doxorubicin, cyclophosphamide, prednisone), - Polatuzumab vedotin + bendamustine + rituximab, - tafasitamab + lenalidomide, - Pixantrone monotherapy, - radiotherapy, - and best supportive care

Studies and Results

No. of studies
(best subpopulation)
0 (Data not accepted)
Study design
(best subpopulation)
Data not accepted (Dossier: Single-arm + no comparison)
Reason for dividing into subpopulations (G-BA) Patient eligibility
ACT change 01.06.2023 – BSG-Urteil (2023) Off-Label-Use

  • Clinical trials
    • The single-arm Phase II LOTIS-2 trial investigated the efficacy and safety of loncastuximab tesirin in adults with relapsed or refractory non-otherwise-specified (NOS) DLBCL, DLBCL with MYC and BCL2 and/or BCL6 rearrangements, and primary mediastinal large B-cell lymphoma (PMBCL).

a) Adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL) following two or more lines of systemic therapy, who are eligible for CAR-T cell therapy or stem cell transplantation

  • An additional benefit is not proven.
  • Overall assessment
    • The results of the submitted single-arm LOTIS-2 study are not suitable for assessing additional benefit, as they do not allow for a comparison with the appropriate comparator therapy.
    • Consequently, additional benefit from loncastuximab tesirin as monotherapy in adults with relapsed or refractory DLBCL and HGBL is not proven following two or more lines of systemic treatment.

b) Adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (HGBL) following two or more lines of systemic therapy, who are not eligible for CAR-T cell therapy or stem cell transplantation

  • The additional benefit is not proven.
  • Overall assessment
    • The results of the single-arm LOTIS-2 study submitted are not suitable for assessing additional benefit, as they do not allow for a comparison with the appropriate comparator therapy.
    • Consequently, additional benefit from loncastuximab tesirin as monotherapy in adults with relapsed or refractory DLBCL and HGBL is not proven following two or more lines of systemic treatment.

Courtesy translation only, please refer to the German original.

Associated procedures

Loncastuximab tesirin (1) Zynlonta® Swedish Orphan Biovitrum GmbH Oncological diseases Diffuse large B-cell lymphoma (DLBCL) and highly malignant B-cell lymphoma (HGBL), ≥ 2 prior therapies) 1,360–1,900 100% additional benefit not proven


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