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. 2023 Mar 17;28(3):199-207.
doi: 10.1093/oncolo/oyac256.

Clinical Treatment Guidelines for Tafasitamab Plus Lenalidomide in Patients with Relapsed or Refractory Diffuse Large B-Cell Lymphoma

Adrienne Nedved  1 , Kami Maddocks  2 , Grzegorz S Nowakowski  1
Affiliations

Clinical Treatment Guidelines for Tafasitamab Plus Lenalidomide in Patients with Relapsed or Refractory Diffuse Large B-Cell Lymphoma

Adrienne Nedved et al. Oncologist. .

Abstract

Diffuse large B-cell lymphoma (DLBCL) accounts for approximately 24% of new cases of B-cell non-Hodgkin lymphoma in the US each year. Up to 50% of patients relapse or are refractory (R/R) to the standard first-line treatment option, R-CHOP. The anti-CD19 monoclonal antibody tafasitamab, in combination with lenalidomide (LEN), is an NCCN preferred regimen for transplant-ineligible patients with R/R DLBCL and received accelerated approval in the US (July 2020) and conditional marketing authorization in Europe (August 2021) and other countries, based on data from the L-MIND study. The recommended dose of tafasitamab is 12 mg/kg by intravenous infusion, administered in combination with LEN 25 mg for 12 cycles, followed by tafasitamab monotherapy until disease progression or unacceptable toxicity. Tafasitamab + LEN is associated with durable responses in patients with R/R DLBCL. The majority of clinically significant treatment-associated adverse events are attributable to LEN and can be managed with dose modification and supportive therapy. We provide guidelines for the management of patients with R/R DLBCL treated with tafasitamab and LEN in routine clinical practice, including elderly patients and those with renal and hepatic impairment, and advice regarding patient education as part of a comprehensive patient engagement plan. Our recommendations include LEN administration at a reduced dose if required in patients unable to tolerate the recommended dose. No dose modification is required for tafasitamab in special patient populations.

Keywords: DLBCL; dose adjustment; lenalidomide; routine clinical practice; supportive therapy; tafasitamab.

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Conflict of interest statement

Adrienne Nedved reported a consulting relationship with Axis Medical Education. Kami Maddocks reported honoraria from Pharmacyclics, Celgene, Seattle Genetics, MorphoSys AG, Bristol-Myers Squibb, Karyopharm Therapeutics, Kite Pharma/Gilead Company, ADC Therapeutics and Genmab, Genentech, Lilly, Epizyme, and Incyte, as well as research funding from Pharmacyclics, Merck and Bristol-Myers Squibb. Grzegorz S. Nowakowski reported research funding from Celgene, NanoString Technologies, MorphoSys AG; and a consultancy/advisory role with: Celgene, MorphoSys AG, Genentech, Selvita, Debiopharm Group, amd Kite/Gilead.

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