# Loncastuximab tesirine

Source: https://onco.cc/drugs/zynlonta/  
OnCo record `zynlonta` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Loncastuximab tesirine (Zynlonta) is a CD19 ADC with a DNA-crosslinking payload for relapsed large B-cell lymphoma.

## Summary

Loncastuximab tesirine (Zynlonta) is a humanised anti-CD19 antibody carrying SG3199, a pyrrolobenzodiazepine (PBD) dimer that forms interstrand DNA crosslinks, through a cleavable valine-alanine linker at a drug-to-antibody ratio of about 2.3. It is given at 0.15 mg/kg every 3 weeks for two cycles, then 0.075 mg/kg, with dexamethasone premedication, for relapsed or refractory DLBCL after two or more lines. Accelerated approval in 2021 rested on LOTIS-2 (objective response rate 48 percent), and the EU granted conditional authorisation in 2022. PBD payloads are extremely potent but bring oedema and effusions, photosensitivity, thrombocytopenia and raised GGT, toxicities that have limited the class in solid tumours. Its place alongside CD19 CAR-T and CD20 bispecifics remains to be settled. It is a CD19-directed ADC with a DNA-crosslinking payload for lymphoma that has come back.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-04
- Brand: Zynlonta
- Modality: ADC
- Mechanism: Humanised anti-CD19 with PBD dimer; interstrand DNA crosslinks.
- Payload: SG3199 (PBD dimer, DNA crosslinker), DAR ~2.3
- Linker: Val-Ala, cleavable
- Approvals: US 2021: Relapsed/refractory DLBCL after ≥2 systemic therapies; EU 2022: R/R DLBCL ≥2 lines (conditional)
- Dosing: IV infusion; 0.15 mg/kg every 3 weeks for 2 cycles, then 0.075 mg/kg every 3 weeks; dexamethasone premedication

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Loncastuximab_tesirine
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Loncastuximab%20tesirine

## Connected records

- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/)
- technologies: [Antibody-drug conjugate (ADC)](https://onco.cc/technologies/adc/)
- targets: [CD19](https://onco.cc/targets/cd19/)
- companies: [ADC Therapeutics](https://onco.cc/companies/adc-therapeutics/)
- terms: [DNA crosslinker payloads (PBD dimers)](https://onco.cc/terms/pbd-dimer-payloads/), [PBD dimer (SG3199 / tesirine)](https://onco.cc/terms/pbd-sg3199/), [Val-Ala dipeptide](https://onco.cc/terms/val-ala/), [What the NHS in England funds for lymphoma, appraisal by appraisal](https://onco.cc/terms/lymphoma-tx-uk-access/)
- trials: [A Study of MT-2111 in Patients With Relapsed/Refractory DLBCL](https://onco.cc/trials/nct05658562/), [LOTIS-2](https://onco.cc/trials/lotis-2/), [Study to Evaluate Loncastuximab Tesirine With Rituximab Versus Immunochemotherapy in Participants With Relapsed or Refractory Diffuse Large B-Cell Lym](https://onco.cc/trials/nct04384484/)
- biomarkers: [CD19 expression (CD19-positive)](https://onco.cc/biomarkers/cd19-expression/)

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