Are there antibody-drug conjugates approved for Mantle Cell Lymphoma

Antibody-Drug Conjugates (ADCs) for Mantle Cell Lymphoma

Based on the current NCCN Guidelines for B-Cell Lymphomas (Version 3.2025), antibody-drug conjugates have a limited but emerging role in mantle cell lymphoma treatment, particularly in the relapsed/refractory setting.

Current ADC Options in MCL

Loncastuximab tesirine-lpyl is mentioned in the NCCN guidelines as an option for relapsed/refractory mantle cell lymphoma. This is a CD19-directed antibody-drug conjugate that combines an antibody targeting CD19 (a protein on lymphoma cells) with a toxic payload designed to kill cancer cells.

According to NCCN Guidelines, loncastuximab tesirine-lpyl may be considered for patients with:

• Relapsed or refractory disease who have progressed on prior therapies
• Disease that has progressed after CAR T-cell therapy (in combination with other approaches)

Important Context

The NCCN Guidelines note an important consideration: "It is unclear if tafasitamab-cxix or loncastuximab tesirine-lpyl or if any other CD19-directed therapy would have a negative impact on the efficacy of subsequent anti-CD19 CAR T-cell therapy." This means doctors need to carefully consider the sequence of treatments, since using a CD19-directed ADC might affect how well CAR T-cell therapy (another CD19-targeted approach) works later.

What This Means for Your Situation

ADCs are not typically first-line treatments for newly diagnosed mantle cell lymphoma. According to NCCN Guidelines, initial therapy focuses on:

• Aggressive chemotherapy combinations (like TRIANGLE, Nordic, or LyMA regimens)
• BTK inhibitors (like ibrutinib, acalabrutinib, or zanubrutinib)
• Less aggressive options for older or frail patients

ADCs become relevant options after disease has relapsed or become refractory to standard treatments.

Questions to Ask Your Oncologist

1. Is my disease newly diagnosed or relapsed/refractory? (This determines if ADCs are appropriate now)
2. If my disease progresses, would an ADC be considered before or after CAR T-cell therapy? (The sequencing matters)
3. Are there clinical trials available that include ADCs for my specific situation?
4. What other options exist if standard treatments don't work?

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.