Tafasitamab for Follicular Lymphoma

 I like surprises.

And I have to admit, this one surprised me. As much as I follow what's happening in the world of Follicular Lymphoma, I think this is the first I've heard of Tafasitamab. I searched the blog, and couldn't find any mention of it anywhere. But a phase 3 trial is just starting, looking at Tafasitamab combined with Lenalidomide (Revlimid)  and Rituxan (the two treatments that make up R-Squared). The trial involves patients with Relapsed and Refractory Follicualr Lymphoma (they've already had at least one treatment that didn't work or stopped working).

Tafasitamab is not new. It was actually approved by the FDA last year as a treatment for Diffuse Large B Cell Lymphoma, in combination with Lenalidomide. The combination of Tafasitamab and Lenalidomide has its own name, and it might be the coolest lymphoma treatment name I've ever heard: Monjuvi. 

The DLBCL approval came after a phase 2 clinical trial, since Tafasitamab was considered a first-in-class treatment -- it works on cancer cells in a way that no other treatment had ever done before. 

Tafasitamab is a monoclonal antibody, like Rituxan (rituximab) and Obinutuzumab. That's why they all end in "-mab" -- short for Monoclonal Anti Body. It's diffeernt from the other two, which both target the protein CD20 on cancer cells. Tafasitamab targets CD19 (the same protein that some CAR-T and bispecific treatments go after -- it's definitely the hot new target these days, the Anya Taylor-Joy of cancer cell targets).

Like Obinutuzumab, Tafasitamabis "humanized," made from human components (Rituxan is made from mice). Tafasitamabis also FC-modified, which means it has been changed so it will do a better job of staying in the blood and finding the cancer cells. (If you want a full, very scientific explanation, you can find one here. I understand enough of it to know that it's an improvement on Rituxan.)

So while this is the first I've heard of it, and it's just the beginning of a phase 3 trial (which means it could still be a few years before FL patients see it become available, it does hold a lot of promise. The trial is planning to enroll 618 patients with FL and Marginal Zone Lymphoma. Half will get the Tafasitamabis + Lenalidomide + Rituxan combo, and half will get just Lenalidomide + Rituxan. As I've said before, it seems like combinations of treatments will be a big part of our future -- several different ways of getting at cancer cells, as long as the combination remains safe. If this combination is moving to phase 3, there has to be some evidence that it is safe and effective.

I take al of this as good news. While I don't like to miss out of things while they are in early stages, it also tells me that there is so much good stuff out there in trials that it is inevitable that I'll miss some. 

That's a good thing.