Targeted Oncology Videos on Follicular Lymphoma

 The website Targeted Oncology has a new video series called "Emerging Treatment Updates: Antibody Drug Conjugates in Relapsed/Refractory Follicular Lymphoma." The series has six videos (so far, anyway), featuring Dr. Juan Pablo Alderuccio of the Sylvester Comprehensive Cancer Center in Miami, Florida. It's one of those video series that gives an overview of FL treatments, though this one also puts a lot of focus on a particular type of treatment.

As the title of the series implies, there is a lot of focus here on Antibody Drug Conjugates, or ADCs.

An ADC is kind of a combination of a couple of different types of treatments. One of the elements is an antibody -- something like Rituxan. Antibodies are useful treatments for FL because they target the cancer cell. Rituxan, for example, works so well because it can seek out a particular protein (CD20) on B cells (the type of immune cell that is affected by FL). Going right to the cancer cell makes it different from something like traditional chemotherapy, which would affect cancer cells, but would also affect a lot of other healthy cells as well.

With an antibody conjugate, an antibody is combined with another type of treatment. The antibody can identify the cancer cell and close to it, and then deliver that small amount of the second treatment directly to the cancer cell. So you get the potential power of the second treatment along with the focus on the antibody. (And example is something like Zevalin, which attached a small bit of radiation to the antibody. Powerful, effective treatment that should have been used more than it was.) 

The Antibody Drug Conjugate that Dr. Alderuccio discusses in these videos is Loncastuximab Tesirine, which is approved by the FDA and the European Medical Agency for treatment of DLBCL. Loncastuximab is an antibody that targets CD19, and Tesirine is the "payload" that gets added to it. Tesirine is a type of chemotherapy called a pyrrolobenzodiazepine. Its job is to mess with the DNA of cancer cells and keep them from growing. 

So, like other ADCs, Loncastuximab Tesirine combines an antibody that can recognize the cancer cells, and a powerful substance that can affect them. 

The video series starts with an overview of current treatments for Relapsed/Refractory FL, and then gets more into Loncastuximab Tesirine in particular. A recent study combined it with Rituxan, making it effective because the two antibodies are targeting two different proteins on the surface of the cancer cell (CD19 and CD20), increasing its chances of finding the cell but not increasing its side effects. (This research was discussed at ASH, and it had very good results in a small trial.)

In a later video in the series, Dr. Alderuccio discusses some other ADCs in development -- Polatuzumab Vedotin and Pinatuzumab Vedotin and their use to treat Diffuse Large B Cell Lymphoma. He finishes by looking at the future of FL treatment and how ADCs might fit into the options available. (I always enjoy seeing and hearing a Lymphoma expert get excited about future treatment options.)

It's a pretty good video series -- the videos are fairly short, though there are unfortunately no transcripts for translation purposes. But it does highlight a type of treatment that we haven't heard much about for Follicular Lymphoma, despite its success in more aggressive lymphomas. 

I have to say, I'm a fan of ADCs, going back many years to when I first started reading about Zevalin and other RadioImmunoTherapies. I like the idea of using a proven targeting agent and trying to minimize side effects. It will be interesting to see if these ADCs continue to be effective for FL as trials move on. I'm all in favor of us having more treatment options.