Zynlonta is a brand-name prescription medication. It’s FDA-approved to treat certain types of large B-cell lymphoma in adults.

Large B-cell lymphoma is a kind of cancer that affects white blood cells called B cells. These cells are part of your immune and lymphatic systems.

Zynlonta is used to treat the following types of large B-cell lymphoma:

  • diffuse large B-cell lymphoma (DLBCL) that’s not otherwise specified, meaning it doesn’t have a specific known cause
  • DLBCL that started as low-grade (slow-growing) lymphoma
  • high-grade (quick-growing) B-cell lymphoma

Zynlonta is used to treat lymphoma that has relapsed (come back) or is refractory (didn’t improve after previous treatment). The drug is prescribed for adults who have already received at least two treatments for their cancer.

Drug details

Zynlonta contains the active ingredient loncastuximab tesirine-lpyl, which is a biologic.

Zynlonta is an antibody-drug conjugate. It contains an antibody (an immune system protein) that’s linked to a chemotherapy drug.

Zynlonta comes in a single-dose vial of powder. A healthcare professional will mix the powder with liquid to create a solution. They’ll give you Zynlonta as an IV infusion at a hospital, doctor’s office, or clinic.

The drug is available in one strength: 10 milligrams (mg).

FDA approval

In 2021, Zynlonta received accelerated approval from the Food and Drug Administration (FDA).

Accelerated approval is based on early clinical trial results. A drug can get this “fast-track” approval if there aren’t many effective treatment options for the condition it treats. This is the case for relapsed and refractory large B-cell lymphoma.

The FDA will decide whether to grant full approval of Zynlonta for large B-cell lymphoma after more extensive clinical trials are completed.

Effectiveness

For information about the effectiveness of Zynlonta, see the “Zynlonta uses” section below.

Zynlonta (loncastuximab tesirine-lpyl), which is a biologic, is not available in a generic or biosimilar form. Biosimilars are like generic drugs, but for biologics.

Nonbiologic drugs are made from chemicals, so these drugs can be copied exactly. A generic drug is an exact copy of the active drug in a brand-name medication. Biologic drugs are made from living cells, so it’s not possible to copy these drugs exactly.

The “-lpyl” at the end of loncastuximab tesirine is a suffix given specifically to Zynlonta. When a biosimilar form of Zynlonta comes out, it will have a different suffix. This distinguishes the active ingredient in a brand-name biologic medication (parent drug) from that of its biosimilars.

Biosimilars are considered to be just as safe and effective as their parent drug. Like generics, biosimilars typically cost less than brand-name medications.

Zynlonta can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Zynlonta. These lists do not include all possible side effects.

For more information about the possible side effects of Zynlonta, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Zynlonta, you can do so through MedWatch.

Mild side effects

Mild side effects* of Zynlonta can include:

Most of these side effects may go away within a few days to a couple of weeks. If they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Zynlonta. To learn about other mild side effects, talk with your doctor or pharmacist, or view Zynlonta’s prescribing information.

Serious side effects

Serious side effects of Zynlonta are possible. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects of Zynlonta and their symptoms can include:

* For more information about this side effect, see “Side effect details” below.

Side effect details

Here’s some detail on certain side effects this drug may cause. To find out how often side effects occurred in the clinical trial, see the prescribing information for Zynlonta.

Fluid retention

Fluid retention may occur during Zynlonta treatment. This was one of the more common side effects reported in the drug’s clinical trial.

Fluid retention is also called edema. The most common symptom of edema is swelling anywhere in the body, such as your legs, hands, or abdomen. Other symptoms may include:

  • rapid weight gain
  • chest pain
  • trouble breathing
  • bloating

In most cases, fluid retention due to Zynlonta is mild or manageable. A serious type of fluid retention called an effusion is less common. An effusion is an abnormal buildup of fluid between tissues in the body. Effusions can put pressure on your organs, preventing them from working properly.

In rare cases, some people in Zynlonta’s clinical trial had to stop the treatment due to effusions. These included pleural effusion (fluid buildup around the lungs) and pericardial effusion (fluid buildup around the heart).

What you can do

If you have rapid weight gain or swelling anywhere in your body during Zynlonta treatment, talk with your doctor. They may prescribe a diuretic medication to help ease fluid retention. Other ways to relieve this side effect include getting moderate exercise and limiting how much sodium (salt) you consume. Your doctor may also recommend that you wear compression stockings to help ease swelling.

Be sure to talk with your doctor right away if you have trouble breathing or chest pain. If you have an effusion, a possible treatment is draining the fluid. Your doctor will also likely pause or stop your Zynlonta treatment. If they have you start receiving the drug again, they may reduce your dosage. This depends on how long the effusion takes to go away.

Skin reactions

Zynlonta treatment may cause skin reactions that can be mild to severe. Mild skin reactions were common in the drug’s clinical trial, while serious reactions were less common.

Skin reactions reported with Zynlonta include:

  • skin rash
  • photosensitivity (increased sensitivity to natural or artificial sunlight)
  • itching
  • skin peeling, reddening, or discoloration
  • hand-foot syndrome, which may cause pain, blistering, or discoloration of the palms of your hands and soles of your feet

What you can do

While you receive Zynlonta, avoid direct sunlight and tanning beds. If you must be in the sun, make sure to wear protective clothing and sunscreen. Be sure to talk with your doctor right away if you develop symptoms of a skin reaction.

If the reaction is bothersome, your doctor may pause your use of Zynlonta until the side effect goes away. They may send you to a dermatologist for treatment. If your doctor has you start receiving Zynlonta again, they may reduce your dosage. This depends on how long it takes the skin reaction to clear up.

If you have a serious skin reaction, your doctor will likely have you stop receiving Zynlonta. They may recommend a different treatment instead.

Decreased levels of blood cells

Zynlonta treatment can decrease the levels of blood cells. In the drug’s clinical trial, this was one of the more common side effects.

Decreased levels of blood cells typically do not cause symptoms unless they become severely low. Your doctor will use complete blood count tests to regularly monitor you for:

Neutrophils are important because they’re part of your immune system. They help your body respond to germs and fight off infection. Without enough neutrophils, you may have an increased risk of infection, such as pneumonia.

What you can do

Be sure to have all blood tests that your doctor orders. If your blood cell levels become too low, your doctor may pause your Zynlonta treatment. They may also prescribe medication, such as filgrastim (Neupogen), to raise your blood cell levels.

If your doctor restarts your Zynlonta treatment, they may reduce your dosage. This depends on how long it takes for your blood cell levels to recover.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Zynlonta.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Zynlonta, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

As with all medications, the cost of Zynlonta can vary. To find current prices for Zynlonta in your area, check out WellRx.com.

The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan and your location. There may also be costs for the visits to your doctor’s office or another healthcare facility where you receive Zynlonta doses.

Before approving coverage for Zynlonta, your insurance company may require you to get prior authorization. This means your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Zynlonta, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Zynlonta, or if you need help understanding your insurance coverage, help is available.

ADC Therapeutics SA, the manufacturer of Zynlonta, offers a program called Advancing Patient Support. For more information and to find out if you’re eligible for support, call 855-690-0340 or visit the program website.

To learn more about saving money on prescriptions, check out this article.

Biosimilar version

Zynlonta (loncastuximab tesirine-lpyl), which is a type of drug called a biologic, is not available in a generic or biosimilar form. Biosimilars are like generic drugs, but for biologics.

Nonbiologic drugs are made from chemicals, so these drugs can be copied exactly. A generic drug is an exact copy of the active drug in a brand-name medication. Biologic drugs are made from living cells, so it’s not possible to copy these drugs exactly.

Biosimilars are considered to be just as safe and effective as their parent drug. Like generics, biosimilars typically cost less than brand-name medications.

The Zynlonta dosage your doctor prescribes will depend on several factors. These include:

  • your body weight
  • side effects you may have during Zynlonta treatment and how severe they are

The following information describes dosages that are commonly used or recommended. Your doctor will determine the best dosage to fit your needs.

Drug form and strength

Zynlonta comes in a single-dose vial of powder. A healthcare professional will mix the powder with liquid to create a solution. They’ll give you Zynlonta as an IV infusion at a hospital, doctor’s office, or clinic.

The drug is available in one strength: 10 milligrams (mg).

Dosage for large B-cell lymphoma

You’ll likely receive a dose of Zynlonta on day 1 of a 21-day treatment cycle. This means you’ll receive an infusion of the drug once every 3 weeks.

Your doctor will calculate your dose of Zynlonta based on your body weight in kilograms (kg). One kg is equal to about 2.2 pounds (lb).

For the first two cycles, the typical dosage of Zynlonta is 0.15 mg per kg of body weight (mg/kg). For the third cycle and on, the recommended dosage is 0.075 mg/kg.

If you have side effects during Zynlonta treatment, your doctor may reduce your dosage or pause your dosing schedule. This depends on the severity of the side effects.

Because you’ll receive Zynlonta from a healthcare professional, an overdose of the drug is unlikely.

What if I miss an appointment for a dose?

If you miss an appointment for a Zynlonta infusion, let your doctor know as soon as possible. You should also call the staff at the location where you receive your doses right away. They can reschedule your appointment.

Missing doses of Zynlonta can cause the medication not to work as well as usual to treat your cancer.

To help make sure you don’t miss an appointment, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to receive this drug long term?

Zynlonta is meant to be used as a long-term treatment. You and your doctor will determine how many treatment cycles of Zynlonta you’ll receive. Your number of cycles will depend on how effective the drug is at treating your cancer. Another factor is whether you have any severe side effects during Zynlonta treatment.

Zynlonta is used to treat certain types of large B-cell lymphoma in adults.

Large B-cell lymphoma is a type of cancer that affects white blood cells called B cells (also known as B lymphocytes). The most common form is diffuse large B-cell lymphoma (DLBCL). With DLBCL, B cells start growing irregularly in the lymph nodes or other lymph system tissues, such as the spleen. These abnormal B cells (also called lymphoma cells) can build up, which may cause lumps and other symptoms.

Zynlonta is a targeted therapy called an antibody-drug conjugate. Zynlonta contains an antibody (an immune system protein) that’s linked to a chemotherapy drug. Each part of Zynlonta plays a role in how the medication works to reduce the size of lymphoma cells and ease your symptoms. The way a drug works is called its mechanism of action.

Zynlonta contains loncastuximab, a CD19-directed antibody. This antibody attaches to CD19, a protein found on the surface of certain cells, including large B cells. Once the antibody is inside the cell, it releases the drug part of Zynlonta: tesirine. This is a type of chemotherapy drug called an alkylating agent. Tesirine works by damaging the lymphoma cell’s DNA, stopping it from multiplying (making more cells).

To learn if Zynlonta is right for your type of B-cell lymphoma, talk with your doctor.

How long does it take to work?

Zynlonta starts working as soon as you receive your first dose. In the drug’s clinical trial for DLBCL, it took an average of 1.3 months (with a range of 1.1 to 8.1 months) for some people to have a partial or complete response. With a partial response, the size of lymphoma cells decreased. With a complete response, the lymphoma cells were so small that they couldn’t be detected on a lab test.

Keep in mind that individual results can vary. Also, you may not notice whether Zynlonta is working. Your doctor will order tests during your treatment to see if the drug is effective.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Zynlonta, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) is prescribed for a purpose other than what it’s approved for.

Alternatives for large B-cell lymphoma

Examples of other drugs that may be used to treat certain types of large B-cell lymphoma include:

  • other antibody-drug conjugates, such as:
    • polatuzumab vedotin (Polivy)
  • antibody treatments, such as:
  • chemotherapy drugs, such as:
    • carboplatin
    • cisplatin
    • cyclophosphamide (Cytoxan)
    • doxorubicin
    • gemcitabine (Infugem)
    • ifosfamide (Ifex)
    • oxaliplatin (Eloxatin)
    • procarbazine (Matulane)
    • vincristine
  • lenalidomide (Revlimid), an immunomodulator
  • selinexor (Xpovio), a targeted therapy

Zynlonta isn’t known to interact with specific medications, supplements, or foods.This is because the Food and Drug Administration (FDA) granted Zynlonta accelerated approval,* so clinical trials of the medication are still ongoing.

It’s important to note that interactions with Zynlonta may still be possible. Other drugs that work similarly to Zynlonta can interact with certain medications, including:

To be safe, it’s a good idea to talk with your doctor and pharmacist before you start Zynlonta treatment. ­Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

* To learn more, see “FDA approval” in the “What is Zynlonta?” section above.

There are no known interactions between Zynlonta and alcohol.

It’s important to note that drinking too much or too often can lead to liver problems such as cirrhosis. The liver helps clear Zynlonta out of your system. If you have a liver problem, the drug may build up in your body. This can increase your risk of side effects from the medication.

If you drink alcohol, talk with your doctor about how much, if any, is safe to drink during your treatment with Zynlonta.

The Food and Drug Administration (FDA) approves prescription drugs such as Zynlonta to treat certain conditions. Zynlonta may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

Zynlonta for large B-cell lymphoma

Zynlonta is FDA-approved* to treat certain types of a cancer called large B-cell lymphoma. The drug is used to treat the following in adults:

  • diffuse large B-cell lymphoma (DLBCL) that’s not otherwise specified, meaning it doesn’t have a specific known cause
  • DLBCL that started as low-grade (slow-growing) lymphoma
  • high-grade (quick-growing) B-cell lymphoma

Specifically, Zynlonta is used to treat lymphoma that has relapsed (come back) or is refractory (didn’t improve after previous treatment). The drug is prescribed for adults who have already received at least two treatments for their cancer.

* To learn more, see “FDA approval” in the “What is Zynlonta?” section above.

Large B-cell lymphoma explained

LBCL is a type of cancer that affects white blood cells called B cells (also known as B lymphocytes). These lymphoma cells are named for their larger size compared with regular lymphocytes. LBCL is a type of non-Hodgkin lymphoma.

The most common form of LBCL is diffuse large B-cell lymphoma (DLBCL). With DLBCL, B cells start growing irregularly in the lymph nodes or other lymph system tissues, such as the spleen. These abnormal B cells can build up, which may cause lumps and other symptoms.

Symptoms of LBCL may include:

To learn more about managing and treating lymphoma, you can refer to our cancer hub.

Effectiveness for large B-cell lymphoma

In a clinical trial, Zynlonta has been shown to be an effective treatment for LBCL in adults. For more information about Zynlonta’s clinical trial, see the manufacturer’s website or the drug’s prescribing information.

Zynlonta and children

Zynlonta is FDA-approved for use only in adults. The drug’s safety and effectiveness in children is unknown.

If your child has LBCL, talk with their doctor about possible treatments.

A corticosteroid drug called dexamethasone is typically used as a premedication for Zynlonta. A premedication is a drug given before a treatment to help minimize its side effects or improve its effectiveness.

Your doctor will likely prescribe oral tablets of dexamethasone. You’ll likely take this drug the day before, the day of, and the day after you receive an infusion of Zynlonta.

If you do not start taking dexamethasone the day before your Zynlonta infusion, tell your doctor. They’ll likely have you take it at least 2 hours before you receive Zynlonta. The dexamethasone should still help ease infusion side effects. However, it may not work as well as if it’s taken on the same day as your Zynlonta treatment.

Your doctor can tell you more about taking dexamethasone with Zynlonta.

Zynlonta comes in a single-dose vial of powder. A healthcare professional will mix the powder with liquid to create a solution. They’ll give you Zynlonta as an IV infusion at a hospital, doctor’s office, or clinic. An IV infusion is an injection into a vein over a period of time.

It takes about 30 minutes to receive a Zynlonta infusion.

When you’ll receive Zynlonta

You’ll receive Zynlonta as an IV infusion once every 3 weeks.

To help make sure that you don’t miss an appointment to receive your dose, try using a medication reminder. This can include adding a note on your calendar or setting a reminder on your phone.

Your doctor will likely recommend that you do not receive Zynlonta while you’re pregnant. Based on how the drug works, Zynlonta may harm a developing fetus. There haven’t been any human or animal clinical studies of the drug during pregnancy.

If you can become pregnant, your doctor will likely recommend taking a pregnancy test before you start Zynlonta treatment. This is to confirm that you’re not pregnant.

If you’re pregnant or planning a pregnancy, talk with your doctor about the best treatment option for you during this time.

Zynlonta and fertility

Based on an animal study, Zynlonta may affect male* fertility. (The term fertility refers to the ability to make someone pregnant or to become pregnant.) The study’s findings included the reduced size of male genitalia and decreased sperm count. The animals were checked 12 weeks after receiving Zynlonta, and the effects had not gone away.

It isn’t known if Zynlonta has any effects on female* fertility.

If you’re concerned about your fertility, talk with your doctor before starting Zynlonta treatment.

* Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

Zynlonta may harm a developing fetus based on how the drug works. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you receive Zynlonta.

For more information about Zynlonta and pregnancy, see the “Zynlonta and pregnancy” section above.

For females receiving Zynlonta. If you’re a female* who may become pregnant, your doctor will likely recommend using birth control during treatment with Zynlonta. You should continue using birth control for 9 months after your last dose of Zynlonta.

For males receiving Zynlonta. If you’re a male* and your sexual partner can become pregnant, your doctor will likely recommend using birth control, such as condoms, during Zynlonta treatment. You should continue doing so for 6 months after your last dose of Zynlonta.

* Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

Your doctor will likely recommend that you do not breastfeed while you’re receiving Zynlonta. They’ll also likely advise you not to breastfeed for at least 3 months after your last dose of Zynlonta.

It isn’t known if Zynlonta passes into breast milk or how the drug might affect a breastfed child. No clinical studies have been done in humans or animals for this purpose.

If you’re breastfeeding or planning to breastfeed, talk with your doctor. They’ll usually recommend other feeding options for your child so that you can receive Zynlonta for your condition.

Here are answers to some frequently asked questions about Zynlonta.

Is Zynlonta a type of chemotherapy?

Yes and no. Zynlonta is a targeted therapy called an antibody-drug conjugate (ADC). It contains an antibody (an immune system protein) that’s connected to a chemotherapy drug.

ADCs work by delivering chemotherapy directly to specific targets in the body. This is unlike traditional chemotherapy drugs, which often can’t distinguish between cancer cells and healthy cells. Not being able to tell the difference between cells is why chemotherapy medications tend to cause a lot of side effects. One such side effect is hair loss.

Targeted therapies generally cause fewer side effects than traditional chemotherapy drugs.

To learn more about how Zynlonta works, see the “How Zynlonta works” section above.

Will I need any tests during Zynlonta treatment?

Yes. During your treatment with Zynlonta, your doctor will likely order routine blood tests. Your doctor will monitor your complete blood count regularly. This blood test checks your levels of blood cells, including your white blood cells, red blood cells, and platelets. If your levels become too low, your doctor may pause or stop your treatment.

Other blood tests you’ll usually receive check the health of your liver and kidneys as well as your blood sugar level.

If you have additional questions about tests you may need with Zynlonta, ask your doctor.

How long do Zynlonta infusions usually take?

It takes about 30 minutes to receive a Zynlonta IV infusion. This is an injection into a vein over time.

You’ll receive Zynlonta infusions at a hospital, doctor’s office, or clinic. Although the infusion itself is about 30 minutes long, your appointment may take a couple of hours. This is because you may need a dose of dexamethasone at least 2 hours before your Zynlonta infusion. (For more details, see the “Zynlonta use with other drugs” section above.)

Your doctor can help answer any other questions about what to expect during your infusion appointments.

This drug comes with several precautions. Before receiving Zynlonta, talk with your doctor about your health history. Zynlonta may not be right for you if you have certain medical conditions or other factors affecting your health. These include the ones mentioned below.

Note: For more information about the potential negative effects of Zynlonta, see the “Zynlonta side effects” section above.

Liver problems. If you have a mild liver problem such as fatty liver disease or hepatitis, talk with your doctor before receiving Zynlonta. The liver helps clear the drug out of your system. So if your liver isn’t working properly, Zynlonta may build up in your body. This can increase your risk of side effects from the medication.

In addition, it’s not known whether Zynlonta is safe for people with moderate or severe liver problems such as cirrhosis or liver failure. If you have a liver problem, your doctor may monitor you closely during your Zynlonta treatment.

Infection. Zynlonta may decrease the levels of blood cells, including white blood cells called neutrophils. These blood cells help your body fight off infections. If you currently have an infection or were recently treated for one, tell your doctor before starting Zynlonta treatment. They’ll likely have you wait until your infection is treated or cleared before receiving Zynlonta.

Diabetes. Zynlonta may cause hyperglycemia as a side effect. If you already have diabetes, Zynlonta may make your blood sugar levels challenging to manage. Talk with your doctor about a plan to monitor and manage your blood sugar during Zynlonta treatment.

Allergic reaction. If you’ve had an allergic reaction to Zynlonta or any of its ingredients, your doctor will likely not prescribe Zynlonta. Ask your doctor what other medications may be better options for you.

Pregnancy. Your doctor will likely recommend that you do not receive Zynlonta while you’re pregnant. For more information, see the “Zynlonta and pregnancy” section above.

Breastfeeding. Your doctor will likely recommend that you do not breastfeed while you receive Zynlonta. For more information, see the “Zynlonta and breastfeeding” section above.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.