A novel treatment option could benefit patients with relapsed or refractory (R/R) diffuse large B cell lymphoma (DLBCL), according to a recent study in Blood Advances.
“In patients with R/R B-cell NHL, mosunetuzumab retreatment was effective and well tolerated with a safety profile consistent with that observed with initial treatment,” the authors wrote.
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This cohort, open-label study served as a single arm phase 1/2 clinical trial that included a total of 88 patients previously diagnosed with R/R DLBCL disease to 2 or more therapeutic schemes with at least an anthracycline and an antiCD20 monoclonal antibody. Some cases even had received antiCD19 chimeric antigen receptor T cell (CAR-T) and/or autologous cell transplant in 29.5% and 17% of the cases, respectively.
Almost all individuals (73.9%) had denovo DLBCL, and only 19% had double or even triple-hit lymphoma. Study participants were between 24 and 96 years of age.
All participants received at least 8 cycles for 21 days each and received steroids 1 hour prior to mosunetuzumab in cycles 1 and 2, and optional in cycle 3.
This treatment achieved an overall response and complete remission rate of 42.0% and 23.9%, respectively. Although still important for each individual patient that showcased a complete response, these data are not statistically significant when compared to historical control. Moreover, among the 26 participants who had previously undergone CAR-T, the complete remission rate was 12%
The median time in which patients demonstrated the first response was 1.4 months, and the median progression-free survival was 3.2 months.
Regarding the safety profile of mosunetuzumab, the cytokine release syndrome was rather frequent, occurring in 26.1% of the cases. Among these, most were in grade 1 or 2 and predominantly in the first cycle. Only 4.5% of the participants had to abandon the treatment due to adverse events.
“Further study is warranted to evaluate the potential use of mosunetuzumab in earlier lines of therapy and the optimal sequencing of treatment with other agents, including CAR-T therapies,” the authors concluded.
Bartlett N, Assouline S, Giri P, et al. Mosunetuzumab monotherapy is active and tolerable in patients with relapsed/refractory diffuse large B-cell lymphoma. Blood Adv. Published online April 17, 2023. doi:10.1182/bloodadvances.2022009260