Safety and Efficacy of Mosunetuzumab in Elderly Patients With DLBCL

Adam J. Olszewski, MD, associate professor of medicine at Brown University, lymphoma clinician at Rhode Island Hospital in Providence, Rhode Island, discusses findings from a phase 1b/2 study (NCT03677154) which evaluated treatment with mosunetuzumab (Lunsumio) for the treatment of elderly/unfit patients who were previously untreated for their diffuse large B-cell lymphoma (DLBCL).

In the study, 43% of patients achieved a complete response (CR), and the median duration of CR was 15.8 months (95% CI, 8.5-not estimable). Eleven of 23 patients who reached a CR maintained it for >12 months. For safety, no new safety signals were observed.

Transcription:

0:10 | The treatment is quite safe. It was administered as an outpatient for most patients. It causes CRS, or cytokine release syndrome, in about a quarter of patients, but this is often a low-grade CRS that can be managed with acetaminophen or fewer suppressing agents. Very few patients required hospitalization. Only 1 person required corticosteroids to suppress the CRS, and no patients required intensive care admissions or administration of tocilizumab [Actemra]. It's a safe treatment and many patients did have neutropenia, but it was asymptomatic with only febrile neutropenia. Only 1 of these 54 very elderly patients up to the age of 100 stopped therapy because of treatment-related adverse effects; only 1 in 54.

1:00 | In terms of the efficacy, it turns out that for many patients who experienced progression early during the first 2, 3 weeks of treatment, these patients moved down to standard treatment, it was available to them without any detriment to their other treatment options. Fifty-six percent of patients achieved the response, and 43% of patients achieved complete response, so 4 out of 10 patients achieved complete response with complete disappearance of lymphoma, typically, after within 3 months of treatment, without any exposure to chemotherapy.