Division of Oncology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO.
Division of Haematology, Jewish General Hospital, Montreal, QC, Canada.
Blood Adv. 2023 Sep 12;7(17):4926-4935. doi: 10.1182/bloodadvances.2022009260.
As part of a phase 1 or 2 study, this single-arm expansion cohort established the efficacy and safety of mosunetuzumab monotherapy in patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) (received ≥2 previous lines of therapy). Intravenous mosunetuzumab was administered with cycle (C) 1 step-up dosing for cytokine release syndrome (CRS) mitigation: C1 day (D) 1: 1 mg; C1D8 2 mg; C1D15 and C2D1: 60 mg; C3 + D1: 30 mg. Hospitalization was not mandatory. Patients with complete response (CR) completed treatment after C8; those with partial response or stable disease continued treatment for a total of 17 cycles. The primary end point was CR rate (best response), assessed against a historical control CR rate (20%) by independent review facility. Eighty-eight patients (73.9% de novo DLBCL; 26.1% transformed follicular lymphoma) were enrolled; all had received previous anthracycline and anti-CD20 therapy. Overall response and CR rates were 42.0% (95% confidence interval [CI], 31.6-53.1) and 23.9% (95% CI, 15.4-34.1), respectively; CR rate did not reach statistical significance vs the historical control (P = .36). Median time to first response was 1.4 months. Median progression-free survival was 3.2 months (95% CI, 2.2-5.3). The CR rate in 26 patients who received previous chimeric antigen receptor T-cell (CAR-T) therapy was 12%. CRS was one of the most common adverse events (26.1% of patients); predominantly grade 1 to 2 and primarily in C1. Four patients (4.5%) discontinued mosunetuzumab owing to adverse events. Mosunetuzumab demonstrated notable efficacy and a manageable safety profile in patients with R/R DLBCL, including those previously treated with CAR-Ts. This trial was registered at www.clinicaltrials.gov as #NCT02500407.
在一项 1 期或 2 期研究中,该单臂扩展队列确定了 mosunetuzumab 单药治疗复发/难治性 (R/R) 弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者的疗效和安全性(接受了≥2 线治疗)。静脉注射 mosunetuzumab 进行了细胞周期 (C) 1 步加量以减轻细胞因子释放综合征 (CRS):C1D1:1mg;C1D8:2mg;C1D15 和 C2D1:60mg;C3+D1:30mg。住院不是强制性的。完全缓解 (CR) 的患者在 C8 后完成治疗;部分缓解或疾病稳定的患者继续接受总共 17 个周期的治疗。主要终点是根据独立审查机构的历史对照 CR 率(20%)评估的 CR 率。88 名患者(73.9%为新发 DLBCL;26.1%为转化滤泡性淋巴瘤)入组;所有患者均接受了先前的蒽环类药物和抗 CD20 治疗。总缓解率和 CR 率分别为 42.0%(95%CI,31.6-53.1)和 23.9%(95%CI,15.4-34.1);CR 率与历史对照相比无统计学意义(P=.36)。首次反应的中位时间为 1.4 个月。中位无进展生存期为 3.2 个月(95%CI,2.2-5.3)。26 名接受过嵌合抗原受体 T 细胞(CAR-T)治疗的患者的 CR 率为 12%。细胞因子释放综合征是最常见的不良事件之一(26.1%的患者);主要为 1 级和 2 级,主要发生在 C1。4 名患者(4.5%)因不良事件停止使用 mosunetuzumab。Mosunetuzumab 在 R/R DLBCL 患者中表现出显著的疗效和可管理的安全性,包括那些先前接受过 CAR-T 治疗的患者。该试验在 www.clinicaltrials.gov 上注册为 #NCT02500407。
Cochrane Database Syst Rev. 2021-9-13
Cancers (Basel). 2025-7-30
Front Med (Lausanne). 2025-7-2
J Immunother Cancer. 2025-6-24
Blood Neoplasia. 2024-12-4
J Natl Compr Canc Netw. 2022-3