Hematology Unit, Azienda Ospedaliera Annunziata, Cosenza, Italy.
Laboratorio di Ricerca Traslazionale Azienda USL-IRCSS Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy.
Expert Opin Biol Ther. 2024 Oct;24(10):1039-1048. doi: 10.1080/14712598.2024.2404079. Epub 2024 Sep 16.
Follicular lymphoma (FL) is an indolent non-Hodgkin lymphoma that shows a progressive increase in relapses and refractory in its natural history and a median survival of approximately 18-20 years. The advent of anti-CD20 monoclonal antibodies has changed the FL therapeutic algorithm, with an increase in progression-free survival. T-cell-dependent bispecific antibodies (BsAbs) represent an emerging drug class against FL.
In this review, we selected papers from the principal databases (PubMed, Medline, Medscape, ASCO, ESMO) between January 2021 and June 2024, using the keywords 'mosunetuzumab' and 'follicular lymphoma' to provide an overview of mosunetuzumab-axgb, a pioneering BsAb. Its mechanism of action, efficacy, safety, and future perspectives were analyzed.
Mosunetuzumab grants a directing T-cell mediated cytotoxicity and allows a step-up dosing that reduces adverse events, such as cytokine release syndrome, with promising tolerability. At the same time, it improves outcomes in the evolving landscape of FL management, even in post-CAR-T FL patients. Prognostic factors and targetable mechanisms of resistance need to be explored.
滤泡性淋巴瘤（FL）是一种惰性非霍奇金淋巴瘤，其自然病程中复发率逐渐增加，且难治性增加，中位生存期约为 18-20 年。抗 CD20 单克隆抗体的出现改变了 FL 的治疗算法，使无进展生存期增加。T 细胞依赖性双特异性抗体（BsAbs）是一种针对 FL 的新兴药物类别。
在这篇综述中，我们选择了 2021 年 1 月至 2024 年 6 月期间主要数据库（PubMed、Medline、Medscape、ASCO、ESMO）中的论文，使用关键字“mosunetuzumab”和“follicular lymphoma”，概述了 mosunetuzumab-axgb，一种开创性的 BsAb。分析了其作用机制、疗效、安全性和未来前景。
Mosunetuzumab 赋予 T 细胞介导的细胞毒性，并允许逐步增加剂量，从而降低细胞因子释放综合征等不良反应，具有良好的耐受性。同时，它改善了 FL 管理不断发展的环境中的预后，甚至在 CAR-T 后 FL 患者中也是如此。需要探索预后因素和可靶向的耐药机制。
