Adam J. Olszewski, MD, discusses findings from a phase 1b/2 study which evaluated treatment with mosunetuzumab for the treatment of elderly/unfit patients who were previously untreated for their diffuse large B-cell lymphoma.
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.
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.