New study results may lead to an earlier treatment option for people with follicular lymphoma. The Phase 3 CELESTIMO trial studied mosunetuzumab with lenalidomide after at least one prior treatment.
CELESTIMO studied mosunetuzumab earlier in treatment
Mosunetuzumab (Lunsumio, Genentech) is a bispecific antibody directed to CD20 and CD3. This makes T cells (CD20) in the immune system target and remove B cells (CD3) that are causing follicular lymphoma.
Mosunetuzumab is currently approved in the United States for certain adults with follicular lymphoma. It can be used when lymphoma returns or does not respond after two or more prior treatments. This is called a third-line treatment.
The CELESTIMO trial studied mosunetuzumab earlier. People in the trial had received at least one prior treatment.
Researchers compared two treatment combinations:
Mosunetuzumab plus lenalidomide
Rituximab plus lenalidomide
Mosunetuzumab combination improved progression-free survival
The CELESTIMO trial met its main goal. Mosunetuzumab plus lenalidomide improved progression-free survival compared with rituximab plus lenalidomide. Progression-free survival is the amount of time a person is alive from the start of cancer treatment before the cancer grows or changes.
The difference was statistically significant. This means the difference was unlikely to be due to chance. The difference was also large enough to be meaningful for patient care.
Overall survival cannot be studied yet because it is still too soon to know how this treatment will affect the total amount of time a person with follicular lymphoma may live.
More detailed results are expected at an upcoming medical meeting. These results may provide more information about the benefits.
What do we know about the side effects?
No new safety concerns were found in the CELESTIMO trial. The safety results were similar to what was already known about both treatments. Detailed safety results from the trial have not yet been reported.
Mosunetuzumab can cause cytokine release syndrome (CRS). CRS is an immune reaction that can happen when immune cells become very active. CRS can be serious and can affect the nervous system. Symptoms may include fever, chills, low blood pressure, headache, dizziness, nausea, or trouble breathing.
Other serious side effects can include infections, nerve problems, and low blood cell counts. Your healthcare team will watch for these problems during treatment.
The mosunetuzumab combination can be given in an outpatient setting. This means treatment may not require a hospital stay. Mosunetuzumab itself can be administered as an intravenous infusion (IV) (Lunsumio) or as a subcutaneous injection (Lunsumio Velo).
Mosunetuzumab could become an earlier treatment option
Mosunetuzumab plus lenalidomide delayed follicular lymphoma progression better than rituximab plus lenalidomide. The CELESTIMO study could support a possible future approval of mosunetuzumab as a second-line treatment. It is currently approved as a third-line or later treatment. Ask your follicular lymphoma specialist about your treatment options.
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