Glofitamab 2.5mg/2.5ml solution for infusion vials

BackgroundThe advent of novel therapies including chimeric antigen receptor (CAR) T cells, bispecific antibodies (BsAbs), and antibody-drug conjugates (ADCs), has markedly improved clinical outcomes for relapsed or refractory large B-cell lymphoma (R/R LBCL). However, direct comparisons of efficacy and safety among systemic treatments for R/R LBCL are lacking, complicating clinical decision-making.MethodsA systematic literature search was conducted across PubMed, Embase, and the Cochrane Library to identify eligible randomized controlled trials (RCTs). A Bayesian network meta-analysis (NMA) was performed to evaluate the systemic therapies across transplant-eligible and transplant-ineligible patients with R/R LBCL. The primary endpoint was progression-free survival (PFS), secondary endpoints included event-free survival (EFS), overall survival (OS), objective response rate (ORR) and grade ≥3 treatment-emergent adverse events (TEAEs).ResultsThe analysis included 14 RCTs comprising a total of 3,329 patients. Among the transplant-eligible cohort (7 evaluated regimens), CAR-T therapies maximized disease control; lisocabtagene maraleucel (liso-cel) ranked highest for PFS [hazard ratio (HR) =0.42; 95% credible intervals (CrI): 0.28-0.64] and EFS (HR =0.37, 95% CrI: 0.26-0.54), whereas axicabtagene ciloleucel (axi-cel) was associated with the highest incidence of grade ≥3 TEAEs [risk ratio (RR) =2.09; 95% CrI: 1.08-4.19]. In the transplant-ineligible cohort (9 evaluated regimens), glofitamab plus gemcitabine and oxaliplatin (Glofit-GemOx) ranked highest for PFS (HR =0.32; 95% CrI: 0.23-0.45), while polatuzumab vedotin plus bendamustine and rituximab (Pola-BR) yielded the maximum benefit for OS (HR =0.42; 95% CrI: 0.24-0.73) and ORR [odds ratio (OR) =5.21; 95% CrI: 2.01-14.3]. Both regimens were associated with higher toxicities, but remained overall manageable.ConclusionsThis NMA provides a comprehensive comparison of systemic treatment strategies for R/R LBCL regarding efficacy and safety profiles.

Abstract licence: CC BY-NC-ND

Glofitamab is a novel bispecific antibody targeting CD20×CD3, capable of simultaneously targeting CD20 and CD3 to activate T cells and release cytotoxic proteins that kill cancer cells. Cytokine release syndrome (CRS) is one of the most common adverse events observed in clinical trials of glofitamab. In most cases, CRS is mild, transient, and manageable with appropriate treatment. This paper reports a case of persistent CRS in a patient with mantle cell lymphoma following glofitamab treatment and reviews the relevant literature for reference.

Abstract licence: CC BY-NC 3.0