11 December 2019

A new antibody treatment has shown significant promise in bringing patients with recurring B-cell non-Hodgkin’s lymphoma (NHL) to remission, a major haematology conference has heard.

Almost 50% of patients with slow-growing lymphomas had complete responses to mosunetuzumab in a global trial of the treatment, the American Society of Hematology (ASH) annual meeting heard.

Patients in the trial had disease that was resistant or recurring after multiple treatments, including CAR‑T therapy. Among the CAR‑T patients, 22% experienced complete remission after treatment with the drug.

The project was coordinated by the Abramson Cancer Center at the University of Pennsylvania, USA. The analysis involved 193 patients in seven countries including the UK. There were 124 with aggressive disease and 67 with slow-growing disease.

Mosunetuzumab, a bispecific antibody drug, binds to CD20 and to a natural receptor on T cells. The researchers say it may also help to boost failing CAR‑T treatment.

Researchers say that at six months of follow-up, most patients who achieved complete remissions remained free of disease. This included 24 out of 29 patients (83%) with slow-growing lymphomas, and 17 of 24 patients (71%) with aggressive disease.

Dr Stephen Schuster, who led the project, said: “There is still a large need for new treatments in relapsed or refractory cases, since some patients fail CAR-T and others are too sick to wait for cell manufacturing.

“One of the benefits of this treatment is that it’s ‘off-the-shelf,’ meaning it does not need to be manufactured for each patient.”

He added: “Mosunetuzumab generates long-lasting responses with a very tolerable safety profile in patients with B-cell non-Hodgkin lymphomas for whom multiple prior treatments have failed and whose prognosis is poor. Of particular interest, we are seeing durable complete remissions in patients whose lymphomas progressed after CAR-T.

“This could mean that not only does mosunetuzumab have the ability to kill cancer, but also that it may help re-engage CAR-T cells and boost the effect of the prior CAR treatment."

Dr Schuster told the conference: “Larger, randomised trials are needed to further confirm these promising data and determine whether the treatment benefit of mosunetuzumab is enhanced when it is used earlier in the course of lymphoma therapy or in combination with other agents.”


Source: ASH 8 December 2019 Plenary session