Strengthening Induction Therapy for Aggressive B-Cell Lymphoma

Glofitamab is a bispecific T-cell engaging monoclonal antibody with single-agent activity in relapsed or refractory large B-cell lymphoma (LBCL). Now, investigators have assessed the safety and efficacy of combining glofitamab with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) or Pola-R-CHP (polatuzumab, rituximab, cyclophosphamide, doxorubicin, and prednisone) in patients with high-risk international prognostic index scores, double-hit (DH) LBCL, or both. Glofitamab was initiated with stepped-up dosing in cycle 2; after completing induction chemotherapy, an additional two cycles of single-agent glofitamab were given. The primary endpoint was safety; response and survival outcomes were secondary endpoints.

Of 80 eligible patients, 11% had DH LBCL and 74% received an initial cycle of R-CHOP; 96% completed all planned treatment cycles. In each arm, about 40% of patients had peripheral neuropathy and about 20% had cytokine release syndrome. The overall best response rate was 100%; one patient in each arm had progressive disease. At a median follow-up of 17 months postinduction, the estimated 24-month progression-free survival was 86% and overall survival was 92% in both arms. Overall, 8 patients experienced disease progression, with 2 deaths occurring while in remission.