SWOG 2308: Randomized Phase III Study of Mosunetuzumab Versus Rituximab for Low‑Tumor Burden Follicular Lymphoma
Mosunetuzumab provides higher complete metabolic response rates and is hypothesized to improve progression‑free survival compared with rituximab as first‑line therapy in low‑tumor burden follicular lymphoma.
Follicular lymphoma (FL) remains largely incurable with standard therapies, especially in patients with low‑tumor burden disease where active surveillance or rituximab monotherapy are commonly used. Recent data highlight a high complete metabolic response (CMR) rate with subcutaneous rituximab and suggest the possibility of cure with monoclonal antibody therapy. Mosunetuzumab, a CD20×CD3 bispecific antibody approved for FL after two prior therapies, has produced an 87 % CMR rate in untreated, low‑tumor burden FL. This phase‑III, open‑label trial will randomize patients to receive either rituximab or mosunetuzumab to compare progression‑free survival (PFS) and 3‑year milestone PFS, with secondary endpoints of overall survival, overall response rate, and event‑free survival. Accrual of 540 participants is underway.
Demonstrating superior efficacy and durability of mosunetuzumab could shift first‑line management of low‑tumor burden follicular lymphoma from surveillance or single‑agent rituximab to a curative, fixed‑duration, T‑cell‑engaging bispecific antibody strategy.
Evidence level: Állatkísérletes. Állatmodellben vizsgálták.
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