Glofitamab Shows Benefit Regardless of Prior BTK Exposure in R/R MCL

Commentary
Video

All patient populations benefitted from glofitamab in a phase 1/2 trial, but the design excluded capture of high-risk features present in similar studies.

All patient subgroups with relapsed/refractory mantle cell lymphoma (MCL) appeared to benefit from treatment with glofitamab-gxbm (Columvi), even among groups with or without prior exposure to Bruton’s tyrosine kinase (BTK) inhibitors and those with COVID-19 related events, according to Tycel Phillips, MD.

Phillips, an associate professor in the Division of Lymphoma and Department of Hematology & Hematopoietic Stem Cell Transplantation at City of Hope in Duarte, California, spoke with CancerNetwork® during the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting about an analysis from a phase 1/2 study (NCT03075696) evaluating glofitamab monotherapy in patients with heavily pretreated relapsed/refractory MCL.

He highlighted a lack of disparity in outcomes among patient populations who appeared to derive equal efficacy from glofitamab, especially in the post-BTK setting. However, he noted that the trial was not designed to focus on many high-risk disease features that investigators typically report in other MCL studies. According to Phillips, the agent may be usable among country-wide centers accustomed to the use of bispecific antibodies to increase the accessibility of T-cell therapies for MCL.

Transcript:

As of right now, we don’t really have a true subset analysis, but overall, we didn’t see a patient population that did not benefit from it. Unfortunately, as the trial was designed, we didn’t really capture a lot of those high-risk features that typically are present in a lot of these mantle cell lymphoma studies. Overall, [across] the BTK-exposed or BTK-naïve [groups], which are probably the big 2 categories we can separate patients into, we really didn’t see a difference in outcomes again, especially.If we do center some of the COVID-19 related events, it does appear that these patients receive equal efficacy. If you look at a post-BTK setting, this is a very effective drug. A drug that, again, as more centers get used to using bispecific antibodies, is something that can be given throughout the country, and will increase the accessibility of a T-cell directed therapy for all patients with mantle cell lymphoma.

Reference

Phillips TJ, Carlo-Stella C, Morschhauser F, et al. Glofitamab monotherapy in patients with heavily pretreated relapsed/refractory (R/R) mantle cell lymphoma (MCL): updated analysis from a phase I/II study. J Clin Oncol. 2024;42(suppl 16). doi:10.1200/JCO.2024.42.16_suppl.700

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