VIDEO: Mosunetuzumab approval a 'big deal' for follicular lymphoma

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Well, the approval of the first bispecific antibody for follicular lymphoma, mosunetuzumab, is a hugely big deal because it is really mechanistically distinct therapy. You know, when patients are progressing through chemotherapy, especially those that progress rapidly, they are our worst prognosis. Follicular lymphoma patients, we sometimes call these early relapsers, or POD 24, POD 24 patients, meaning they have progressed with their disease within 24 months of standard chemotherapies. Historically either R CHOP or R-bendamustine. And although most patients with follicular lymphoma live for years and decades, really, I would say the unmet need for follicular lymphoma patients is those early relapsers after chemotherapy, the POD24 patients. And historically, you know, 10 and certainly 20 years ago, we just gave those folks more types of chemotherapies, and more aggressive chemotherapies, and even intuitively just giving more of a similar type of therapy, not very gratifying. So with the FDA approval of highly effective immunotherapy, bispecific antibody, mosunetuzumab, now we get to attack those cancer cells in a very different way. The way that a mobilized T-cell kills a lymphoma cell with granzyme perforin and maybe fast ligand, is just a very different way for that cell to die. If that tumor cell has learned to resist bendamustine and alkylator-based chemotherapies broadly, they can still be exquisitely sensitive to immunotherapies. So with that approval of mosunetuzumab, we see very high response rates regardless of chemo-refractory disease. And it's similar story with the recent prior approval of CAR-T cells, axis cells specifically. The main difference being that bispecific antibodies are even more user-friendly, don't require lymphodepletion with fludarabine cyclophosphamide, don't require referral to a CAR-T center. Don't require a personalized development of the therapy, like all CAR-T cells or autologous CAR-T cells that are approved due today. Just an off the shelf, pretty easy to use therapy. I don't want to minimize the risks. There are smaller risks of cytokine release syndrome, mostly just a fever lasting for a day or so. But the recipe for mosunetuzumab does not require any inpatient hospitalization for monitoring. Some patients might need that, but certainly not across the board. So developing this, you know, mechanistically distinct therapy is just a huge win for the patients that had the greatest unmet need, those chemo-refractory and chemo-early relapsing patients with follicular lymphoma.