Cytokine release syndrome (CRS), including serious or life-threatening reactions, can occur in patients receiving mosunetuzumab. Initiate treatment with the mosunetuzumab step-up dosing schedule to reduce the risk of CRS. Withhold mosunetuzumab until CRS resolves or permanently discontinue based on severity.
Lunsumio: FDA approved December 2022; anticipated availability currently unknown.
Follicular lymphoma: Treatment of relapsed or refractory follicular lymphoma in adults after ≥2 lines of systemic therapy.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported in adults.
>10%:
Cardiovascular: Edema (17%)
Dermatologic: Pruritus (21%), skin rash (39%), xeroderma (16%)
Endocrine & metabolic: Decreased serum magnesium (34%), decreased serum phosphate (78%), decreased serum potassium (33%), increased serum glucose (42%), increased uric acid (22%)
Gastrointestinal: Abdominal pain (12%), diarrhea (17%), nausea (17%)
Hematologic & oncologic: Decreased hemoglobin (68%; grades 3/4: 12%), decreased neutrophils (58%; grades 3/4: 40%), decreased white blood cell count (60%; grades 3/4: 13%), lymphocytopenia (100%; grades 3/4: 98%), thrombocytopenia (46%; grades 3/4: 10%)
Hepatic: Increased gamma-glutamyl transferase (34%), increased serum alanine aminotransferase (32%), increased serum aspartate aminotransferase (39%)
Hypersensitivity: Cytokine release syndrome (44%)
Nervous system: Chills (13%), dizziness (12%), fatigue (42%), headache (32%), insomnia (12%), peripheral neuropathy (20%)
Neuromuscular & skeletal: Arthralgia (11%), musculoskeletal pain (28%)
Respiratory: Cough (22%), dyspnea (11%), upper respiratory tract infection (14%)
Miscellaneous: Fever (29%)
1% to 10%:
Dermatologic: Desquamation (10%)
Genitourinary: Urinary tract infection (10%)
Hematologic & oncologic: Tumor flare (<10%), tumor lysis syndrome (<10%)
Infection: Epstein-Barr infection (<10%), sepsis (<10%)
Nervous system: Anxiety (<10%), mental status changes (<10%; including cognitive dysfunction, confusion, delirium, disturbance in attention, drowsiness, encephalopathy), motor dysfunction (<10%; including abnormal gait, ataxia, tremor)
Renal: Renal insufficiency (<10%)
Respiratory: Pneumonia (<10%)
Frequency not defined:
Hematologic & oncologic: Febrile neutropenia
Infection: Serious infection (including opportunistic infection)
Nervous system: Neurotoxicity (including immune effector cell-associated neurotoxicity syndrome)
There are no contraindications listed in the manufacturer's labeling.
