Mitigation strategies used in BsAb clinical trials and resulting CRS rates
Trial ID . | N. . | Histology, setting . | Drug(s) . | Route . | Full dose, mg . | Mitigation strategies during C1 . | % CRS‡ . | % serious CRS . | % toci use . | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
SUD . | Hosp∗ . | Other† . | G1 . | G2 . | G3 . | G4 . | G5 . | ||||||||
NCT03677154 | 29 | DLBCL, ND | MOSUN | IV | 13.5 (8), 30 (21) | Yes | Mandatory | 17 | 3 | 0 | 0 | 0 | NR | 0 | |
NCT02500407 | 197 | Mixed, R/R | MOSUN | IV | 2.8-40.5 | Yes§ | Optional only in exp. cohorts | 21 | 6 | 1 | 0 | 0 | 7 | 1.5 | |
90 | FL, R/R | MOSUN | IV | 30 | Yes | Optional | 26 | 17 | 1 | 1‖ | 0 | NR | 7.8 | ||
39 | Mixed, R/R | MOSUN | SC | 45 | Yes | Optional | 11 | 4 | 0 | 0 | 0 | 178 | 10.3 | ||
27 | Mixed, R/R | MOSUN, rapid SUD | SC | 45 | Yes | Optional | 33 | 8 | 0 | 0 | 0 | 4 | 0 | ||
NCT03075696 | 258 | Mixed, R/R | GLOFIT | IV | 0.6-30 | Yes§ | Mandatory | Obin¶ | 31 | 23 | 4 | 2 | 0 | 36 | 20% at RP2D |
155 | DLBCL, R/R | GLOFIT | IV | 30 | Yes | Mandatory | Obin¶ | 47 | 12 | 3 | 1 | 0 | NR | 32 | |
24 | FL, R/R | GLOFIT | IV | 16 (3), 30 (21) | Yes | Mandatory | Obin¶ | 63 | 13 | 4 | 0 | 0 | 50 | 8.3 | |
29 | FL, R/R | GLOFIT, ext. SUD | IV | 30 | Yes | Mandatory | Obin¶ | 35 | 21 | 0 | 0 | 0 | 31 | 21 | |
19 | FL, R/R | GLOFIT-obin | IV | 30 | Yes | Mandatory | Obin¶ | 53 | 26 | 0 | 0 | 0 | 26 | 26 | |
29 | MCL, R/R | GLOFIT | IV | 0.6-30 | Yes§ | Mandatory | Obin¶ | 35 | 21 | 0 | 3 | 0 | 38 | 24 | |
NCT03625037 | 68 | Mixed, R/R | EPCOR | SC | 0.0128-60 | Yes§ | Mandatory | Post-dose CS | 29 | 29 | 0 | 0 | 0 | NR | 0 |
157 | LBCL, R/R | EPCOR | SC | 48 | Yes | Mandatory | Post-dose CS | 32 | 15 | 2 | 0 | 0 | NR | 14 | |
NCT04082936 | 40 | Mixed, R/R | IgM2323 | IV | 0.5-1000 | Yes§ | Mandatory | 18 | 5 | 3 | 0 | 0 | NR | NR | |
NCT02924402 | 64 | Mixed, R/R | PLAMO | IV | 0.7-450ug/Kg, or 50 | Yes§ | NR | 19 | 33 | <1 | <1 | 0 | NR | NR | |
NCT02290951 | 145 | Mixed, R/R | ODRON | IV | 0.5-320 | Yes | Mandatory | Split-dose | 36 | 18 | 6 | 1 | 0 | NR | NR |
NCT03677141 | 40 | DLBCL, ND | MOSUN-CHOP | IV | 30 | Yes | NR | 40 | 13 | 0 | 0 | 0 | NR | 5 | |
NCT03467373 | 31 | Mixed, R/R | GLOFIT-R-CHOP | IV | 0.07-30 | Yes§ | Mandatory | GLOFIT from C2 | 32 | 13 | 10 | 0 | 0 | 26 | 26 |
26 | DLBCL, ND | GLOFIT-R-CHOP | IV | 30 | Yes | Mandatory | GLOFIT from C2 | 4 | 4 | 0 | 0 | 0 | 0 | 0 | |
NCT04663347 | 24 | DLBCL, ND | EPCOR-R-CHOP | SC | 24 (4), 48 (20) | Yes | Mandatory | Post-dose CS | 17 | 17 | 4 | 0 | 0 | NR | NR |
29 | DLBCL, R/R | EPCOR-R-DHAX | SC | 48 | Yes | Mandatory | Post-dose CS | 38 | 28 | 10 | 0 | 0 | NR | 7 | |
26 | DLBCL, R/R | EPCOR-GemOx | SC | 48 | Yes | Mandatory | Post-dose CS | 27 | 38 | 4 | 0 | 0 | NR | 19 | |
NCT03671018 | 63 | DLBCL (60), FL (3), R/R | MOSUN-pola | IV | 30 | Yes | Optional | 16 | 2 | 0 | 0 | 0 | 8 | 0 | |
NCT03533283 | 59 | Mixed, R/R | GLOFIT-pola | IV | 10 (6), 30 (53) | Yes | NR | GLOFIT from C1D8 | 29 | 12 | 0 | 0 | 2 | 24 | 11.9 |
NCT04246086 | 29 | FL, R/R | MOSUN-len | IV | 30 | Yes | Optional | 24 | 3 | 0 | 0 | 0 | 14 | 0 | |
NCT04663347 | 29 | FL, R/R | EPCOR-R-len | SC | 2 (3), 48 (26) | Yes | Mandatory | Post-dose CS | 28 | 14 | 7 | 0 | 0 | NR | NR |
Trial ID . | N. . | Histology, setting . | Drug(s) . | Route . | Full dose, mg . | Mitigation strategies during C1 . | % CRS‡ . | % serious CRS . | % toci use . | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
SUD . | Hosp∗ . | Other† . | G1 . | G2 . | G3 . | G4 . | G5 . | ||||||||
NCT03677154 | 29 | DLBCL, ND | MOSUN | IV | 13.5 (8), 30 (21) | Yes | Mandatory | 17 | 3 | 0 | 0 | 0 | NR | 0 | |
NCT02500407 | 197 | Mixed, R/R | MOSUN | IV | 2.8-40.5 | Yes§ | Optional only in exp. cohorts | 21 | 6 | 1 | 0 | 0 | 7 | 1.5 | |
90 | FL, R/R | MOSUN | IV | 30 | Yes | Optional | 26 | 17 | 1 | 1‖ | 0 | NR | 7.8 | ||
39 | Mixed, R/R | MOSUN | SC | 45 | Yes | Optional | 11 | 4 | 0 | 0 | 0 | 178 | 10.3 | ||
27 | Mixed, R/R | MOSUN, rapid SUD | SC | 45 | Yes | Optional | 33 | 8 | 0 | 0 | 0 | 4 | 0 | ||
NCT03075696 | 258 | Mixed, R/R | GLOFIT | IV | 0.6-30 | Yes§ | Mandatory | Obin¶ | 31 | 23 | 4 | 2 | 0 | 36 | 20% at RP2D |
155 | DLBCL, R/R | GLOFIT | IV | 30 | Yes | Mandatory | Obin¶ | 47 | 12 | 3 | 1 | 0 | NR | 32 | |
24 | FL, R/R | GLOFIT | IV | 16 (3), 30 (21) | Yes | Mandatory | Obin¶ | 63 | 13 | 4 | 0 | 0 | 50 | 8.3 | |
29 | FL, R/R | GLOFIT, ext. SUD | IV | 30 | Yes | Mandatory | Obin¶ | 35 | 21 | 0 | 0 | 0 | 31 | 21 | |
19 | FL, R/R | GLOFIT-obin | IV | 30 | Yes | Mandatory | Obin¶ | 53 | 26 | 0 | 0 | 0 | 26 | 26 | |
29 | MCL, R/R | GLOFIT | IV | 0.6-30 | Yes§ | Mandatory | Obin¶ | 35 | 21 | 0 | 3 | 0 | 38 | 24 | |
NCT03625037 | 68 | Mixed, R/R | EPCOR | SC | 0.0128-60 | Yes§ | Mandatory | Post-dose CS | 29 | 29 | 0 | 0 | 0 | NR | 0 |
157 | LBCL, R/R | EPCOR | SC | 48 | Yes | Mandatory | Post-dose CS | 32 | 15 | 2 | 0 | 0 | NR | 14 | |
NCT04082936 | 40 | Mixed, R/R | IgM2323 | IV | 0.5-1000 | Yes§ | Mandatory | 18 | 5 | 3 | 0 | 0 | NR | NR | |
NCT02924402 | 64 | Mixed, R/R | PLAMO | IV | 0.7-450ug/Kg, or 50 | Yes§ | NR | 19 | 33 | <1 | <1 | 0 | NR | NR | |
NCT02290951 | 145 | Mixed, R/R | ODRON | IV | 0.5-320 | Yes | Mandatory | Split-dose | 36 | 18 | 6 | 1 | 0 | NR | NR |
NCT03677141 | 40 | DLBCL, ND | MOSUN-CHOP | IV | 30 | Yes | NR | 40 | 13 | 0 | 0 | 0 | NR | 5 | |
NCT03467373 | 31 | Mixed, R/R | GLOFIT-R-CHOP | IV | 0.07-30 | Yes§ | Mandatory | GLOFIT from C2 | 32 | 13 | 10 | 0 | 0 | 26 | 26 |
26 | DLBCL, ND | GLOFIT-R-CHOP | IV | 30 | Yes | Mandatory | GLOFIT from C2 | 4 | 4 | 0 | 0 | 0 | 0 | 0 | |
NCT04663347 | 24 | DLBCL, ND | EPCOR-R-CHOP | SC | 24 (4), 48 (20) | Yes | Mandatory | Post-dose CS | 17 | 17 | 4 | 0 | 0 | NR | NR |
29 | DLBCL, R/R | EPCOR-R-DHAX | SC | 48 | Yes | Mandatory | Post-dose CS | 38 | 28 | 10 | 0 | 0 | NR | 7 | |
26 | DLBCL, R/R | EPCOR-GemOx | SC | 48 | Yes | Mandatory | Post-dose CS | 27 | 38 | 4 | 0 | 0 | NR | 19 | |
NCT03671018 | 63 | DLBCL (60), FL (3), R/R | MOSUN-pola | IV | 30 | Yes | Optional | 16 | 2 | 0 | 0 | 0 | 8 | 0 | |
NCT03533283 | 59 | Mixed, R/R | GLOFIT-pola | IV | 10 (6), 30 (53) | Yes | NR | GLOFIT from C1D8 | 29 | 12 | 0 | 0 | 2 | 24 | 11.9 |
NCT04246086 | 29 | FL, R/R | MOSUN-len | IV | 30 | Yes | Optional | 24 | 3 | 0 | 0 | 0 | 14 | 0 | |
NCT04663347 | 29 | FL, R/R | EPCOR-R-len | SC | 2 (3), 48 (26) | Yes | Mandatory | Post-dose CS | 28 | 14 | 7 | 0 | 0 | NR | NR |
The table separates single-agent studies (upper portion) from combination studies (lower portion). Data generally refer to the CRS episode with highest frequency and/or of the highest grade following BsAb dosing. These varied among trials. Virtually all patients received acetaminophen, antihistamine, and corticosteroids premedication. The distinction between CTCAE-defined infusion-related reaction and CRS was either not explicitly made or left at the treating physician's discretion, thus it is possible that the true incidence of CRS be different than reported in some studies.
C, cycle; CS, corticosteroids; (D)LBCL, (diffuse) large B-cell lymphoma; EPCOR, epcoritamab; esc, escalation; exp, expansion; FL, follicular lymphoma; GLOFIT, glofitamab; G, grade; len, lenalidomide; hosp, hospitalization; MCL, mantle cell lymphoma; MOSUN, mosunetuzumab; ND, newly diagnosed, NR, not reported; obin, obinutuzumab; ODRON, odronextamab; PLAMO, plamotamab; pola, polatuzumab, RP2D, recommended phase-2 dose; R/R relapsed/refractoy; SC, subcutaneous; SUD, step-up dosing; toci, tocilizumab.
Prescribed on the day of expected highest risk of CRS.
In all reported studies, corticosteroids were used as part of the premedication during cycle 1 and, in some cases cycle 2.
Incidence as reported by authors, separately reported single components are not listed in this table.
Performed in only part of the study population, for example, at certain dose levels or in expansion cohorts only.
Patient with leukemic phase FL.
Generally administered on cycle 1, day 7; defined according to the ASBMT consensus criteria.