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SOHO 2026 | Optimizing glofitamab use in R/R LBCL: insights into dosing and patient selection
Gilles Salles, MD, PhD, Memorial Sloan Kettering Cancer Center, New York, NY, discusses the efficacy of glofitamab in relapsed/relapsed large B-cell lymphoma (R/R LBCL), noting durable complete responses with minimal relapse after two to three years of follow-up. He discusses the step-up dosing schedule, which currently requires hospitalization due to the risk of CRS, as well as combination approaches and the ongoing challenge of optimizing patient selection. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
So glofitamab is a very nice drug and has really demonstrated efficacy in the relapse setting. In third line of therapy, half of the patients respond, about 40% get a CR. And in June, we learned that after five years, patients who have CR remain in CR. There are virtually no relapses after two to three years. So we have a curable drug here. It’s a little bit challenging in terms of the step-up dosing, which at this time requires a lot of precaution and mostly hospitalization for the first or the first dose of glofitamab...
So glofitamab is a very nice drug and has really demonstrated efficacy in the relapse setting. In third line of therapy, half of the patients respond, about 40% get a CR. And in June, we learned that after five years, patients who have CR remain in CR. There are virtually no relapses after two to three years. So we have a curable drug here. It’s a little bit challenging in terms of the step-up dosing, which at this time requires a lot of precaution and mostly hospitalization for the first or the first dose of glofitamab. Remember that before the first dose or second dose, we deliver obinutuzumab to deplete the circulating B cells. So at this point, we mostly admit patients for these two first doses. So one of the challenges really, can we avoid that? Are there indexes that will indicate that this patient is very unlikely to present a CRS? Can we investigate tocilizumab as prophylaxis? Can we investigate markers that will facilitate the use of these bispecific antibodies, knowing that after the step of dosing, it’s one infusion every three weeks, time-limited duration, 12 cycles in total, and an easy combination we have learned with GemOx, we have learned with polatuzumab or loncastuximab. So a wide variety of patients you can treat in second-line setting depending on what they had received initially. So that’s the first thing. The second thing is do we know who are the patients who will respond to bispecific who are better candidates with bispecific? I think we don’t know yet. That’s probably one of the most interesting and challenging questions. Is that the tumor genetic itself? Is that the microenvironment? Is that the T cell, defect in T cell, T cell exhaustion? There is a lot of work going on. We are working on this like other groups. And we do hope that in the near future, we’ll have indices to provide to clinicians to better select patient candidates for bispecific antibodies alone or in combinations.
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