The CD20xCD3 bispecific antibody glofitamab was shown to have durable responses when combined with Pola-R-CHP or R-CHOP, according to results from the phase II COALITION trial.
The COALITION trial is an investigator-initiated study, led by Adrian Minson, MBBS, PhD, of the Peter MacCallum Cancer Centre in Australia. The combination is being examined as a first-line treatment in patients 65 years or younger with high-risk large B-cell lymphoma (LBCL). The results were published in the Journal of Clinical Oncology (JCO(R)).
Dr. Minson and colleagues wrote that “patients with high burden or rapid progression are often excluded from first-line trials due to screening requirements,” and that “improved outcomes are needed for patients with high-risk LBCL, who have less than a 50% chance of cure with first-line R-CHOP chemotherapy.” R-CHOP is the standard-of-care treatment in first line LBCL.
In this trial, 80 evaluable patients (median, 58 years) began treatment soon after diagnosis (median, 14 days).
To enroll, patients had to have at least one high-risk feature, defined as an IPI score of 3 or higher, an NCCN-IPI score of 4 or higher, or MYC and BCL2 or BCL6 rearrangement. Patients received one cycle of R-CHOP and were then randomly assigned to five additional cycles of either Glofit-Pola-R-CHP or Glofit-R-CHOP, followed by two cycles of glofitamab consolidation.
Twenty-one percent of patients experienced grade 2 or lower cytokine release syndrome. The patients responded to treatment, with an overall response rate of 100% and a complete response rate of 98%. After a median follow-up of 20.7 months, the estimated two-year progression-free survival was 86% and overall survival was 92%.
“The combination of glofitamab with R-CHOP or Pola-R-CHP is deliverable and results in high rates of durable response in this population of younger patients with high-burden, HR LBCL, supporting its ongoing exploration as a [first-line] treatment,” Dr. Minson and colleagues concluded in the JCO report.
Reference
Minson A, Verner E, Giri P, et al. Glofitamab combined with Pola-R-CHP or R-CHOP as first therapy in younger patients with high-risk large B-cell lymphoma: results from the COALITION study. J Clin Oncol. 2025. doi:10.1200/JCO-25-00481
