Multicenter Phase II Study of Mosunetuzumab and Polatuzumab Vedotin With Split-Dose CHP Chemotherapy for Elderly Patients With Diffuse Large B-Cell Lymphoma

This single-arm, interventional phase 2 study is designed to evaluate whether the inclusion of mosunetuzumab subcutaneous and polatuzumab vedotin (Mosun-Pola) to a split-dose CHP chemotherapy backbone will improve outcomes for elderly patients with a new diagnosis of diffuse large B-cell lymphoma.

开始日期2024-12-01

申办/合作机构

Medical College of Wisconsin

NCT06569680 / Recruiting临床2期IIT

Phase II Trial of Mosunetuzumab in Patients With Newly Diagnosed Extranodal Marginal Zone Lymphoma (EMZL) (ML44933)

The purpose of this study is to test a new medication called Mosunetuzumab to see if it can help people with Extranodal Marginal Zone Lymphoma (EMZL). This study will include people who have not yet received any treatment for cancer and whose cancer is in stage I-IV. This study will help doctors understand if Mosunetuzumab improves outcomes in people with EMZL and if it is safe to use.

开始日期2024-11-19

申办/合作机构

University of Miami

[+1]

100 项与莫妥珠单抗相关的临床结果

登录后查看更多信息

100 项与莫妥珠单抗相关的转化医学

登录后查看更多信息

100 项与莫妥珠单抗相关的专利（医药）

登录后查看更多信息

项与莫妥珠单抗相关的文献（医药）

2025-01-01·EUROPEAN JOURNAL OF HAEMATOLOGY

Comparative Analysis of Bispecific Antibodies and CAR T‐Cell Therapy in Follicular Lymphoma

Review

作者: Talami, Annalisa ; Morabito, Fortunato ; Martino, Massimo ; Gentile, Massimo ; Martino, Enrica Antonia ; Nizzoli, Maria Elena ; Neri, Antonino ; Pozzi, Stefano

ABSTRACT:

The treatment landscape for relapsed/refractory follicular lymphoma (RR‐FL) is marked by a pivotal debate between chimeric antigen receptor T‐cell (CAR‐T) therapy and bispecific antibodies (BsAbs). While both CAR‐T therapy and BsAbs target similar immunobiology and molecular markers, their efficacy comparisons are hindered by the lack of direct clinical trial comparisons. Key trials, such as the ZUMA‐5 study, underscore axicabtagene ciloleucel (axi‐cel)'s efficacy in treating RR‐FL, achieving a 79% complete response rate with a median duration of response exceeding 3 years. Similarly, lisocabtagene maraleucel (liso‐cel) in the TRANSCEND FL study reports a 94% complete response rate, emphasizing robust outcomes in heavily pretreated patients. Among BsAbs, mosunetuzumab showed promise in the GO29781 trial, with a 62% overall response rate in heavily pretreated RR‐FL patients. Thus, CAR‐T therapy offers potential curative benefits with a single infusion. However, its efficacy is tempered by significant adverse events such as cytokine release syndrome (CRS), neurotoxicity, and cytopenias, requiring specialized management and patient monitoring. In contrast, BsAbs provide a more tolerable treatment option counterbalancing by lower response rates and frequent dosing requirements. Personalized treatment strategies are crucial because of these distinct efficacy and safety profiles. When considering cost‐effectiveness, both therapies need to be evaluated in the context of their clinical outcomes and quality of life improvements. Cost‐effectiveness considerations are essential; while CAR‐T therapies incur higher initial costs, their potential for long‐term remission may mitigate expenses associated with repeated treatments or hospitalizations. Future research into resistance mechanisms and optimal therapeutic sequencing will further refine RR‐FL management strategies.

2024-12-31·mAbs

A pivotal decade for bispecific antibodies?

Article

作者: Surowka, Marlena ; Klein, Christian

Bispecific antibodies (bsAbs) are a class of antibodies that can mediate novel mechanisms of action compared to monospecific monoclonal antibodies (mAbs). Since the discovery of mAbs and their adoption as therapeutic agents in the 1980s and 1990s, the development of bsAbs has held substantial appeal. Nevertheless, only three bsAbs (catumaxomab, blinatumomab, emicizumab) were approved through the end of 2020. However, since then, 11 bsAbs received regulatory agency approvals, of which nine (amivantamab, tebentafusp, mosunetuzumab, cadonilimab, teclistamab, glofitamab, epcoritamab, talquetamab, elranatamab) were approved for the treatment of cancer and two (faricimab, ozoralizumab) in non-oncology indications. Notably, of the 13 currently approved bsAbs, two, emicizumab and faricimab, have achieved blockbuster status, showing the promise of this novel class of therapeutics. In the 2020s, the approval of additional bsAbs can be expected in hematological malignancies, solid tumors and non-oncology indications, establishing bsAbs as essential part of the therapeutic armamentarium.

2024-12-31·JOURNAL OF MEDICAL ECONOMICS

Cost-effectiveness analysis of mosunetuzumab for treatment of relapsed or refractory follicular lymphoma after two or more lines of systemic therapy in the United States

Article

作者: Sanchez Alvarez, Javier ; Lin, Shih-Wen ; Parisé, Hélène ; Di Maio, Danilo ; Zuk, Eric ; Matasar, Matthew ; Kim, Eunice ; Shapouri, Sheila

AIMS:

Mosunetuzumab has received accelerated approval by the US Food and Drug Administration for adult patients with relapsed or refractory (R/R) follicular lymphoma (FL) after two or more lines of systemic therapy. We evaluated the cost-effectiveness of mosunetuzumab for the treatment of R/R FL from a US private payer perspective.

MATERIALS AND METHODS:

A partitioned survival model simulated lifetime costs and outcomes of mosunetuzumab against seven comparators: axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), tazemetostat (taz, EZH2 wild-type only), rituximab plus lenalidomide (R-Len) or bendamustine (R-Benda), obinutuzumab plus bendamustine (O-Benda), and a retrospective real-world cohort (RW) based on current patterns of care derived from US electronic health records (Flatiron Health). Efficacy data for mosunetuzumab were from the pivotal Phase II GO29781 trial (NCT02500407). Relative treatment efficacy was estimated from indirect treatment comparisons (ITCs). Costs included were related to treatment, adverse events, routine care, and terminal care. Except for drug costs (March 2023), all costs were inflated to 2022 US dollars. Costs and quality-adjusted life-years (QALYs) were used to calculate incremental cost-effectiveness ratios (ICERs). Net monetary benefit (NMB) was calculated using a willingness-to-pay (WTP) threshold of $150,000/QALY.

RESULTS:

Mosunetuzumab dominated taz, tisa-cel, and axi-cel with greater QALYs and lower costs. Mosunetuzumab was projected to be cost-effective against R-Benda, O-Benda, and RW with ICERs of $78,607, $42,731, and $21,434, respectively. Mosunetuzumab incurred lower costs but lower QALYs vs. R-Len. NMBs showed that mosunetuzumab was cost-effective against comparators except R-Len.

LIMITATIONS:

Without head-to-head comparative data, the model had to rely on ITCs, some of which were affected by residual bias. Model inputs were obtained from multiple sources. Extensive sensitivity analyses assessed the importance of these uncertainties.

CONCLUSION:

Mosunetuzumab is estimated to be cost-effective compared with approved regimens except R-Len for the treatment of adults with R/R FL.

320

项与莫妥珠单抗相关的新闻（医药）

2024-12-11

·PipelineReview

ADC Therapeutics Announces Positive Initial Data from LOTIS-7 Clinical Trial Evaluating ZYNLONTA® in Combination with Bispecific Antibody in Patients with Relapsed/Refractory Diffuse Large B-cell Lymphoma

ZYNLONTA in combination with glofitamab demonstrated clinically meaningful benefit with 94% best ORR and 72% CR rate Safety data show no dose-limiting toxicities (DLTs), no high-grade cytokine release syndrome (CRS) or high-grade immune effector cell-associated neurotoxicity syndrome (ICANS) across all patients Company to host conference call today at 8:30 a.m. EST LAUSANNE, Switzerland I December 11, 2024 I ADC Therapeutics SA (NYSE: ADCT ), a commercial-stage global leader and pioneer in the field of antibody drug conjugates (ADCs), today announced positive initial data from the LOTIS-7 Phase 1b open-label clinical trial evaluating the safety and efficacy of ZYNLONTA ® in combination with the bispecific antibody glofitamab (COLUMVI ™ ) in patients with relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL). “We are excited by the strong initial results observed with ZYNLONTA plus glofitamab in second line plus patients with relapsed or refractory DLBCL,” said Mohamed Zaki, MD, PhD, Chief Medical Officer of ADC Therapeutics. “We believe these data support our hypothesis that combining these two potent, approved, single-agent-drugs with complementary mechanisms of action will yield additive or synergistic efficacy, and a manageable safety profile given no overlapping non-hematologic toxicities, enabling administration across care settings. We are encouraged by the initial promising safety and efficacy data at both doses tested in the expansion arm.” Initial Clinical Data from Phase 1b LOTIS-7 Trial LOTIS-7 is an ongoing Phase 1b global multicenter, multi-arm study in patients with relapsed or refractory (r/r) B-cell non-Hodgkin lymphoma (B-NHL) including Part 1 (dose escalation) and Part 2 (dose expansion). As of the November 20, 2024 cutoff date, a total of 29 B-NHL patients from Part 1 and Part 2 across all dose levels were treated and evaluated for safety. An initial efficacy analysis was conducted on all 18 evaluable 2L+ DLBCL patients who received dose levels of 120 µg/kg (n=9) or 150 µg/kg (n=9) of ZYNLONTA plus the bispecific antibody glofitamab: Encouraging efficacy data was observed across patients with different numbers of lines and types of prior treatments and across different histologies. Initial safety data on all 29 patients suggest that ZYNLONTA plus glofitamab is generally well tolerated with no DLTs across all dose levels: “These compelling initial results support the potential of ZYNLONTA plus the bispecific glofitamab to be a best-in-class combination in a highly competitive market,” said Ameet Mallik, Chief Executive Officer of ADC Therapeutics. “We look forward to completing enrollment of dose expansion in the first half of 2025 and plan to engage with regulatory authorities on the path forward as data including additional patients with longer follow-up become available.” Conference Call Information To access the conference call, please register here . The participant toll-free dial-in number is 1-800-836-8184 for North America and Canada. It is recommended that you join 10 minutes before the event, though you may pre-register at any time. A live webcast of the call will be available under “Events and Presentations” in the Investors section of the ADC Therapeutics website at ir.adctherapeutics.com . The archived webcast will be available for 30 days following the call. About LOTIS-7 LOTIS-7 is a Phase 1b global multicenter, multi-arm study in patients with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL) including Part 1 (dose escalation) and Part 2 (dose expansion). The three dosing arms include ZYNLONTA plus polatuzumab vedotin, ZYNLONTA plus glofitamab, and ZYNLONTA plus mosunetuzumab T-cell-engaging bispecific monoclonal antibodies (BsAbs). Enrollment in LOTIS-7 includes Part 1 of the study with a 3+3 dose escalation in 3L/3L+ heavily pre-treated patients with ZYNLONTA doses starting at 90 µg/kg and then proceeding to 120 µg/kg and 150 µg/kg. Part 2 includes dose expansion in 2L/2L+ large B-cell lymphoma in the ZYNLONTA plus glofitamab arm at dose levels determined from Part 1 (120 µg/kg and 150 µg/kg of ZYNLONTA plus the approved dosing of glofitamab). Primary endpoints of the study include safety and tolerability. Secondary efficacy endpoints include ORR, DOR, CRR, PFS, RFS, and OS as well as pharmacokinetics and immunogenicity. For more information about the LOTIS-7 trial, visit clinicaltrials.gov (NCT04970901). About ADC Therapeutics ADC Therapeutics (NYSE: ADCT ) is a commercial-stage global leader and pioneer in the field of antibody drug conjugates (ADCs). The Company is advancing its proprietary ADC technology to transform the treatment paradigm for patients with hematologic malignancies and solid tumors. ADC Therapeutics’ CD19-directed ADC ZYNLONTA (loncastuximab tesirine-lpyl) received accelerated approval by the FDA and conditional approval from the European Commission for the treatment of relapsed or refractory diffuse large B-cell lymphoma after two or more lines of systemic therapy. ZYNLONTA is also in development in combination with other agents and in earlier lines of therapy. In addition to ZYNLONTA, ADC Therapeutics has multiple ADCs in ongoing clinical and preclinical development. ADC Therapeutics is based in Lausanne (Biopôle), Switzerland, and has operations in London and New Jersey. For more information, please visit https://adctherapeutics.com/ and follow the Company on LinkedIn . ZYNLONTA ® is a registered trademark of ADC Therapeutics SA. SOURCE: ADC Therapeutics

抗体药物偶联物临床结果临床1期上市批准加速审批

2024-12-11

·GlobeNewswire-Health Care

Five-year results confirm Roche’s Polivy combination therapy as new standard of care for previously untreated aggressive lymphoma

Exploratory long-term follow-up analysis of the phase III POLARIX study indicated a positive trend in overall survival in favour of Polivy in combination with R-CHP for people with first-line diffuse large B-cell lymphoma (DLBCL)1 Patients treated with Polivy in combination with R-CHP required fewer subsequent treatments, potentially reducing burdens on patients and healthcare systems1 These encouraging five-year results continue to highlight the potential of this Polivy combination to improve outcomes in first-line DLBCL, an area that previously had little advancement in nearly two decades 8 December 2024 - Roche (SIX: RO, ROG; OTCQX: RHHBY) announced today data from a five-year follow-up of the pivotal phase III POLARIX study evaluating Polivy® (polatuzumab vedotin) in combination with MabThera®/Rituxan® (rituximab), cyclophosphamide, doxorubicin and prednisone (R-CHP) in people with untreated diffuse large B-cell lymphoma (DLBCL). Data were presented in an oral session at the 66th American Society of Hematology (ASH) Annual Meeting and Exposition, 7-10 December 2024 in San Diego, US. This latest analysis conducted after a median follow-up of 60.9 months, includes descriptive data on primary and secondary endpoints, as well as safety results.1 “POLARIX was the first trial to elevate treatment standards for frontline diffuse large B-cell lymphoma in 20 years and we are additionally encouraged by the five-year follow-up results,” said Levi Garraway, MD, PhD, Roche’s Chief Medical Officer and Head of Global Product Development. “More than 38,000 people worldwide have been treated with Polivy in combination with R-CHP and these data continue to underscore its potential to improve outcomes for people diagnosed with this aggressive lymphoma.” Follow-up exploratory analysis after five-years indicated a positive trend in overall survival (OS) in the intent-to-treat (ITT) population in favour of Polivy in combination with R-CHP compared to MabThera/Rituxan plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). Results showed a trend in reduction in the risk of death (HR 0.85; 95% CI: 0.63–1.15) for people with previously untreated DLBCL with the Polivy combination, an improvement on the three-year follow-up data (HR 0.94; 95% CI: 0.67–1.33). The five-year analysis of POLARIX indicates that the full difference in OS between treatment arms has yet to be observed and an additional two years of follow-up will continue.1 “Diffuse large B-cell lymphoma is a notoriously challenging cancer to treat, however, Polivy in combination with R-CHP has shown to be a critical advance for patients by helping to reduce relapse and disease progression,” said Gilles Salles, MD, PhD, Chief of Lymphoma Service, Division of Hematological Malignancies, Memorial Sloan Kettering Cancer Center, US. “The survival trend seen in this follow-up analysis reinforces the potential impact of frontline treatment with Polivy in combination with R-CHP and its role as a standard of care therapy.” In addition to the positive trend in OS, an observational analysis suggested nearly 25% fewer follow-up treatments such as radiation, systemic chemotherapy and CAR-T cell therapy were needed in patients receiving Polivy in combination with R-CHP compared to those treated with R-CHOP (38.3% vs 61.7%).1 Based on findings from a previous economic analysis which found that total healthcare costs increased with each additional line of treatment in relapsed or refractory DLBCL, a reduction in the number of subsequent therapies could potentially alleviate some of the burdens associated with relapse and disease progression.2 At five years of follow-up, benefits in progression-free survival and disease-free survival with Polivy in combination with R-CHP were maintained, consistent with the three-year follow-up data, reinforcing the potential of Polivy in combination with R-CHP to provide durable and lasting remissions. The latest follow-up data also showed a numerical reduction in death related to patients’ lymphoma in those treated with Polivy in combination with R-CHP compared to those treated with R-CHOP (9.0% vs 11.4%). The safety profile remains consistent with the known profiles of the individual study medicines with no new safety signals observed, reinforcing the positive benefit-risk profile of this Polivy combination.1 Results from an expanded cohort of 1,000 patients including global and Chinese patients demonstrated comparability to the global ITT population.1 Polivy in combination with R-CHP is currently approved for the treatment of first-line (1L) DLBCL in more than 90 countries worldwide including the US, countries throughout the EU, the UK, Japan, Canada and China. Roche continues to work with health authorities around the world to bring this treatment regimen to even more patients. Roche aims to offer various treatment options for DLBCL that meet the diverse needs of patients and healthcare systems. In an effort to elevate treatment standards even further, Roche is exploring Polivy in combination with other molecules including its bispecific antibodies. Studies include the phase III SUNMO trial evaluating the efficacy and safety of subcutaneously administered Lunsumio® (mosunetuzumab) in combination with intravenous (IV) Polivy versus IV MabThera/Rituxan plus gemcitabine and oxaliplatin (R-GemOx) in second-line or later DLBCL, and the phase III SKYGLO trial investigating the efficacy of Polivy in combination with R-CHP and Columvi® (glofitamab) versus Polivy in combination with R-CHP in 1L DLBCL. POLARIX [NCT03274492] is an international phase III, randomised, double-blind, placebo-controlled study evaluating the efficacy, safety and pharmacokinetics of Polivy® (polatuzumab vedotin) plus MabThera®/Rituxan® (rituximab), cyclophosphamide, doxorubicin, and prednisone (R-CHP) versus rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) in people with previously untreated diffuse large B-cell lymphoma (DLBCL). Eight-hundred and seventy-nine patients were randomised 1:1 to receive either Polivy plus R-CHP plus a vincristine placebo for six cycles, followed by MabThera/Rituxan for two cycles; or R-CHOP plus a Polivy placebo for six cycles, followed by two cycles of MabThera/Rituxan. The primary outcome measure is progression-free survival (PFS) as assessed by the investigator using the Lugano Response Criteria for malignant lymphoma. PFS is a clinically meaningful disease-related outcome for patients with previously untreated DLBCL as it represents the goal of first-line therapy: decreasing the risk of disease worsening. Overall survival is a secondary endpoint in the POLARIX study. DLBCL is the most common form of non-Hodgkin lymphoma (NHL), accounting for about one in three cases of NHL.3 DLBCL is an aggressive (fast-growing) type of NHL. While it is generally responsive to treatment in the frontline, as many as 40% of people will relapse or have refractory disease, at which time salvage therapy options are limited and survival is short. 4,5 Improving treatments earlier in the course of the disease and providing much needed alternative options could help to improve long-term outcomes. Approximately 160,000 people worldwide are estimated to be diagnosed with DLBCL each year.1,6 Polivy is a first-in-class anti-CD79b antibody-drug conjugate (ADC). The CD79b protein is expressed specifically in the majority of B-cells, an immune cell impacted in some types of non-Hodgkin lymphoma (NHL), making it a promising target for the development of new therapies. Polivy binds to cancer cells such as CD79b and destroys these B-cells through the delivery of an anti-cancer agent, which is thought to minimise the effects on normal cells. Polivy is being developed by Roche using Pfizer ADC technology and is currently being investigated for the treatment of several types of NHL. Roche has been developing medicines for people with malignant and non-malignant blood diseases for more than 25 years; our experience and knowledge in this therapeutic area runs deep. Today, we are investing more than ever in our effort to bring innovative treatment options to patients across a wide range of haematologic diseases. Our approved medicines include MabThera/Rituxan, Gazyva®/Gazyvaro® (obinutuzumab), Polivy, Venclexta®/Venclyxto® (venetoclax) in collaboration with AbbVie, Hemlibra® (emicizumab), PiaSky® (crovalimab), Lunsumio® (mosunetuzumab) and Columvi® (glofitamab). Our pipeline of investigational haematology medicines includes T-cell engaging bispecific antibody cevostamab, targeting both FcRH5 and CD3 and Tecentriq® (atezolizumab). Our scientific expertise, combined with the breadth of our portfolio and pipeline, also provides a unique opportunity to develop combination regimens that aim to improve the lives of patients even further. Founded in 1896 in Basel, Switzerland, as one of the first industrial manufacturers of branded medicines, Roche has grown into the world’s largest biotechnology company and the global leader in in-vitro diagnostics. The company pursues scientific excellence to discover and develop medicines and diagnostics for improving and saving the lives of people around the world. We are a pioneer in personalised healthcare and want to further transform how healthcare is delivered to have an even greater impact. To provide the best care for each person we partner with many stakeholders and combine our strengths in Diagnostics and Pharma with data insights from the clinical practice. For over 125 years, sustainability has been an integral part of Roche’s business. As a science-driven company, our greatest contribution to society is developing innovative medicines and diagnostics that help people live healthier lives. Roche is committed to the Science Based Targets initiative and the Sustainable Markets Initiative to achieve net zero by 2045. Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan. References [1] Gilles S, et al. Five-Year Analysis of the POLARIX Study: Prolonged Follow-up Confirms Positive Impact of Polatuzumab Vedotin Plus Rituximab, Cyclophosphamide, Doxorubicin, and Prednisone (Pola-R-CHP) on Outcomes. Presented at: ASH Annual Meeting and Exposition; 2024 Dec 7-10; San Diego, CA, USA. Abstract #469. [2] Gatwood J, et al. Total cost of care in Relapsed/Refractory (R/R) Diffuse Large B-Cell Lymphoma (DLBCL). Presented at: ASH Annual Meeting and Exposition; 2022, Dec 10-13. Abstract #3527 [3] Cancer.Net. Lymphoma - Non-Hodgkin: Subtypes. [Internet; cited December 2024]. Available from: https://www.cancer.net/cancer-types/lymphoma-non-hodgkin/subtypes [4] Sehn LH, et al. Diffuse Large B-Cell Lymphoma. N Engl J Med. 2021;384(9):842-858. [5] Maurer MJ, et al. Event-free survival at 24 months is a robust end point for disease-related outcome in diffuse large B-cell lymphoma treated with immunochemotherapy. J Clin Oncol. 2014;32:1066-73. [6] World Health Organization. Numbers derived from GLOBOCAN 2022. Non-Hodgkin Lymphoma Factsheet [Internet; cited December 2024]. Available from: https://gco.iarc.who.int/media/globocan/factsheets/cancers/34-non-hodgkin-lymphoma-fact-sheet.pd. The content above comes from the network. if any infringement, please contact us to modify.

临床结果ASH会议上市批准

2024-12-11

·药智网

中国TCE双抗，走在世界前列

在许多领域中，总有一些挑战能引发人们浓厚的兴趣，就像某些复杂的数学游戏中不足2.7%的单一数字中奖率仍是很多人“以小博大”的最佳选择。而在中国医药产业中，另一场全球300余家企业积极参与的竞争却正在上演，即“TCE双抗”的新药研发。不过，近日关于这场竞争也有了些许阶段性成果，恩沐生物、岸迈生物、同润生物、嘉和生物等多家中国Biotech企业成功拔得头筹，半年超10亿美元的首付款交易，引全球新药行业关注。何为TCE双抗？所谓TCE双抗，简单来说，就是一种链接T细胞和肿瘤的衔接器疗法，能够同时结合肿瘤相关抗原和T细胞上CD3的靶点。结构上，TCE双抗一端是以CD3 为代表的免疫细胞激活位点，另一端则为肿瘤靶向端，与肿瘤细胞表面抗原结合。作用上，通过TCE双抗，机体内的T细胞可以被有效聚集于肿瘤细胞周围，以T细胞激活实现肿瘤杀伤。机制上，TCE双抗与需要多种免疫过程介导的单抗不同，其不依赖NK细胞、巨噬细胞等机制杀伤肿瘤，而是可以直接激活T细胞。 TCE双抗在临床应用方面的对手主要为单抗、ADC、CAR-T三者：与常规的IgG相比，机制上TCE被认为比传统Fc介导的ADCC（细胞杀伤作用）更有效。与ADC相比，TCE的细胞毒性仅依赖于宿主自身的免疫系统，非化学有效载荷的细胞毒性，且主要攻击休眠状态和积极分裂的癌细胞，安全性更好。与CAR-T相比，其虽常被称为“低配版CAR-T”，虽是两种完全不同的药物形式，但在作用机制方面有相似性，均依靠T细胞行使主要职能，但TCE不需要利用基因技术对T细胞进行改造，无需定制化且制作成本相对较低，更具有实际应用价值。图注：CAR-T与TCE的作用机制对比图片来源：博药因此，TCE以其独特优势在市场上的关注度越来越高，目前不仅占据了全球双抗研发的半壁江山。并且随着其成药性愈发确定，其相较多种疗法的优势也在进一步放大，甚至在T细胞干预疗法中，对比CAR-T、TCR-T、TIL等机理疗法，也正在脱颖而出。血液瘤 TCE双抗的过去在过去很长一段时间里，TCE双抗的重点方向都是围绕着血液肿瘤在进行（或许现在也是），这一方面是由于血液系统肿瘤细胞可以直接暴露于T细胞之前，使得TCE双抗可以更好地行使作用；另一方面则是由于治疗过程中对B细胞与骨髓细胞造成的误伤，可以通过造血干细胞进行再补充，弱化其副作用。当然，TCE双抗与Car-t类似的作用机制也导致其面临与Car-t相类似的局限性，比如T细胞浸润的局限性、免疫抑制性肿瘤微环境（TME）的阻碍、非肿瘤组织靶向的毒性风险与T细胞功能耗竭等，这也导致TCE在实体瘤方面的推进相对缓慢。截至目前，全球获批上市的11款TCE双抗（一款退市）中，针对骨髓瘤、淋巴瘤等血液肿瘤的品种共有8款，占比72.7%（下图）。数据来源：药智数据其中，Lindis的catumaxomab虽是历史上第一款获批上市的TCE双抗，但最终折戟于商业化，无奈退市。因此，严格意义上，安进与百济神州的blinatumomab才是历史上第一款商业化成功的TCE双抗。而从2014年到如今，整整十年的快速发展，血液肿瘤TCE双抗领域内也发生了不少变化，上市血液TCE产品从CD19逐渐演变至CD20、BCMA与Gprc5d的组合。当然，随着越来越多血液肿瘤靶向端的新靶点的发现，在研血液瘤TCE方面则还有更多有潜力的组合亟待验证，比如在AML病例中高表达的关键靶点CD123，目前就有赛诺菲、Xencor、强生、赛诺菲等多家企业布局。 CD3xCD19 作为TCE领域严格意义上的第一款商业化产品，其肿瘤靶向端选择的是CD19，而CD19又高表达于大多数急性淋巴细胞白血病（ALL）、慢性淋巴细胞白血病（CLL）和B细胞淋巴瘤（在其他多数B细胞恶性肿瘤中表达较低），因此该组合下的主要适应症基本围绕淋巴细胞白血病进行。数据来源：药智数据目前，全球范围内CD3xCD19靶点组合仅有安进与百济神州的Blinatumomab获批上市，适应症为前体B细胞急性淋巴细胞白血病与急性淋巴细胞白血病等，而基于其优异的临床表现，其自2014年12月上市以来，全球销售额稳定增长，年增速保持在20%-55%，从2015年的0.8亿美元增长到2022年的5.8亿美元，年复合增长率达24.3%。2023年该产品销售额更是获得了大幅度增长，销售额达到了8.61亿美元。数据来源：药智数据而在研药物方面，CD3xCD19双抗的数量则相对较多，并且在该领域内中国Biotech企业占比较大，具有代表意义就有同润生物的CD3xCD19双抗CN201，其通过增加Fc段进行了结构优化，延长了药物的半衰期，可实现了每周一次输注（Blinatumomab需连续28天24h持续静脉输注），使治疗便捷性大幅提升。而在双抗之外，国内布局CD19多抗的企业同样不少，恩沐生物、博锐生物、惠和生物与百利药业等知名Biotech企业就是显著代表，几乎占据了TCE血液肿瘤多抗的主导地位。 CD3xCD20 如果说CD3xCD19的组合是TCE双抗的先驱，那么CD3xCD20就是TCE双抗的发扬者，同时其也是该领域竞争最激烈的靶点组合，靶向B细胞来源的肿瘤细胞表面CD20抗原的特点，也导致其适应症清一色集中于淋巴瘤方向（细分领域有所不同）。数据来源：药智数据目前，CD3xCD20是获批上市TCE双抗中数量最多的组合，共有4款获批，包括罗氏的Glofitamab和Mosunetuzumab，艾伯维的Epcoritamab以及再生元的Odronextamab。数据来源：药智数据而在研板块，国内领域，相同靶点、相同适应症范围的产品布局不多，进入临床阶段的管线主要有康诺亚（CM-355）、天广实（MBS-303）嘉和生物（GB-261）、君实生物（JS203）和正大天晴（TQB2825）等。 BCMAxCD3 BCMA靶点主要表达于成熟B淋巴细胞及浆细胞表面，通过介导下游信号通路，对多发性骨髓瘤（MM）细胞的存活、增殖、转移和耐药中起着关键性的作用，被视为治疗MM的极具潜力的抗原靶点。 BCMAxCD3双抗通过同时结合T细胞上的CD3受体与MM细胞表面高表达的BCMA，激活并重定向细胞毒性T淋巴细胞（CTL）至肿瘤细胞处以介导其死亡。数据来源：药智数据目前共有2款BCMAxCD3双抗获批上市，分别为强生/Genmab的Teclistamab以及辉瑞的Elranatamab，适应症均为治疗复发或难治性（R/R）多发性骨髓瘤（MM）患者。数据来源：药智数据国内布局BCMAxCD3双抗的Biotech亦有不少，其中具有代表意义的有岸迈生物（EMB-06）、智翔金泰（GR-1803）、康诺亚（CM336）等。 CD3xGprc5D GPRC5D是一种孤儿G蛋白偶联受体，不仅在MM细胞表面高表达，并且独立于BCMA特异性高表达，既可单靶向也可双靶向开发治疗药物，使得GPRC5D成为继BCMA后又一极具潜力的MM治疗靶点。数据来源：药智数据目前全球范围内仅有一款CD3xGRPC5D双抗获批上市，即强生/Genmab的Talquetamab，适应症为复发或难治性多发性骨髓瘤患者。数据来源：药智数据国内布局CD3xGRPC5D双抗的Biotech主要有维立志博（LBL-034）、齐鲁制药（QLS-32015）、正大天晴（TQB-2029）；布局GRPC5D三抗的Biotech主要有天广实生物（MBS-314）、先祥医药（SIM-0500）等。自免 TCE双抗的现在纵然，对于绝大多数企业而言，等待头部Biotech企业解决了创新技术的“成药性与商业化”问题后再入局，不失为最保险的方式，但同时这种模式下也导致企业很难获得先发优势，尤其是在如今创新药内卷的大行情之下。同时，合适入局绝大多数情况下还需要考虑市场因素，如技术难点能否解决、人才缺口能否满足，融资人市场认可度等，因此选择一个合适时机入局，是绝大多数Biotech企业都在重点思考的内容。今年4月，Georg Schett教授在Nature Medicine期刊发表了一篇TCE应用于自免疾病的研究论文，也正是这篇论文，让TCE双抗的市场导向发生重大转折，TCE双抗在自免疾病的潜力逐渐得到了市场的认可。而从原理上讲，TCE双抗在自免疾病领域能引起市场关注，主要可归因于两者，一者是TCE双抗可更直接、更有效地清除B细胞，另一个则是自免疾病的临床需求正好与TCE双抗在肿瘤的局限性相匹配。对于前者而言，由于自身免疫性疾病可以分为两种类型，一种是T细胞介导的免疫反应，另一种则是B细胞介导的免疫反应，前者主要为自身免疫反应过度损失自身组织，后者则是B细胞产生的自身抗体介导免疫反应，也是单抗、TCE双抗、CAR-T等疗法的主要作用点，类风湿关节炎就是最常见的疾病代表。而单抗、TCE双抗与CAR-T等多种创新疗法，其作用机制就是通过各种手段清除B细胞，继而减轻自身免疫反应，以此达到疾病缓解的目的。而理论上，TCE双抗的作用更为直接，更深度、更持久的清除B细胞，达到持续治疗B细胞介导的自免疾病。对于后者而言，由于TCE双抗在肿瘤领域的最大研发难题在于，如何合理控制CD3抗体的亲和力，如何找到最佳靶向杀伤和细胞因子释放之间的平衡。以往经验告诉我们，过高的亲和力会导致对T细胞的招募能力过强，以至于治疗过程中会出现更多的细胞因子风暴，导致药物的安全性下降；而过低的亲和力又会导致药品的有效性不足，难以与多数其他疗法拉开差距，临床价值不够。而自免疾病与肿瘤治疗不同，其现阶段的临床诉求主要围绕控制症状、减少炎症反应和延缓疾病进展进行，并非完全清楚所有的异常细胞，这一点上，正好与TCE双抗在肿瘤治疗上的局限性相匹配，在保证足够安全性的同时，也能让较低有效性的特点发挥作用。数据来源：药智数据截至目前，全球进入临床阶段的自免TCE双/多抗超过10款，其中多数适应症集中于系统性红斑狼疮与类风湿关节炎等疾病，而原研企业方面，海外MNC与国内Biotech所占比例将近。数据来源：药智数据海外药企方面，Cullinan Therapeutics、IGM Biosciences与Xencor是比较具有代表意义的企业。 IGM Biosciences是海外较早布局CD3双抗的企业，早期靶点较分散，同时涉及肿瘤与自免领域，后专注于自免领域，目前，在研管线中进展最快的是CD20xCD3双抗Imvotamab，系统性红斑狼疮与类风湿关节炎适应症均已进入临床I期。 Cullinan 作为海外另一家备受关注的TCE双抗Biotech，其CD19/CD3双抗CLN-978早前刚刚进入临床阶段，成为首个FDA批准自免适应症IND的CD19 T细胞衔接器疗法，其疗法最大的特点在于经工程改造可实现与CD19的极高亲和力结合（即便是CD19表达量极低的B细胞），另外其还含有一个与人血清白蛋白结合的单结构域抗体，以延长血清半衰期。目前，该创新疗法用于系统性红斑狼疮的适应症也已进入临床I期。国内企业方面，神州细胞的SCTB35针对系统性红斑狼疮的适应症已经进入了临床I期，是所有国内在研自免TCE双抗中研究进度最快的产品，其次亿一生物与天劢源和的A-319也已进入了临床I期间，之后还有不少Biotech企业在该领域有所布局，如天广实生物的MBS-303、岸迈生物的EMB-06、惠和生物的CC-312。实体瘤 TCE双抗的未来虽说，自免疾病现阶段被认为是最适合TCE双抗的疾病领域，但最终自免疾病能否成为TCE双抗的最终讨论却并未得出结论，毕竟一方面自免市场适应症多以小而散的情况分布，无论是患者基数还是大适应症数量都没法与肿瘤相比，另一方面自免领域患者临床教育严重不足、支付意愿不高等特点也导致其短期内的市场天花板不高。因此，在TCE双抗在研领域，国内大部分药企还是选择将TCE双抗的注意力瞄准在实体瘤领域。截至目前，上市产品方面已有两款产品获批实体瘤治疗，分别是Immunocore的Tebentafusp（2022年1月）和安进的Tarlatamab（2024年5月）。数据来源：药智数据其中，Tebentafusp是一款CD3xPMEL组合的双特异性融合蛋白，可以借用T细胞杀伤gp100阳性的黑色素瘤细胞；而Tarlatamab同时靶向DLL3和CD3，可结合癌细胞上的DLL3和T细胞上的CD3，将T细胞募集到小细胞肺癌细胞附近，激活T细胞杀伤肿瘤细胞，适应症为用于治疗在接受铂类化疗期间或之后疾病进展的广泛期小细胞肺癌（ES-SCLC）成人患者。而在研TCE双/多抗方面，实体瘤适应症布局企业则数量庞大，虽疗法多处于早期阶段，却难掩其竞争激烈的现有局面。据数据显示，全球领域实体瘤TCE双/多抗在研管线接近100余款。数据来源：药智数据就临床阶段分布而言，该领域最高临床阶段已达III期，共有两款产品，分别是安进与百济神州的AMG-509与友芝友生物与正大天晴的M-701；而实体瘤适应症阶段达临床II期的管线有25款，临床I期管线数量更多，共计65款产品。数据来源：药智数据从适应症方面来看，实体瘤TCE双/多抗中适应症为实体瘤的管线数量最多，其次是非小细胞肺癌、前列腺癌与胃癌，均有超过10款新药涉及；其次还有胰腺癌、结直肠癌、乳腺癌与卵巢癌等多种大品种肿瘤均有不同数量的新药管线涉及。但与此同时，对于TCE双抗在实体瘤的靶点组合与适应症选择上，海内外却存在一定程度上的差距，全球领域上占比较高的非小细胞肺癌与前列腺癌，国内企业布局并不多，仅有百济神州、岸迈生物、百利药业等几家企业专注于此。反而是在全球领域占比稍低的胃癌、乳腺癌等领域布局较多。这一点上，可以看出国内Bioech的TCE双/多抗脚步显得十分激进，已经在少数癌种中占据了主导地位。齐鲁制药、和铂医药与信达生物等企业选择靶向CLDN18.2与CD3，看重的就是CLDN18.2在胃癌中的高表达特性（在所有胃癌、胰腺癌患者中的阳性率可以达到近60%），因此这一类管线的适应症也几乎都是针对胃癌、胃食管癌与胰腺癌等上消化道肿瘤，其中齐鲁的QLS-31905与和铂医药的HBM-7022目前正处于临床II期阶段。恩沐生物、友芝友生物与爱思迈生物等企业选择靶向HER2和CD3，主要针对HER2阳性耐药性乳腺癌患者，且均采用CD3低亲和力方式，降低T细胞活化所引发的细胞因子释放综合征的毒性。时迈药业的CMD011与智康弘义的BC-3448选择靶向EGFR与CD3，是该领域仅有的两家国内Biotech企业，也是全球4家布局企业之一。结语新靶点、新机制回顾最近半年的TCE双抗，为何恩沐生物一款临床II期的管线值得3亿美元的首付款；为何同润生物一款靶向CD19与CD3的双抗也能值得7亿美元现金首付款；为何近来MNC如此频繁地来中国进货TCE双抗？数据来源：药智数据其实，表面的原因是中国创新药事业在全球范围内有了一定的知名度，MNC企业对中国创新药产品有了一定程度认可，但更深层次的原因，则是中国创新药从“中国新”转向“全球新”取得了初步成效，在TCE双抗这些个别领域，具备了探寻新靶点、新机制的能力，比如：在传统血液瘤领域，同润生物可以通过结构优化实现药物半衰期的大幅延长。在自免领域神州细胞可以做到系统性红斑狼疮研发第一梯队。在实体瘤方向，和铂医药、恩沐生物、友芝友生物等企业可以不盲目跟风非小细胞肺癌与前列腺，转而专注胃癌、乳腺癌等还未被占领的市场。或许，上述绝大多数Biotech企业终其一生都无法走向世界舞台与MNC抗衡，但要相信它们的创新疗法现在已经能获得MNC的关注，并且随着未来再生元、安进、艾伯维、阿斯利康、勃林格殷格翰、诺华、辉瑞、强生等跨国药企对该领域的关注持续增长，还会有更多优秀的TCE双抗走向世界舞台。友情推荐：医药行业深度技术内容，点击“博药”查看详情~ 来源 | 博药（药智网获取授权转载）撰稿 | 头孢责任编辑 | 八角声明：本文系药智网转载内容，图片、文字版权归原作者所有，转载目的在于传递更多信息，并不代表本平台观点。如涉及作品内容、版权和其它问题，请在本平台留言，我们将在第一时间删除。商务合作 | 王存星 19922864877（同微信）阅读原文，是受欢迎的文章哦

细胞疗法免疫疗法抗体药物偶联物引进/卖出

100 项与莫妥珠单抗相关的药物交易

登录后查看更多信息

外链

KEGG	Wiki	ATC	Drug Bank
D11463	-	-	DB15434

研发状态

批准上市

10 条最早获批的记录,

后查看更多信息

适应症	国家/地区	公司	日期
滤泡性淋巴瘤	欧盟	Roche Registration GmbH	2022-06-03
滤泡性淋巴瘤	冰岛	Roche Registration GmbH	2022-06-03
滤泡性淋巴瘤	列支敦士登	Roche Registration GmbH	2022-06-03
滤泡性淋巴瘤	挪威	Roche Registration GmbH	2022-06-03

未上市

10 条进展最快的记录,

后查看更多信息

适应症	最高研发状态	国家/地区	公司	日期
大B细胞淋巴瘤	临床3期	瑞士	Roche Holding AG	2023-05-23
难治性侵袭性非霍奇金淋巴瘤	临床3期	美国	Hoffmann-La Roche, Inc.	2022-04-25
难治性侵袭性非霍奇金淋巴瘤	临床3期	中国	Hoffmann-La Roche, Inc.	2022-04-25
难治性侵袭性非霍奇金淋巴瘤	临床3期	日本	Hoffmann-La Roche, Inc.	2022-04-25
难治性侵袭性非霍奇金淋巴瘤	临床3期	阿根廷	Hoffmann-La Roche, Inc.	2022-04-25
难治性侵袭性非霍奇金淋巴瘤	临床3期	巴西	Hoffmann-La Roche, Inc.	2022-04-25
难治性侵袭性非霍奇金淋巴瘤	临床3期	加拿大	Hoffmann-La Roche, Inc.	2022-04-25
难治性侵袭性非霍奇金淋巴瘤	临床3期	以色列	Hoffmann-La Roche, Inc.	2022-04-25
难治性侵袭性非霍奇金淋巴瘤	临床3期	墨西哥	Hoffmann-La Roche, Inc.	2022-04-25
难治性侵袭性非霍奇金淋巴瘤	临床3期	新西兰	Hoffmann-La Roche, Inc.	2022-04-25

登录后查看更多信息

临床结果

适应症

分期

评价

查看全部结果

研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


ASH2024	N/A	难治性滤泡性淋巴瘤	-	Mosunetuzumab	鏇襯餘願繭齋鏇構膚餘(襯鑰淵淵憲願願願壓淵) = B-cell recovery to detectable levels was observed after a median of 19.0 months (95% CI: 12.8-25.1); immunoglobulin M recovery to the lower limit of normal was observed after a median of 40.7 months (95% CI: 36.1-NE) 襯觸鑰觸鬱網築膚壓獵 (繭糧襯壓窪積遞築鏇網 ) 更多	-	2024-12-09
ASH2024	N/A	难治性套细胞淋巴瘤	-	Mosunetuzumab	廠艱壓鹹齋願遞構鹹鹹(衊襯鹹夢蓋鬱積遞憲積) = The most common adverse events (AEs) were CRS (52%) 簾製鹽廠窪廠選糧鏇鑰 (餘憲醖積顧遞簾鹽憲醖 )	-	2024-12-07
ASH2024	N/A	滤泡性淋巴瘤	-	Mosunetuzumab SC	遞鬱夢顧獵繭壓選襯窪(憲齋淵簾壓衊繭鬱願鬱) = cytokine release syndrome (CRS; 30%) 鏇獵襯餘艱構膚願觸餘 (鏇網鬱窪鑰觸壓構醖壓 ) 更多	-	2024-12-07
NCT05315713 (CTgov)	临床1/2期	滤泡性淋巴瘤 \| 难治性B细胞淋巴瘤	8	Mosunetuzumab SC+tocilizumab+Tiragolumab	積衊膚襯窪遞鹹鬱鹹窪(製獵簾糧艱鬱顧網膚鏇) = 夢網廠襯製網廠獵製構鹽壓鹹齋窪選醖醖鬱窪 (夢壓淵鑰衊醖淵簾糧鏇, 醖願憲廠衊糧範獵齋鑰 ~ 製鏇鏇膚艱獵壓醖襯範) 更多	-	2024-10-04
SOHO2024	N/A	大B细胞淋巴瘤	-	Mosunetuzumab with Polatuzumab Vedotin	製觸鏇廠醖壓夢顧鹽餘(鏇壓衊壓構願網鬱顧糧) = 選鹹獵觸構糧衊壓鑰遞艱廠範選鑰積膚顧襯襯 (艱壓網衊醖襯獵鏇艱醖 ) 更多	-	2024-09-04
SOHO2024	N/A	难治性滤泡性淋巴瘤	-	Mosunetuzumab	艱構廠衊壓鏇鹽蓋網糧(膚糧膚願顧壓窪艱網憲) = CRS events occurred in 44.4% of patients (Grade 3/4, 2.2%); all resolved 蓋遞憲構齋簾鏇鬱願蓋 (範膚網壓壓獵選醖範齋 ) 更多	-	2024-09-04
ASCO2024	N/A	非霍奇金淋巴瘤一线 CD20 \| CD3	124	Mosunetuzumab monotherapy	艱鬱餘簾簾選鑰膚窪鏇(艱憲窪餘網艱觸遞遞選) = common adverse effects given in the table 蓋餘築壓夢築鑰鬱鏇製 (蓋淵構鹽顧鹽網餘蓋鏇 ) 更多	积极	2024-05-24
ASCO2024	N/A	非霍奇金淋巴瘤一线 CD20 \| CD3	124	Mosunetuzumab + CHOP		积极	2024-05-24
NCT02500407 (EHA2024) 人工标引	临床2期	复发性滤泡性淋巴瘤 \| 难治性滤泡性淋巴瘤	90	Mosunetuzumab monotherapy	廠窪廠壓網膚觸網齋鏇(鬱餘範衊廠築鑰窪壓餘) = 憲醖憲憲網憲齋顧壓築築簾餘窪艱網鬱膚窪鹹 (鹽願積鬱網艱淵膚範鑰 ) 更多	积极	2024-05-14
NCT02500407 (EHA2024) 人工标引	临床2期	复发性滤泡性淋巴瘤 \| 难治性滤泡性淋巴瘤	90	Mosunetuzumab monotherapy (POD24)	廠窪廠壓網膚觸網齋鏇(鬱餘範衊廠築鑰窪壓餘) = 獵鹹構膚鏇築齋壓糧廠築簾餘窪艱網鬱膚窪鹹 (鹽願積鬱網艱淵膚範鑰 ) 更多	积极	2024-05-14
NCT05169658 (EHA2024) 人工标引	临床2期	淋巴瘤一线 ctDNA	35	Mosunetuzumab OBINUTUZUMAB	窪鑰範窪製淵淵窪蓋憲(廠窪鹹艱齋願壓簾衊鏇) = 願繭淵襯窪製製選範蓋願醖齋獵鹽顧鏇獵獵壓 (願築鬱憲齋夢鏇願鹹餘 ) 更多	积极	2024-05-14
NCT04313608 (CTgov)	临床1期	高级别B细胞淋巴瘤 \| 复发性弥漫性大B细胞淋巴瘤	23	Tocilizumab+Obinutuzumab+Gemcitabine+Glofitamab+Oxaliplatin (Arm A: Glofit-GemOx)	鹹選顧積簾鑰範淵繭襯(憲壓窪憲鹽淵鹹鬱遞醖) = 繭網餘淵製鬱齋膚壓齋鹹淵糧範觸網蓋構艱淵 (網觸鏇築積遞憲餘願鹹, 製簾網觸獵餘淵醖夢窪 ~ 壓廠繭鏇壓築廠範蓋壓) 更多	-	2024-03-25
NCT04313608 (CTgov)	临床1期	高级别B细胞淋巴瘤 \| 复发性弥漫性大B细胞淋巴瘤	23	Mosunetuzumab+Tocilizumab+Gemcitabine+Oxaliplatin (Arm B: Mosun-GemOx)	鹹選顧積簾鑰範淵繭襯(憲壓窪憲鹽淵鹹鬱遞醖) = 膚鏇淵鑰獵遞簾醖選鬱鹹淵糧範觸網蓋構艱淵 (網觸鏇築積遞憲餘願鹹, 淵築齋餘範鹽繭遞夢築 ~ 繭齋網淵窪艱鑰齋網壓) 更多	-	2024-03-25