Development

Roche’s Lunsumio combination hits Phase III PFS goal in 2L+ follicular lymphoma

Roche’s Lunsumio combination hits Phase III PFS goal in 2L+ follicular lymphoma

Roche's (SIX: RO, ROP; OTCQX: RHHBY) reported that the Phase III CELESTIMO study of mosunetuzumab (Lunsumio) in combination with lenalidomide met its primary progression-free survival (PFS) endpoint in relapsed or refractory follicular lymphoma.

CELESTIMO is the confirmatory trial required to convert mosunetuzumab's accelerated FDA approval and conditional EU marketing authorization — both held for third-line or later (3L+) follicular lymphoma — to full approval, and to support a new indication covering second-line or later (2L+) disease.

The trial compared mosunetuzumab plus lenalidomide against Roche's own rituximab (MabThera/Rituxan) plus lenalidomide in patients who had received at least one prior line of therapy. Roche described the PFS improvement as statistically significant and clinically meaningful at the interim analysis, though numerical data — hazard ratio, median PFS, and p-value — have not yet been disclosed. Overall survival data were immature at the time of the analysis. The safety profile was consistent with the known profiles of the individual agents, with no new signals identified. Detailed results will be submitted to health authorities and presented at an upcoming medical meeting.

Mosunetuzumab is a CD20×CD3 bispecific antibody that simultaneously engages CD20 on malignant B cells and CD3 on T cells, redirecting the patient's existing T cells to kill the tumor cells. It is administered as a fixed-duration regimen — a meaningful distinction in a disease that typically requires lifelong management — and is available in both intravenous and subcutaneous formulations, with the subcutaneous Lunsumio Velo receiving FDA accelerated approval in December 2025.

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Genmab and AbbVie’s Epkinly (epcoritamab) in combination with rituximab and lenalidomide received full FDA approval in November 2025 for R/R follicular lymphoma after at least one prior line, making it the most directly comparable approved CD20×CD3 bispecific regimen in the 2L+ setting. A positive CELESTIMO submission could move mosunetuzumab into direct competition with epcoritamab at an earlier treatment line than its current 3L+ accelerated approval.

The FDA recently accepted a supplemental Biologics License Application for mosunetuzumab in combination with Roche's Polivy (polatuzumab vedotin) for 2L+ diffuse large B-cell lymphoma, based on the Phase III SUNMO study that demonstrated a 59% reduction in risk of progression or death versus rituximab plus gemcitabine and oxaliplatin. The Phase III MorningLyte study of mosunetuzumab plus lenalidomide in previously untreated follicular lymphoma is ongoing, extending the program into the first-line setting.


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