Pirtobrutinib + Mosunetuzumab for Follicular Lymphoma

This trial examines how pirtobrutinib and mosunetuzumab work together to help people with follicular lymphoma that has returned or not responded to other treatments. Pirtobrutinib blocks a protein that promotes cancer cell growth, while mosunetuzumab aids T cells in attacking the cancer. Combining these treatments might enhance effectiveness and reduce certain side effects. This trial may suit those who have tried at least two other treatments for grade 1-3a follicular lymphoma without success or have experienced a recurrence. As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group of participants.

The trial protocol does not specify if you must stop taking your current medications. However, you cannot participate if you have used certain cancer treatments or therapies recently, such as monoclonal antibodies or chemotherapeutic agents, within a specified time before starting the trial.

Research is investigating the safety of combining pirtobrutinib and mosunetuzumab to treat follicular lymphoma. In other studies, mosunetuzumab demonstrated an 80% response rate, surpassing the 65% seen in real-world data, suggesting strong efficacy. However, safety remains a key concern.

Mosunetuzumab can cause cytokine release syndrome (CRS), a side effect where the immune system releases too many proteins into the blood too quickly. Combining it with pirtobrutinib might help reduce this side effect. Pirtobrutinib blocks certain proteins that aid cancer cell growth and is generally well-tolerated.

Researchers are excited about pirtobrutinib and mosunetuzumab for follicular lymphoma because they bring innovative mechanisms to the table. Unlike most treatments that primarily focus on chemotherapy, pirtobrutinib is a highly selective BTK inhibitor that targets specific proteins involved in the growth of cancer cells, potentially leading to fewer side effects. Mosunetuzumab, on the other hand, is a bispecific antibody that redirects the body's immune system to attack the cancer cells directly. This dual approach not only targets the cancer more precisely but also harnesses the power of the immune system, offering new hope for more effective and targeted treatment.

Research has shown that mosunetuzumab yields promising results for patients with relapsed or refractory follicular lymphoma. Studies found that 80% of patients experienced a reduction in their cancer. On average, patients lived for 24 months without their cancer worsening. In this trial, participants will receive a combination of mosunetuzumab and pirtobrutinib. Pirtobrutinib blocks a protein called BTK, which aids cancer cell growth. By blocking BTK, pirtobrutinib may help stop cancer growth and enhance the effectiveness of T cell-based treatments like mosunetuzumab. Using these treatments together could improve their ability to kill cancer cells and reduce some side effects.²³⁶⁷⁸