Mosunetuzumab and Polatuzumab Vedotin Show High Response in Refractory MCL

Mantle cell lymphoma remains a clinically heterogeneous B-cell malignancy where patients with high-risk features, such as TP53 mutations or blastoid morphology, often experience poor outcomes with conventional chemoimmunotherapy [1]. While Bruton tyrosine kinase inhibitors have significantly altered the treatment landscape, the prognosis for patients who progress after such therapy remains historically poor, with limited effective salvage options [2]. Chimeric antigen receptor T-cell therapies offer a potent alternative but are frequently limited by significant toxicities, such as neurotoxicity, and manufacturing complexities that can delay treatment for several weeks [3]. Bispecific antibodies and antibody-drug conjugates have emerged as distinct therapeutic modalities to address these gaps by leveraging T-cell redirection and targeted cytotoxic delivery, respectively [4]. A recent multicenter phase 2 study evaluated the efficacy and safety of combining these two mechanisms, mosunetuzumab and polatuzumab vedotin, in a heavily pretreated patient population.