mosunetuzumab

Contraindicated in:

Active infection;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

History of recurrent or chronic infection, with underlying conditions that may predispose to infections or previously received immunosuppressive treatment;
Rep: Women of reproductive potential;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: edema

Derm: dry skin, pruritus, rash, skin exfoliation

Endo: hyperglycemia

F and E: hypokalemia, hypomagnesemia, hypophosphatemia

GI: abdominal pain, diarrhea, ↑liver enzymes, nausea

GU: renal impairment

Hemat: anemia, leukopenia, lymphocytopenia, neutropenia, thrombocytopenia, HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS (HLH)

Metab: hyperuricemia

MS: arthralgia, pain

Neuro: dizziness, fatigue, headache, insomnia, peripheral neuropathy, anxiety, ataxia, attention disturbance, cognitive disorder, confusion, delirium, encephalopathy, gait disturbance, IMMUNE EFFECTOR CELL-ASSOCIATED NEUROTOXICITY SYNDROME (ICANS), sedation, tremor

Resp: cough, dyspnea

Misc: chills, fever, cytokine release syndrome (crs), infection , TUMOR LYSIS SYNDROME, tumor flare

Interactions ⬆ ⬇

Drug-drug:

Use with CNS depressants, including opioids, benzodiazepines, nonbenzodiazepine sedative/hypnotics, anxiolytics, general anesthetics, muscle relaxants, antipsychotics, and alcohol, may ↑ risk of neurologic toxicity.
May suppress activity of CYP450 drug-metabolizing enzymes (starting after receiving first dose and continuing up to 14 days after the dose on Day 1 of Cycle 2; may also occur during and after experiencing cytokine release syndrome); closely monitor drugs that are CYP450 substrates.

Availability ⬆ ⬇

Solution for injection: 1 mg/mL

Route/Dosage ⬆ ⬇

Duration of each cycle = 21 days.
IV (Adults ): Day 1 of Cycle 1: 1 mg; Day 8 of Cycle 1: 2 mg; Day 15 of Cycle 1: 60 mg; Day 1 of Cycle 2: 60 mg; Day 1 of Cycle 3 and beyond: 30 mg. Continue for a total of 8 cycles unless patient experiences disease progression or unacceptable toxicity. No further treatment required after 8 cycles if complete response achieved. For patients achieving partial response or with stable disease after 8 cycles, an additional 9 cycles (total of 17 cycles) should be administered (unless patient experiences disease progression or unacceptable toxicity).

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Acts as a T-cell engager, binding to the CD3 receptor on T cells and CD20 on lymphoma cells and some B cells. It activates T cells, releasing proinflammatory cytokines and causing lysis of B cells.

Therapeutic effects:

Decreased progression of follicular lymphoma.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: monoclonal antibodies, T-cell engagers

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Minimally distributed to tissues.

Metabolism/Excretion: Unknown.

Half-Life: 16.1 days.

Time/Action Profile ⬆ ⬇

(depletion of B cells)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	22 days	persists through completion of 8 cycles

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care provider before taking other medications.
Teach the patient how to recognize and respond to signs/symptoms of neurologic toxicities, including CRS. Advise patient to wear medical ID describing disease process and medication regimen at all times in case of emergencies.
Advise patient to notify health care provider immediately if signs/symptoms of ICANS, opportunistic infections, HLH or cytopenias occur.
Inform patient to notify a health care provider if signs/symptoms of a tumor flare occur.
Rep: May cause fetal harm. Advise women of reproductive potential to use effective contraception and to avoid breastfeeding during therapy and for 3 mo after last dose.

Pronunciation ⬆ ⬇

moe-SUN-e-TOOZ-ue-mab

Code ⬆

NDC Code

50242- Genentech, Inc.
- 50242-142- Lunsumio
  - 50242-142-01- 1 VIAL in 1 CARTON (50242-142-01) / 30 mL in 1 VIAL

50242- Genentech, Inc.
- 50242-159- Lunsumio
  - 50242-159-01- 1 VIAL in 1 CARTON (50242-159-01) / 1 mL in 1 VIAL

50242- Genentech, Inc.
- 50242-242-
  - 50242-242-01- 120 L in 1 TANK (50242-242-01)

50242- Genentech, Inc.
- 50242-243-
  - 50242-243-06- 6 L in 1 BAG (50242-243-06)

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Indications ⬇

Contraind./Precautions ⬆ ⬇