Health-related quality of life with mosunetuzumab plus polatuzumab vedotin in R/R LBCL: Phase 3 SUNMO trial

Intensive lymphoma therapies can have significant impact on patient health-related quality of life (HRQoL), which is important to understand using patient-reported outcomes (PROs). This analysis reports PROs from the positive phase 3 SUNMO trial evaluating mosunetuzumab plus polatuzumab vedotin (Mosun-Pola) vs rituximab, gemcitabine, and oxaliplatin (R-GemOx) in patients with autologous stem cell transplant (ASCT)-ineligible relapsed/refractory (R/R) large B-cell lymphoma (LBCL). Patients were randomized 2:1 to receive Mosun-Pola or R-GemOx. PROs were assessed using EORTC QLQ-C30, FACT-Lym LYMS, and FACT/GOG-NTX. Key PRO endpoints: time to deterioration (TTD), change in scores from baseline, and mixed-effects models with repeated measures. Of 208 randomized patients, questionnaire completion rates remained high (>95%) throughout treatment. Baseline scores indicated mild-to-moderate symptom burden and functioning impairment. Baseline physical functioning was preserved for over one year longer with Mosun-Pola vs R-GemOx (TTD, 17.4 vs 5.3 months; hazard ratio [HR]=0.70). Longitudinal analysis revealed continuous improvement of physical functioning in the Mosun-Pola arm, which was consistent across older and younger age groups. Fatigue trajectories improved post cycle 2 in the Mosun-Pola arm, whereas patients in the R-GemOx arm reported continued deterioration. Mosun-Pola prevented worsening of lymphoma symptoms for longer than R-GemOx (TTD, 7.2 vs 4.6 months; HR=0.82). Low levels of baseline peripheral neuropathy were maintained in both arms, although Mosun-Pola extended the time without worsening of baseline peripheral neuropathy (TTD, 4.4 vs 2.0 months with R-GemOx; HR=0.71). Mosun-Pola provides profound HRQoL benefits, complementing its superior clinical efficacy and manageable safety profile in patients with ASCT-ineligible R/R LBCL. (ClinicalTrials.gov;NCT NCT05171647) MICRO-ABSTRACT In this patient-reported outcomes analysis of the Phase 3 SUNMO trial in ASCT-ineligible relapsed/refractory large B-cell lymphoma, mosunetuzumab plus polatuzumab vedotin extended baseline physical functioning preservation by over one year versus R-GemOx (17.4 vs 5.3 months). Mosun-Pola also reduced on-treatment fatigue and extended the time without worsening of baseline peripheral neuropathy, demonstrating meaningful health-related quality-of-life benefits alongside clinical efficacy.