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. 2025 Jun;14(11):e70936.
doi: 10.1002/cam4.70936.

Care Coordination for Mosunetuzumab Therapy in Patients With Follicular Lymphoma in Community Practices: Learnings From the MorningSun Study Investigators

Tara Graff  1 , Ian Flinn  2 , Jeff P Sharman  3 , Steven Liu  4 , Bertrand M Anz  5 , Mitul Gandhi  6 , Ayed Ayed  7 , Richard Zuniga  8 , Abdul Hai Mansoor  9 , Lourenia M Cassoli  10 , Mei Wu  10 , Prachi Jani  10 , Juliana M L Biondo  10 , Tony Lin  10 , John M Burke  11
Affiliations

Care Coordination for Mosunetuzumab Therapy in Patients With Follicular Lymphoma in Community Practices: Learnings From the MorningSun Study Investigators

Tara Graff et al. Cancer Med. 2025 Jun.

Abstract

Background: Preliminary data from the MorningSun study have demonstrated that outpatient subcutaneous mosunetuzumab can be safely administered.

Aims: This publication describes how community centers in the MorningSun phase 2 study of outpatient subcutaneous mosunetuzumab in B-cell non-Hodgkin lymphomas prepared workflow and logistics (staff coordination, practice networks, and patient support) to monitor patients for cytokine release syndrome (CRS) and other toxicities.

Materials and methods: Ten investigators at US community practice study sites (one rural, seven urban, and two rural/urban) were interviewed between January 12 and February 22, 2024. Interview transcripts were analyzed qualitatively to identify key themes.

Results: Prior to the study, 7/10 had limited/no experience administering bispecific antibodies for lymphoma. Regarding preparation before treatment, staff education was the most frequent need (7/10). All sites provided in-service training for staff involved with treatment administration. Most respondents (6/10) had multidisciplinary plans and agreed these eased logistical concerns. Out of hours, patients either called the triage team, a dedicated on-call number, the physician, or the emergency department. Most practices had preexisting relationships with hospitals for CRS management. All practices established methods for outpatient CRS monitoring; patient education and caregivers played important roles, and all respondents encouraged patients to use self-monitoring devices. Each community practice had different workflow and logistics based on their setting and infrastructure.

Conclusion: Community practices can leverage other sites' experiences and adopt an individualized approach to implementing bispecific antibodies safely and efficiently. Designating a physician champion could provide a local resource to address staff questions and concerns.

Keywords: best practice; bispecific antibodies; care coordination; community practice; outpatient therapy.

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Conflict of interest statement

T.G. has served as a consultant or advisor for AbbVie, Adaptive Biotechnologies, AstraZeneca, Genentech, Inc., Genmab, and TG Therapeutics; a member of advisory boards or steering committees for AbbVie, Bristol Myers Squibb, BeiGene, Genmab, Gilead Sciences, and Eli Lilly; and a speaker for AbbVie, Adaptive Biotechnologies, ADC Therapeutics, AstraZeneca, BeiGene, Genentech, Inc., Genmab, Gilead Sciences, Lilly, and TG Therapeutics. I.F. reports consultancy with AbbVie, BeiGene, Genentech, Inc., Genmab, Kite Pharma, and Vincerx Pharma; has received research funding from 2seventy bio, AbbVie, AstraZeneca, BeiGene, Bristol Myers Squibb, Celgene, City of Hope National Medical Center, Epizyme, F. Hoffmann‐La Roche Ltd., Fate Therapeutics, Genentech, Inc., Gilead Sciences, IGM Biosciences, Incyte, InnoCare Pharma, Janssen, Kite Pharma, Loxo, Marker Therapeutics, Merck, MorphoSys, Myeloid Therapeutics, Novartis, Nurix, Pfizer, Seattle Genetics, TG Therapeutics, and Vincerx Pharma; and has served as a member of a Vincerx Pharma Advisory Committee. J.P.S. reports consultancy for AbbVie, AstraZeneca, BeiGene, Bristol Myers Squibb, Lilly, Merck, Genmab, and Genentech, Inc. S.L. holds equity in Bristol Myers Squibb, Lilly, and Pfizer; and has received research funding from Bristol Myers Squibb, F. Hoffmann‐La Roche Ltd., Genmab, Gilead Sciences, Lilly, Novartis, and Pfizer. B.M.A. reports current employment with Tennessee Oncology; all research is conducted through, and funding is paid directly to, the Sarah Cannon Research Institute. M.G. has received honoraria from GSK, Janssen, Karyopharm Therapeutics, and TG Therapeutics; and has served as a member on advisory boards for GSK, Janssen, Karyopharm, Sanofi, and TG Therapeutics. A.A. reports consultancy for Bristol Myers Squibb, Genentech, Inc., Ipsen, and Janssen. R.Z. has served as a consultant or advisor to Bristol Myers Squibb and Mirati Therapeutics. A.H.M. declares no competing financial interests. L.M.C. is an employee of and holds equity in Genentech, Inc. M.W. is an employee of Genentech, Inc., and holds equity in F. Hoffmann‐La Roche Ltd. P.J. is an employee of Genentech, Inc., and holds restricted stock units in F. Hoffmann‐La Roche Ltd. J.M.L.B. is an employee of Genentech, Inc., and holds equity in and has received honoraria from F. Hoffmann‐La Roche Ltd. T.L. has received grants paid to his institution from BeiGene, and has participated on data safety monitoring boards or advisory boards for AstraZeneca, Boehringer Ingelheim, MSD, Servier, and Transcenta. J.M.B. reports consultancy with AbbVie, AstraZeneca, BeiGene, Bristol Myers Squibb, F. Hoffmann‐La Roche Ltd., Foresight Diagnostics, Genentech, Inc., Genmab, Novartis, Regeneron, and Seagen.

Figures

FIGURE 1
FIGURE 1
Flow diagram for site selection. CAR, chimeric antigen receptor.
FIGURE 2
FIGURE 2
Key insights for community practices wanting to begin outpatient treatment with bispecific antibodies such as mosunetuzumab. Orange represents staff training and coordination prior to mosunetuzumab dosing. Blue represents safe outpatient monitoring after mosunetuzumab dosing. CRS, cytokine release syndrome; HCP, healthcare professional.
See this image and copyright information in PMC

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