About Follicular Lymphoma

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What Is Follicular Lymphoma?

Follicular lymphoma (FL) is a form of non-Hodgkin’s Lymphoma (NHL), a blood cancer that involves white blood cells.

White blood cells help fight infections. However, unhealthy white blood cells can build up in the lymph nodes, bone marrow, and spleen (see picture).

FL can be a life-long disease. FL is the most common type of slow-growing NHL.

What does third-line or later (3L+) follicular lymphoma mean?

3L+ FL means that after at least 2 prior treatments, your FL has relapsed (returned) or is refractory (has not responded to treatment).

What Can 3L+ FL Look Like?

Understanding FL that has returned or has not responded to treatment

When your FL has not responded or has returned following 2 treatments, symptoms may be similar to ones you have experienced before, but this can vary from patient to patient.

You and your doctor can look for some of these possible symptoms:

  • Swelling in your lymph nodes, liver, or spleen
  • An increase in the number of abnormal white blood cells
  • A decrease in the number of normal blood cells
  • Fever, fatigue, and night sweats
  • Unexplained weight loss
  • Severe or frequent infections
  • Easy bruising or bleeding
  • Numbness or tingling in feet and/or hands
  • Headaches and/or blurry vision

Symptoms of FL may be seen in other conditions as well. Only your doctor will be able to tell if your symptoms are related to FL.

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While you are being treated and after your treatment stops, your doctor will continue to monitor your FL in order to decide how best to take care of it

This may include routine tests, such as physical exams, blood cell counts, and bone marrow  biopsies to identify the sources of symptoms.

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Be sure to discuss symptoms with your doctor and understand when treatment is right for you

What Are Treatment Goals for 3L+ FL?

There is no cure for FL. However, based on your experience with FL, you may have different treatment goals, such as:

  1. Achieving remission (disappearance of signs and symptoms)
  2. Maintaining remission
Discuss your treatment goals with your doctor

If your doctor has concluded that your FL is relapsed or refractory to at least 2 prior treatments, you may be a candidate for an innovative option: bispecific antibody treatment.

What Is Bispecific Antibody Treatment?

Antibody treatment is designed to find and destroy specific cells within the body. This therapy is an important part of FL treatment plans. It can also harm healthy cells in the body.


How bispecific antibody treatment works

Bispecific antibodies are designed to target 2 different sites on different cells or the same cell. For example, a bispecific antibody binding to 2 different cells is thought to bring the cells together, such as an immune cell and a cancer cell. LUNSUMIO is designed to target and bind to CD3 proteins found on T cells and CD20 proteins found on FL cells and may bind to some healthy cells.

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Enroll in our patient support program to receive helpful information about treatment.

Important Safety Information & Indication


LUNSUMIO (mosunetuzumab-axgb) is a prescription medicine used to treat adults with follicular lymphoma whose cancer has come back or did not respond to previous treatment, and who have already received two or more treatments for their cancer.

It is not known if LUNSUMIO is safe and effective in children.

The conditional approval of LUNSUMIO is based on response rate. There are ongoing studies to establish how well the drug works.

What is the most important information I should know about LUNSUMIO?

LUNSUMIO may cause Cytokine Release Syndrome (CRS), a serious side effect that is common during treatment with LUNSUMIO and can also be severe or life-threatening.

Get medical help right away if you develop any signs or symptoms of CRS at any time, including:

  • fever of 100.4°F (38°C) or higher 
  • chills  
  • low blood pressure 
  • fast or irregular heartbeat 
  • tiredness or weakness 
  • difficulty breathing
  • headache 
  • confusion 
  • feeling anxious 
  • dizziness or light-headedness 
  • nausea 
  • vomiting

Due to the risk of CRS, you will receive LUNSUMIO on a “step-up dosing schedule.”

  • The step-up dosing schedule is when you receive smaller “step-up” doses of LUNSUMIO on Day 1 and Day 8 of your first cycle of treatment 
  • You will receive a higher dose of LUNSUMIO on Day 15 of your first cycle of treatment  
  • If your dose of LUNSUMIO is delayed for any reason, you may need to repeat the step-up dosing schedule 
  • Before each dose in Cycle 1 and Cycle 2, you will receive medicines to help reduce your risk of CRS  

Your healthcare provider will check you for CRS during treatment with LUNSUMIO and may treat you in a hospital if you develop signs and symptoms of CRS. Your healthcare provider may temporarily stop or completely stop your treatment with LUNSUMIO, if you have severe side effects.

What are the possible side effects of LUNSUMIO?

LUNSUMIO may cause serious side effects, including:

  • Neurologic problems. Your healthcare provider will check you for neurologic problems during treatment with LUNSUMIO. Your healthcare provider may also refer you to a healthcare provider who specializes in neurologic problems. Tell your healthcare provider right away if you develop any signs or symptoms of neurologic problems during or after treatment with LUNSUMIO, including:
    • headache
    • numbness and tingling of the arms, legs, hands, or feet
    • dizziness
    • confusion and disorientation
    • difficulty paying attention or understanding things
    • forgetting things or forgetting who or where you are
    • trouble speaking, reading, or writing
    • sleepiness or trouble sleeping
    • tremors
    • loss of consciousness
    • seizures
    • muscle problems or muscle weakness
    • loss of balance or trouble walking
  • Serious infections. LUNSUMIO can cause serious infections that may lead to death. Your healthcare provider will check you for signs and symptoms of infection before and during treatment. Tell your healthcare provider right away if you develop any signs or symptoms of infection during treatment with LUNSUMIO, including:
    • fever of 100.4°F (38°C) or higher
    • cough
    • chest pain
    • tiredness
    • shortness of breath
    • painful rash
    • sore throat
    • pain during urination
    • feeling weak or generally unwell
  • Low blood cell counts. Low blood cell counts are common during treatment with LUNSUMIO and can also be severe. Your healthcare provider will check your blood cell counts during treatment with LUNSUMIO. LUNSUMIO may cause the following low blood cell counts:
    • low white blood cell counts (neutropenia). Low white blood cells can increase your risk for infection
    • low red blood cell counts (anemia). Low red blood cells can cause tiredness and shortness of breath
    • low platelet counts (thrombocytopenia). Low platelet counts can cause bruising or bleeding problems
  • Growth in your tumor or worsening of tumor related problems (Tumor flare). LUNSUMIO may cause serious or severe worsening of your tumor. Tell your healthcare provider if you develop any of these signs or symptoms of tumor flare during your treatment with LUNSUMIO: tender or swollen lymph nodes, chest pain, cough, trouble breathing, and pain or swelling at the site of the tumor

Your healthcare provider may temporarily stop or permanently stop treatment with LUNSUMIO if you develop severe side effects.

The most common side effects of LUNSUMIO include: tiredness, rash, fever, and headache.

The most common severe abnormal lab test results with LUNSUMIO include: decreased phosphate, increased glucose, and increased uric acid levels.

Before receiving LUNSUMIO, tell your healthcare provider about all of your medical conditions, including if you:

  • have ever had an infusion reaction after receiving LUNSUMIO
  • have an infection, or have had an infection in the past which lasted a long time or keeps coming back
  • have or have had Epstein-Barr Virus
  • are pregnant or plan to become pregnant. LUNSUMIO may harm your unborn baby. Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with LUNSUMIO
  • Females who are able to become pregnant:
    • your healthcare provider should do a pregnancy test before you start treatment with LUNSUMIO
    • you should use an effective method of birth control during your treatment and for 3 months after the last dose of LUNSUMIO
  • are breastfeeding or plan to breastfeed. It is not known if LUNSUMIO passes into your breast milk. Do not breastfeed during treatment and for 3 months after the last dose of LUNSUMIO

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What should I avoid while receiving LUNSUMIO?

Do not drive, operate heavy machinery, or do other dangerous activities if you develop dizziness, confusion, tremors, sleepiness, or any other symptoms that impair consciousness until your signs and symptoms go away. These may be signs and symptoms of CRS or neurologic problems.

These are not all the possible side effects of LUNSUMIO. Talk to your health care provider for more information about the benefits and risks of LUNSUMIO.

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

Please see Important Safety Information, including Serious Side Effects, as well as the LUNSUMIO full Prescribing Information and Medication Guide.