Sub-Q Mosunetuzumab Improves Clinic Workflow, Patient Experience: Zahra Mahmoudjafari, PharmD, MBA, BCOP

In late December, the FDA approved a subcutaneous formulation of mosunetuzumab (Lunsumio VELO; Genentech/Roche) for adults with relapsed or refractory follicular lymphoma, a common subtype of non-Hodgkin lymphoma, who have received 2 or more lines of systemic therapy.¹ The approval makes mosunetuzumab the first subcutaneous bispecific antibody available for this indication, delivered as a fixed-duration, approximately 1-minute injection rather than a 2- to 4-hour intravenous (IV) infusion.

The decision was based on data from the phase 1/2 GO29781 trial (NCT02500407), specifically the subcutaneous cohort.² Results demonstrated pharmacokinetic noninferiority to the IV formulation and a consistent benefit-risk profile, supporting a transition to the more convenient injection without compromising therapeutic efficacy.¹

The American Journal of Managed Care^® (AJMC^®) recently spoke with Zahra Mahmoudjafari, PharmD, MBA, BCOP, a clinical pharmacy manager in the division of hematological malignancies and cellular therapeutics within the University of Kansas Health System, about the significance of the approval. In part 2 of the conversation, Mahmoudjafari discussed mosunetuzumab’s safety profile. Consistent with other bispecific antibodies, cytokine release syndrome and neurotoxicity remain the most common adverse events.

She also explained how the approximately 1-minute subcutaneous injection could significantly improve clinic workflow compared with multihour IV infusions. According to Mahmoudjafari, this shift enables clinics to treat more patients in the time previously required for a single infusion, reducing chair time and increasing scheduling flexibility. From the patient’s perspective, the shorter administration time may improve quality of life by minimizing time spent in the clinic. She concluded by highlighting ongoing health system challenges, including ensuring sustainable access, balancing clinical benefit with cost, and managing operational demands.

“As we have more immune-engaging treatments that enter the market, we have to look at balancing not only the clinical benefit but also the operational feasibility and the cost, so this will naturally be an ongoing discussion across all of our health care systems and with our payers,” Mahmoudjafari said.

Watch part 1 to learn more about the importance of the approval and what sets mosunetuzumab apart from other follicular lymphoma treatments.³

References

1. Joszt L. FDA approves subcutaneous mosunetuzumab for R/R follicular lymphoma. AJMC. December 22, 2025. Accessed March 17, 2025. https://www.ajmc.com/view/fda-approves-subcutaneous-mosunetuzumab-for-r-r-follicular-lymphoma
2. A safety, efficacy and pharmacokinetic study of BTCT4465A (mosunetuzumab) as a single agent and combined with atezolizumab in non-Hodgkin’s lymphoma (NHL) and chronic lymphocytic leukemia (CLL). ClinicalTrials.gov. Updated September 12, 2025. Accessed March 17, 2026. https://clinicaltrials.gov/study/NCT02500407
3. McCormick B, Mahmoudjafari Z. Sub-Q mosunetuzumab approval simplifies R/R follicular lymphoma care: Zahra Mahmoudjafari, PharmD, MBA, BCOP. AJMC. March 17, 2026. Accessed March 19, 2026. https://www.ajmc.com/view/sub-q-mosunetuzumab-approval-simplifies-r-r-follicular-lymphoma-care-zahra-mahmoudjafari-pharmd-mba-bcop