Changgon Kim, Youngil Koh, Youngwoo Jeon, Yoon Seok Choi, Seok Jin Kim, Won Seog Kim, Sang Eun Yoon
Glofitamab, a CD20×CD3 bispecific antibody, has shown durable activity in relapsed/refractory diffuse large B-cell lymphoma (RR-DLBCL), but real-world data from Korean patients and after CAR-T failure remain limited. We retrospectively analyzed 46 patients with RR-DLBCL treated with glofitamab monotherapy. Response and safety were assessed in all patients, whereas the main survival and prognostic analyses were conducted in the non-bridge-intent cohort (n = 41), excluding five bridge-intent patients. Median age was 57.5 years; patients had received a median of three prior lines, and 58.7% had failed prior CAR-T. In the overall cohort, the objective response rate was 39.1% and the complete response rate was 32.6%. In the non-bridge-intent cohort, median progression-free survival (PFS) and overall survival (OS) were 2.6 and 5.9 months, respectively, after a median follow-up of 8.2 months. Median duration of response was not reached, and 10 of 15 responders remained in response. Prior CAR-T exposure was not associated with PFS or OS. A longer pre-glofitamab interval was associated with improved PFS (adjusted hazard ratio 0.51 per category increase; p = 0.018), but not OS. Patients with an interval < 1 month had an ORR of 15.4% and median PFS of 1.0 month. Cytokine release syndrome occurred in 26.1%, all Grade 1 or 2; no immune effector cell–associated neurotoxicity syndrome or treatment-related deaths occurred. Glofitamab monotherapy demonstrated clinically meaningful activity and manageable safety in heavily pretreated RR-DLBCL. In exploratory analyses, a shorter pre-glofitamab treatment interval was associated with poorer outcomes; this hypothesis-generating observation requires prospective validation.