An immune-engaging antibody treatment for some lymphomas
Glofitamab
An immune-engaging antibody treatment used for some types of lymphoma, given into a vein.
What is Glofitamab?
Glofitamab is a specialist cancer treatment used for some types of lymphoma (a cancer of the lymph system) that have come back or not responded to other treatments. It is a bispecific antibody: it grabs hold of the cancer cells using a marker called CD20 and at the same time pulls in the body's own immune cells (T-cells) to attack them. It is given into a vein in carefully increasing steps, with another antibody (obinutuzumab) given first to lower the risk of a serious reaction. The main risks are cytokine release syndrome (a strong immune reaction that can cause fever and low blood pressure), effects on the nervous system, and infections. It is used only under close hospital supervision.
Education and reference only. This is a plain-language guide to Glofitamab — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Glofitamab is a type of treatment called a bispecific antibody, used for some types of lymphoma, a cancer that affects the body's lymph system. It is used mainly when the lymphoma has returned or has not responded to earlier treatments. It works by linking the cancer cells to the body's own immune cells so the immune system attacks the cancer. It is given as an infusion into a vein in a specialist cancer unit, using a step-up schedule that starts low and builds up, and is prescribed and supervised by a haematology team.
How it works
Glofitamab has two grips: one end attaches to CD20, a marker on the lymphoma cells, and the other end attaches to a marker on the body's T-cells, a type of immune cell. By holding the two together, it brings the T-cells right up against the cancer cells and triggers them to kill the cancer. Because this can switch on a lot of immune activity at once, treatment is given in gradually increasing steps, and another antibody called obinutuzumab is given first to reduce the number of lymphoma cells and lower the risk of a strong reaction.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist treatment used in UK cancer centres for some types of lymphoma that have come back or not responded to earlier treatment.
Practical use
How to take Glofitamab
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as a drip into a vein in a specialist unit, using a step-up schedule that starts low and increases.
- An antibody called obinutuzumab is given first to lower the risk of a strong immune reaction.
- Report fever, chills, dizziness or breathlessness straight away, as these can be signs of cytokine release syndrome.
- Tell your team promptly about confusion, severe headache, tremor or trouble speaking, as the nervous system can be affected.
- Use reliable contraception during treatment and for as long as your team advises, as it can harm an unborn baby.
Weighing it up
Advantages & disadvantages of Glofitamab
Advantages
- Uses the body's own immune cells to attack lymphoma cells.
- An option for some lymphomas that have come back or not responded to earlier treatment.
- Given on a carefully planned step-up schedule designed to lower the risk of a strong reaction.
Disadvantages
- Can cause cytokine release syndrome, a strong immune reaction that needs close monitoring.
- Can affect the nervous system, causing confusion, headache or trouble speaking.
- Raises the risk of infections, so fevers must be reported promptly.
Practical use
Good to know
The most important risk to understand with glofitamab is cytokine release syndrome, a strong reaction as the immune system is activated, which can cause fever, chills, a fast heartbeat, low blood pressure and breathlessness. To reduce this, treatment starts with the antibody obinutuzumab, then glofitamab is given in small step-up doses, and you are watched closely; medicines are on hand to treat any reaction. The treatment can also affect the nervous system, causing confusion, headache, tremor or trouble speaking, which should be reported promptly. Because it works on the immune system, infections are more likely, so fevers and signs of infection must be reported straight away. As with other lymphoma treatments, it can harm an unborn baby, so reliable contraception is needed during treatment and for a time afterwards. Your team will explain the schedule, what to watch for, and when to seek urgent help.
Who should not take it / use with caution
- People who have had a serious allergic reaction to glofitamab should not have it.
- It is generally avoided in pregnancy and while breastfeeding because it can harm the baby.
- It is used with caution in people with active infections or significant nervous-system problems, under specialist judgement.
Monitoring
- Close watching during and after infusions for cytokine release syndrome and nervous-system effects.
- Regular blood tests to check blood counts and for signs of infection.
- Reviewing how the lymphoma is responding to treatment.
Side effects
- Cytokine release syndrome, with fever, chills, low blood pressure or breathlessness, especially early in treatment.
- Nervous-system effects such as confusion, headache, tremor or trouble speaking.
- Infections, which can be serious, so fevers must be reported straight away.
- A fall in blood counts, tiredness, rash and joint or muscle aches.
Key interactions
- Other treatments that weaken the immune system can add to the risk of infection.
- Live vaccines are generally avoided around this treatment, so check before any vaccination.
- Tell your team about all your medicines, including anything from a pharmacy or herbal products.
Available as: A solution given as an infusion into a vein, after obinutuzumab pretreatment.
Answers
Glofitamab: frequently asked questions
What is glofitamab used for?
It is used for some types of lymphoma that have come back or not responded to earlier treatment, by linking the cancer cells to the body's immune cells so they are attacked.
What is cytokine release syndrome?
It is a strong reaction as the immune system is activated, causing symptoms like fever, chills, low blood pressure and breathlessness; you are watched closely and medicines are ready to treat it.
Why is obinutuzumab given first?
Obinutuzumab is given before glofitamab to reduce the number of lymphoma cells and lower the risk of a strong immune reaction when treatment starts.
Why might it affect my thinking or speech?
Glofitamab can affect the nervous system, causing confusion, headache, tremor or trouble speaking, so report any such symptoms to your team promptly.
Can I have it during pregnancy?
No. It can harm an unborn baby, so it is avoided in pregnancy and reliable contraception is needed during treatment and for a time afterwards.
Authoritative sources
- BNF
- NICE CKS
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