Mosunetuzumab: A bispecific CD20 × CD3 antibody for follicular lymphoma with promising evidence in other B-NHL subtypes

Mosunetuzumab is a bispecific antibody targeting CD20 x CD3 re-directing T cells to target and destroy CD20-positive B cells. T-cell-based therapies including bispecific antibodies have revolutionized B-cell NHL treatment. Mosunetuzumab is approved for follicular lymphoma with at least 2 prior lines of therapy. There are also NCCN recommendations for its use in diffuse large B-cell lymphoma and in combination with polatuzumab vedotin in relapsed/refractory mantle cell lymphoma with prior BTK inhibitor therapy. Published trials show low rates of severe CRS and support outpatient administration in appropriate settings. Utilizing a search of PubMed, conference abstracts, and clinicaltrials.gov between 2020 and 2026, prospective trial data as well as retrospective real-world evidence and ongoing studies were included for a more complete picture of available data. This review summarizes the molecular design, mechanism of action, clinical efficacy, and safety of mosunetuzumab, an agent representative of immunotherapeutic advancement in lymphoma.