- Approval Id
- 306b0c6c779a714f
- Drug Name
- LUNSUMIO CONCENTRATE FOR SOLUTION FOR INFUSION 1MG/ML
- Product Name
- LUNSUMIO CONCENTRATE FOR SOLUTION FOR INFUSION 1MG/ML
- Approval Number
- SIN17001P
- Approval Date
- 2024-05-08
- Registrant
- ROCHE SINGAPORE PTE. LTD.
- Licence Holder
- ROCHE SINGAPORE PTE. LTD.
- Drug Type
- Therapeutic
- Forensic Classification
- Prescription Only
- Dosage Form
- INFUSION, SOLUTION CONCENTRATE
- Dosage
- <p><strong>2.2 DOSAGE AND ADMINISTRATION</strong><br>
<strong>General</strong><br>
Lunsumio must only be administered as an intravenous infusion under the supervision of a qualified healthcare professional with appropriate medical support to manage severe reactions such as cytokine release syndrome and neurologic toxicity. <em>(see Section 2.4 Warnings and Precautions</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>)</em>.</p>
<p>Do not administer as an IV push or bolus.</p>
<p><strong><em>Prophylaxis and premedication</em></strong><br>
Lunsumio should be administered to well-hydrated patients. Table 1 provides details on recommended premedication for cytokine release syndrome and infusion related reactions.</p>
<img src="/TGIF/Lunsumio-Table1.png" alt="Lunsumio Dosage Table 1" /><br><br>
<p>The recommended dose of Lunsumio for each 21-day cycle is detailed in Table 2.</p>
<img src="/TGIF/Lunsumio-Table2.png" alt="Lunsumio Dosage Table 2" /><br><br>
<p><strong>Duration of Treatment</strong><br>
Lunsumio should be administered for 8 cycles unless a patient experiences unacceptable toxicity or disease progression.</p>
<p>For patients who achieve a complete response, no further treatment beyond 8 cycles is required. For patients who achieve a partial response or have stable disease in response to treatment with Lunsumio after 8 cycles, an additional 9 cycles of treatment (17 cycles total) should be administered, unless a patient experiences unacceptable toxicity or disease progression.</p>
<p><strong>Delayed or Missed Doses</strong><br>
If any dose in cycle 1 is delayed for >7 days, the previous tolerated dose should be repeated prior to resuming the planned treatment schedule.</p>
<p>If a dose interruption occurs between cycles 1 and 2 that results in a treatment-free interval of ≥6 weeks, administer Lunsumio at 1 mg on Day 1, 2 mg on Day 8, then resume the planned cycle 2 treatment of 60 mg on Day 15.</p>
<p>If a dose interruption occurs that results in a treatment-free interval of ≥6 weeks between any cycles in cycle 3 onwards, administer Lunsumio at 1 mg on Day 1, 2 mg on Day 8, then resume the planned treatment schedule of 30 mg on Day 15.</p>
<p><strong>Dose Modifications</strong></p>
<p><em><u>Cytokine Release Syndrome</u></em></p>
<p>Identify cytokine release syndrome (CRS) based on clinical presentation (see section 2.4 <em>Warnings and Precautions</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). Evaluate for and treat other causes of fever, hypoxia, and hypotension, such as infections/sepsis. Infusion related reactions (IRR) may be clinically indistinguishable from manifestations of CRS. If CRS or IRR is suspected, manage according to the recommendations in Table 3.</p>
<img src="/TGIF/Lunsumio_281024-Table3.png" alt="Lunsumio Dosage Table 3" /><br><br>
<p><em><u>Neurologic Toxicity Including Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS)</u></em></p>
<p>Management recommendations for neurologic toxicity, including ICANS, is summarized in Table 4. At the first sign of neurologic toxicity, including ICANS, withhold Lunsumio for grade 2 and above and consider neurology evaluation. Rule out other causes of neurologic symptoms. Provide supportive therapy, which may include intensive care.</p>
<img src="/TGIF/Lunsumio_281024-Table4.png" alt="Lunsumio Dosage Table 4" /><br><br>
<p><strong><em>Dose modifications for other clinically significant adverse reactions</em></strong><br>
Patients who experience grade 3 or 4 reactions should have treatment temporarily withheld until symptoms are resolved.</p>
<p><strong>2.2.1 Special Dosage Instructions</strong><br>
<strong>Pediatric use</strong><br>
The safety and efficacy of Lunsumio in children below 18 years of age have not been established.</p>
<p><strong>Geriatric use</strong><br>
No dose adjustment of Lunsumio is required in patients ≥ 65 years of age (see section 2.5.5 <em>Use in Special Populations, Geriatric Use</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><strong>Renal Impairment</strong><br>
No dose adjustment is required in patients with mild or moderate renal impairment. A recommended dose has not been determined for patients with CrCl <30 mL/min (see sections 2.5.6 <em>Renal Impairment</em> and 3.2.5 <em>Pharmacokinetics in Special Populations</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><strong>Hepatic Impairment</strong><br>
No dose adjustment of Lunsumio is required for patients with mild hepatic impairment [total bilirubin greater than upper limit of normal (ULN) and ≤ 1.5x ULN or aspartate transaminase greater than ULN]. (<em>see 2.5.7 Hepatic Impairment</em> and <em>3.2.5 Pharmacokinetics in special populations</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). A recommended dose has not been determined for Lunsumio in patients with moderate or severe hepatic impairment.</p>
- Route Of Administration
- INTRAVENOUS
- Indication Info
- <p><strong>2.1 THERAPEUTIC INDICATION(S)</strong><br>
Lunsumio as monotherapy is indicated for the treatment of adult patients with relapsed or refractory follicular lymphoma who have received at least two prior systemic therapies.</p>
- Contraindications
- <p><strong>2.3 CONTRAINDICATIONS</strong><br>
Lunsumio is contraindicated in patients with a known hypersensitivity to mosunetuzumab or any of the excipients.</p>
- Atc Code
- L01FX25
- Pharma Manufacturer Name
- ROCHE SINGAPORE PTE. LTD.