Glofitamab in combinaton with gemcitabine and oxaliplatin [GLO2]

Glofitamab with gemcitabine and oxaliplatin for treating relapsed or refractory diffuse large B- cell lymphoma where the following criteria have been met:

1. This application is being made by, and drugs prescribed by, a consultant or senior resident doctor specifically trained and accredited in the use of systemic anti-cancer therapy.
2. The patient has histologically confirmed diffuse large B cell lymphoma (DLBCL) not otherwise specified (NOS), relapsed/refractory following first line treatment.

Note

Note: Primary CNS lymphoma, Burkitt lymphoma, transformed follicular lymphoma and plasmablastic lymphoma are NOT eligible for treatment with glofitamab, gemcitabine and oxaliplatin.

3. The patient has received one line of previous treatment only.

Note

Note: Glofitamab, gemcitabine and oxaliplatin cannot be given if the patient has had more than one prior course of treatment. Glofitamab, gemcitabine and oxaliplatin is intended as second line only.

4. First line treatment that was previously given for DLBCL.

• Pola R-CHP
• R-CHOP
• Other (specify) If ‘other’ was ticked please specify: _______________ Please indicate number of cycles of first line treatment given: _________________

5. The patient has:

• Refractory/resistant DLBCL i.e. no response to first cycle of first line treatment.
• DLBCL that initially went into remission but subsequently relapsed.

6. The patient is not eligible for an autologous stem cell transplant.
7. The patient has not previously received a bispecific antibody treatment.
8. The patient has an ECOG performance status score of 0, 1 or 2.
9. Treatment with glofitamab, gemcitabine and oxaliplatin will be stopped at whichever of the following events occurs first:

• disease progression
• unacceptable toxicity
• withdrawal of patient consent
• a total of eight cycles of glofitamab, gemcitabine and oxaliplatin plus four additional cycles of glofitamab monotherapy

Note

Note: once glofitamab is stopped after 12 cycles of treatment, it cannot be re-started.

10. When a treatment break of more than 6 weeks beyond the expected 3-weekly cycle length is needed, a treatment break approval form will be completed to restart treatment.
11. Glofitamab with gemcitabine and oxaliplatin will be used as per the Summary of Product Characteristics (SPC).

CDF funded From: 13 November 2025

Additional information

Form version: -

CDF Managed Access: No

NICE Technology Appraisal: NA (NA)

Current Form Version

Important

This is an older version of the form. To view the most up to date form follow this link

Older Form Versions

There are previous versions of this form. These may not all be available on this site.