What is COLUMVI and when do doctors prescribe it?
COLUMVI® (glofitamab) is a medicine used to treat adults with blood cancer, called large B-cell lymphoma (LBCL) or specific diffuse large B-cell lymphoma (DLBCL). It is a cancer affecting B cells (type of white blood cells) that has returned or stopped responding after at least two prior treatments.[i],[ii]
How does COLUMVI work?
The active substance in COLUMVI, glofitamab, is a bispecific antibody — meaning it binds to two immune cells in the body at the same time: 1, [iii]
- One end binds to CD20 protein on the surface of cancer cells (B-cells)
- The other binds to CD3 protein on the surface of healthy T-cells (T cells are immune cells, which are body’s natural defence cells that help destroy the cancous cells)
Such binding brings the cancer cells closer to the immune T cells, which release cytokines and kill the cancer cells.3
Why the step-up dosing schedule matters
COLUMVI treatment will be given as an intravenous infusion (through a needle placed in patient’s vein). It uses a step-up dosing schedule to monitor the risk of side effect, called the cytokine release syndrome (CRS), which is a serious immune reaction of the drug, and to also monitor infusion-related reactions, if any.2
The typical step-up sequence looks like: 2
Cycle 1
- Day 1: Pretreatment with obinutuzumab iv
- Day 8: Small first dose of COLUMNVI
- Day 15: Second step-up dose of COLUMNVI
Cycle 2 -12
Day 1 onwards: Full dose of COLUMVI every 3 weeks
Treatment is complete after ~8.5 months (36 weeks)
What usually happens before the first dose
Before starting treatment, doctors typically:2
- Treat or resolve any active infections
- Give pre-medications to lower side-effect risk
- Administer single dose of obinutuzumab to reduce the circulating and lymphoid
tissue B cells.
What to expect on infusion day
COLUMVI is given as an intravenous infusion in the hospital:2
- First complete cycle may last about 4 hours and patients are hospitalized for 24 hours after receiving the first step-up dose on Day 8 and on day 15 if patient experienced any CRS during the first step-up dose.
- First day of second cycle will also last for about 4 hours.
- Later infusions from the third cycle onwards may be shortened to 2 hours if tolerated
Patients are observed carefully during and after infusion in a hospital setting.
Why doctors watch closely during the first cycles?
The early doses carry the highest risk of side effects, which might get serious, due to which the doctors keep a close watch on the patients for possible signs and symptoms of reactions and to prevent them from worsening.2
CRS: What it is, what it can feel like, and when it usually shows up. What to do when it is spotted? Are there any other side effects as well?
The cytokine release syndrome (CRS) includes signs and symptoms such as fever of 100.4°F (38°C) or higher, chills or shaking, fast or irregular heartbeat, dizziness or light-headedness, trouble breathing and shortness of breath.2
Patients are advised to call their healthcare provider or get emergency medical help right away upon experiencing such signs and symptoms.2
Other side effects a patient may experience are musculoskeletal pain, rash and fatigue.2
What tests doctors usually do before and during treatment?
Before giving COLUMVI, the doctor usually checks for active infections and kidney problems. The doctor asks for a pregnancy test or breastfeeding plans as COLUMVI might harm the unborn baby or may pass into the breastmilk.
During treatment, the doctors check for signs and symptoms of CRS, toxicity and neurologic problems.2
How to prepare for the first few appointments and what to pack for a long day at the hospital?
Patient should eat a light meal before appointments to help avoid feeling sick during or after treatment.
When planning to spend most of the day at the clinic or infusion center:
- Patient may wear comfortable, loose-fitting clothing for easier infusion access
- Patient may bring items for comfort, such as a book or blanket
- Patient may bring a family member or friend along for support
How caregivers can help during early treatment
Caregivers play an important role by watching for any adverse signs and symptoms.
Caregivers can also accompany the patient to the hospital during and after treatment for support.2
Response timeline: when doctors start looking for signs it is working and how is it tracked?
COLUMVI treatment schedule is divided into cycles that are 21 days (3 weeks) long. 2 Doctors evaluate response continuously during treatment cycles using different clinical assessments. [iv]
Progress is tracked during full‑dose treatment (Cycles 2–12) using blood tests and tumor response.2
What happens if a dose is delayed or missed
If treatment is delayed: 2
- The step-up dosing schedule may need to be repeated
- Doctors reassess safety before restarting therapy
This helps reduce CRS risk again.
What usually improves first and what can take longer
Clinical trials showed tumor responses during treatment cycles, but ongoing monitoring is required because outcomes differ among individuals.[v]
Scans, labs, and follow-up: how and why progress monitoring matters
Different lab tests help monitor the progress and adverse reactions. This includes lymphocyte, phosphate, neutrophil, platelet, fibrinogen and uric acid counts. 2 Some patients might get serious infections such as pneumonia and sepsis which requires the doctor to regularly monitor the patient’s progress to avoid the reactions. 2
Common fears patients have before the first dose
Common fears a patient may have include fear of side effects and safety. Dosing starts gradually and doctors monitor closely to improve safety during all cycles. Preventive medicines are given before each infusion to reduce reactions that might happen.2
How does Rx4u help the patient?
Medications for treating certain chronic, serious, or life-threatening diseases may not be available in all regions of the world. To gain access to such life-saving medications, the Indian government created a provision allowing access to these medicines under the label of Named Patient Program (NPP). Rx4u platform helps patients obtain such advanced therapies that may not yet be easily available in patient’s country, by procuring them directly from the manufacturer or authorized distributors. It facilitates access to newly launched drugs through named patient import.[vi]
Conclusion: a calmer way to prepare for COLUMVI treatment
COLUMVI treatment follows a structured plan with close monitoring, gradual dosing, and a fixed treatment duration of (~8.5 months). Knowing what to expect can help patients feel more prepared and confident during therapy. 2
FAQs
1. Do all patients need to stay in the hospital during treatment ?
No. Hospitalization is mainly needed during early “step-up” doses or if CRS risk is higher—not for every dose.
2. Can COLUMVI be delayed if not feeling well ?
Yes. Treatment may be delayed or paused to manage side effects safely, and dosing may be adjusted if needed.
3. What should a patient eat or avoid on treatment days ?
Patients can avoid greasy, fried, fatty, sweet, or spicy foods if they make them feel sick after consumption. Instead, they can opt for smaller meals (5-6) throughout the day rather than 3 larger meals, which can include:
- Bland or cold foods (such as toast, rice, crackers, pudding, gelatin, or yogurt)
- Drinking plenty of clear fluids throughout the day, such as water, broth, tea, or other beverages recommended by doctor, to help prevent dehydration
- Foods which don’t have strong odors
4. Does a patient need to use contraception during COLUMVI treatment?
Yes. Women who can become pregnant are advised to use effective contraception during treatment and for a period after the last dose, as the medicine may harm an unborn baby.
5. Can a patient breastfeed while receiving COLUMVI?
No. Breastfeeding is not recommended during treatment and for some time after the last dose because the medicine may pass into breast milk.
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6. Are there any neurological side effects to watch for?
Yes. There might be neurological effects for which patients should be watchful such as symptoms like confusion, difficulty speaking, tremors, or seizures, and report them immediately, as these may indicate serious neurologic effects.
7. What should patients do if they feel unwell between treatment cycles?
Patients should contact their healthcare provider immediately if they experience any unusual symptoms between cycles rather than waiting for the next appointment.
8. Is it important to inform doctor about other medicines which the patient is taking?
Yes. Patients should inform their doctor about all medicines, including prescription medicines, over-the-counter drugs, vitamins and herbal supplements, to avoid potential interactions or complications.
9. Can a patient travel while on COLUMVI
Travel possibilities should be discussed with the treating doctor as risk of side effects need close monitoring during the treatment.
References:
[i] COLUMVI | European Medicines Agency (EMA). Accessed April 9, 2026. https://www.ema.europa.eu/en/medicines/human/EPAR/COLUMVI
[ii] COLUMVI. Genentech USA. Patient brochure. Accessed April 9, 2026. https://www.COLUMVI.com/content/dam/gene/COLUMVI/pdfs/COLUMVI-patient-brochure.pdf
[iii] How COLUMVI™ treats 3L+ DLBCL. How is COLUMVI thought to work? In COLUMVI™ Genentech USA. https://www.COLUMVI.com/about-COLUMVI/how-it-works.html
[iv] COLUMVI® (glofitamab-gxbm) | Genentech Prescribing & Product Information. Accessed April 9, 2026. https://www.genentech-medinfo.com/our-products/oncology/COLUMVI.html#
[v] FDA grants accelerated approval to glofitamab-gxbm for selected relapsed or refractory large B-cell lymphomas. June 16, 2023. Accessed April 9, 2026.
[vi] What is Named Patient Program (NPP)? Rx4U. Accessed April 10, 2026. https://rx4u.in/#:~:text=What%20is%20Named%20Patient%20Program,application%20process%20for%20marketing%20authorization.
Note:
This information is provided for educational purposes only and is not a substitute for professional medical advice. Columvi (Glofitamab) should only be taken under the guidance of a qualified healthcare provider. Patients should always consult their doctor or pharmacist for advice on diagnosis, treatment, and medication use, and should not make changes to their prescribed therapy without medical supervision.
Disclaimer:
Rx4U procures prescribed medicines directly from manufacturers or authorized distributors. It does not claim ownership of any trademarks and complies with the provisions of the Trademark Act, 1999, particularly Sections 30 and 30(1) concerning ‘Fair Use’. It solely facilitates access to new launches through named patient import.
