Dr Awan on the Evolving Role of Bispecific Antibodies Treatment in DLBCL

Farrukh Awan, MD, professor, Department of Internal Medicine, UT Southwestern Medical Center, member, Division of Hematology and Oncology, Harold C. Simmons Comprehensive Cancer Center, discusses the evolving role of bispecific antibodies in the treatment paradigm of relapsed diffuse large B-cell lymphoma (DLBCL).

Despite the success of frontline therapy in curing a substantial proportion of patients with DLBCL, a significant subset of these patients will experience relapse, Awan begins. Historically, treatment options for relapsed disease were limited to salvage chemotherapy, immunotherapy, or CAR T-cell therapy. However, CAR T-cell therapy poses its own unique challenges. For example, the lengthy time that is often needed for manufacturing, which causes a higher risk of disease progression during this period, makes this treatment option inaccessible for individuals in need of immediate intervention, Awan explains.

Awan notes that bispecific antibodies offer a promising alternative in this context, serving as an off-the-shelf immunotherapy option that can be administered without the delay associated with CAR T-cell production, he continues. These agents work by simultaneously engaging T cells and tumor cells, facilitating direct immune-mediated cytotoxicity, Awan explains. Initially introduced for patients in the third-line setting or those who were ineligible for CAR T-cell therapy, bispecific antibodies have demonstrated significant efficacy in these populations, providing an immediate treatment option for those with aggressive disease progression, he reports.

Awan emphasizes that as access to these therapies grows, they are becoming a key component of the treatment landscape for relapsed DLBCL, particularly for patients who are unsuitable for CAR T-cell therapy or those who experience relapse after CAR T-cell therapy treatment, Awan continues. Bispecific antibodies represent a critical advancement in the management of relapsed DLBCL, offering a viable and timely therapeutic alternative that bypasses the manufacturing delays associated with CAR T-cell therapy while maintaining efficacy in this difficult-to-treat patient population, he concludes.