Dr Cherng on Considerations for the Use of Bispecific Antibodies in DLBCL

Hua-Jay “Jeff” Cherng, MD, assistant professor, medicine, Lymphoma Program, Division of Hematology and Oncology, Columbia University Irving Medical Center, discusses efficacy and safety considerations for the use of bispecific antibodies in patients with non-Hodgkin lymphoma, particularly those with diffuse large B-cell lymphoma (DLBCL).

CD3- and CD20-targeting bispecific antibodies are part of a novel class of drugs, several of which have gained regulatory approval for the treatment of patients with relapsed B-cell lymphomas such as follicular lymphoma and DLBCL. The introduction of these agents into the DLBCL treatment paradigm is significant for several reasons, Cherng says. Bispecific antibodies are somewhat analogous to CAR T-cell therapy, which has been shown to be highly effective in the management of relapsed DLBCL since 2017, Cherng explains. Similar to CAR T-cell therapy, bispecific antibodies harness the immune system to target cancer cells, Cherng notes. However, unlike CAR T-cell therapy, which must be administered at accredited cellular therapy centers, bispecific antibodies can potentially be administered in community oncology settings. This broadens access to care for patients who may be unable to obtain treatment at CAR T-cell centers, Cherng emphasizes.

Furthermore, bispecific antibodies provide an additional therapeutic avenue for patients who have relapsed after treatment with chemotherapy, according to Cherng. These agents are also a crucial addition to the DLBCL treatment paradigm because they are alternative options for patients who may not be candidates for CAR T-cell therapy because of logistical, financial, or health reasons, Cherng states.

Despite their treatment potential, bispecific antibodies are associated with unique toxicities, Cherng says. Therefore, health care providers must be educated about the optimal delivery of these agents and the management of their associated adverse effects, Cherng emphasizes. Logistical considerations and factors that influence the choice between bispecific antibodies and CAR T-cell therapy for patients with DLBCL, as well as the best practices for administering each of these agents, are essential topics for ongoing education and discussion, Cherng concludes.