Dr Phillips on the Use of Bispecific Antibodies and CAR T-Cell Therapy in MCL and FL

Tycel Phillips, MD, MPH, associate clinical professor, Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, discusses the use of bispecific antibodies and CAR T-cell therapy across hematologic malignancies, including in patients with mantle cell lymphoma (MCL) and follicular lymphoma (FL).

There are several bispecific antibodies under investigation across the hematologic malignancy landscape, Phillips begins. For example, a phase 3 study with glofitamab-gxbm (Columvi) vs standard-of-care chemotherapy is launching in adult patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL), Phillips says, and accrual to this trial may begin soon. Notably, glofitamab has already been FDA approved in DLBCL not otherwise specified or large B-cell lymphoma arising from FL following at least 2 lines of systemic therapy. Additionally, the bispecific antibody mosunetuzumab was evaluated in the phase 2 GO29781 study (NCT02500407) that showed beneficial safety and efficacy with the agent when given for a fixed duration in patients with relapsed/refractory FL, Phillips explains.

The bispecific antibodies epcoritamab-bysp (Epkinly) and odronextamab do not yet have substantial data in LBCL and DLBCL, respectively, Phillips expands, adding that preliminary data with these agents will show their efficacy. Based on historical data with blinatumomab (Blincyto) in B-cell malignancies, Phillips suspects that epcoritamab and odronextamab will also be effective in this population. However, the safety profiles of these agents may be less favorable, Phillips notes. Bispecific antibodies have different safety profiles in patients with MCL than in those with NHL, making it important to wait and see how the data with these bispecific antibodies play out, he emphasizes. Furthermore, there is an ongoing study in high-risk patients with MCL evaluating the upfront use of glofitamab, he continues.

Regarding CAR T-cell therapy, the early phase 1 Window-3 study (NCT05495464), which is open for accrual at the University of Texas MD Anderson Cancer Center, will investigate first-line CAR T-cell therapy in patients with high-risk MCL, Phillips says. Patients with high-risk MCL have a high level of unmet need, making these ongoing trials vital, Phillips concludes.