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Leo I. Gordon, MD, FACP
Leo I. Gordon, MD, FACP
Posted: Friday, October 7, 2022
Rory Bennett, MBChB, of Peter MacCallum Cancer Centre, Parkville, Victoria, Australia, and colleagues reviewed the emerging safety and efficacy data on CD20/CD3 bispecific T-cell engaging antibodies for the treatment of B-cell lymphoma. During the 2022 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract EXABS-198-ABCL), the study authors elaborated on the pharmacology, efficacy, and toxicity of these antibodies, as well as how they may perform when combined with other treatments.
“Clinical data indicate that bispecific antibodies will earn a place in regular treatment of relapsed aggressive lymphoma,” concluded the study authors. “There is broad development potential in earlier lines of therapy and as a salvage following CAR T-cell therapy.”
Contrary to their predecessors, CD20/CD3 bispecific antibodies currently in development are similar to immunoglobulin-G full-length antibodies. This structure allows them to have a longer half-life and offers clinicians the option to dose intermittently, the study authors noted. Different histologic subtypes of both large B-cell lymphoma (LBCL) and mantle cell lymphoma have exhibited sensitivity to this class of agents.
The CD20/CD3 bispecific antibodies epcoritamab and glofitamab have demonstrated approximately a 40% rate of complete remission after the failure of chimeric antigen receptor (CAR) T-cell therapy. Additionally, the antibody odronextamab has been observed to provide multiyear complete remissions, although the rate of complete response is lower than the aforementioned drugs.
Despite their efficacy, the incidence of reported cytokine-release syndrome was common. Although rare, neurologic toxicities were reported with all agents.
To date, these bispecific antibodies are being combined with standard salvage therapies to treat aggressive and relapsed or refractory disease. Data from EPCORE NHL-2 (ClinicalTrials.gov Identifier NCT04663347), using first-line epcoritamab plus the traditional rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, demonstrated a 96% overall response rate in diffuse LBCL (DLBCL). Additionally, individuals with advanced DLBCL who were treated with epcoritamab plus gemcitabine and oxaliplatin had objective and complete response rates of 92% and 60%, respectively.
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