Bispecific Antibodies ‘Change the Landscape’ of Lymphoma Treatment

The biggest news of 2023 for patients with lymphoma and provers has been the rise of bispecific antibody treatment options, as one expert tells CURE®.

“I think these drugs as single agents in combination are going to change the landscape of indolent and aggressive B-cell lymphomas, including CLL (chronic lymphocytic leukemia) and SLL (small lymphocytic lymphoma),” Dr. Juan Alderuccio, associate professor of medicine and clinical site disease group leader in the lymphoma section at the University of Miami Sylvester Comprehensive Cancer Center, told CURE®. “And I think we will start to see when we start to obtain the data of the currently ongoing clinical trials, we will see that these therapies are going to be used in early lines of therapy and hopefully, will significantly improve the outcome of these patients.”

Bispecific antibodies, which bond to two targets on lymphoma cells at once, work to activate the immune system and help the patient’s body fight the disease.

LEARN MORE: New Horizons for Diffuse Large B-Cell Lymphoma

The Food and Drug Administration (FDA) approved Lunsumio (mosunetuzumab-axgb) — a CD20xCD3 T-cell engaging bispecific antibody touted by Genentech, the manufacturer of the drug, as a new class of fixed-duration cancer immunotherapy — in December 2022 to treat adults with relapsed or refractory follicular lymphoma.

This was followed by the FDA granting accelerated approval for Epkinly (epcoritamab-bysp) — a bispecific CD20-directed CD3 T-cell engager — for the treatment of patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) in May, an approval which also included patients with DLBCL occurring as a result of indolent lymphoma and high-grade B-cell lymphoma after two or more lines of systemic therapy, according to the FDA’s release.

Then, when the agency approved Columvi (glofitamab-gxbm) for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) or those with large B-cell lymphoma resulting from follicular lymphoma after two or more lines of therapy in June, it made Columvi the first bispecific antibody with a fixed-duration treatment for this patient population, according to Columvi manufacturer Genetech.

“We're seeing a whole variety of new immunotherapies to treat primarily lymphomas,” Lee Greenberger, chief scientific officer of the Leukemia and Lymphoma Society, told CURE® earlier this year as part of our Speaking Out® video series.

“In particular, there are new bispecific antibodies,” Greenberger said. “And what that means is a bispecific antibody, what that does is it's a molecule that can bind to the T-cells and bring the T-cells to the tumor cells. So, it's got two binding sites, and when you bring T-cells to the tumors, it's capable, in the name of the T-cells, to kill the tumors.

“And so we've seen approval (in December 2022) for (Lunsumio [mosunetuzumab]) for follicular lymphoma, and there's two other bispecific antibodies that are approved for large B-cell lymphomas, that means diffuse large B-cell lymphoma and advanced cases of follicular lymphoma. So bispecifics, and in general immunotherapy … (and) engaging T-cells to kill tumors has been really a big advancement in the field, really now approved since 2017 but now we're seeing a wave of bispecifics come through.”

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