Dr Moustafa on the Evolving Use of Bispecific Antibodies in DLBCL

Muhamad Alhaj Moustafa, MD, MS, hematologist, medical oncologist, Departments of Hematology and Oncology (Medical), Mayo Clinic, discusses currently available bispecific antibodies for the treatment of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).

The use of bispecific antibodies in relapsed/refractory DLBCL has increased in the last few years, with several agents receiving FDA approval.

On June 15, 2023, the bispecific antibody therapy, glofitamab-gxbm (Columvi) received accelerated approval from the FDA for the treatment of adult patients with relapsed/refractory DLBCL not otherwise specified or large B-cell lymphoma arising from follicular lymphoma who received 2 or more prior lines of systemic therapy. This approval was supported by findings from the phase 1/2 NP30179 trial (NCT03075696), in which patients who received glofitamab achieved an objective response rate of 56% and a complete response rate of 43%.

The addition of agents such as glofitamab to the DLBCL arsenal addresses the lack of effective options for patients who progressed on prior CAR T-cell therapy, Moustafa begins. These antibodies have a novel mechanism of agent, targeting specific cell surface markers and augmenting the immune response against cancer cells. Clinical trials leading to the approval of bispecific antibodies have demonstrated efficacy in providing additional lines of therapy for patients with DLBCL, he adds.

Moustafa explains that prior to the availability of bispecific antibodies, options for patients with DLBCL were somewhat limited. Although the addition of CAR T-cell therapy to the treatment arsenal helped improve patient outcomes in this space, there were few effective alternatives to this therapeutic class. Bispecific antibodies have further expanded the treatment armamentarium in DLBCL, thereby potentially improving patient outcomes, helping to address this unmet need.

Overall, the emergence of bispecific antibodies represents a key advancement in the approach to DLBCL management and underscores the significance of ongoing research and innovation in this disease space, particularly related to the development of targeted immunotherapies. Further investigations are warranted to elucidate the long-term efficacy and safety profile of bispecific antibodies across diverse patient populations.