How do bispecific antibodies and CAR-T therapy differ and how are they the same?

The key similarity between bispecific antibody therapy and CAR T-cell therapy is that they both use the  T-cells within your immune system to recognize and kill the myeloma cells. So, they are both considered immunotherapies.

The key differences between the two therapies have to do with how they are manufactured, administered, and their mechanism of action. 

In CAR T-cell therapy, a myeloma patient’s T-cells are collected, grown in a lab, and modified to recognize and attack the myeloma cells. This process takes time, and patients with a heavy disease burden or rapidly progressing myeloma may not have the time to wait for CAR-T therapy to be ready.

Bispecific antibody therapy is “off-the-shelf,” meaning that it is readily available for patients who need it. They are artificially engineered antibodies, so like most medicines used in myeloma, they can be manufactured in large quantities ahead of time. 

CAR T-cell therapies are administered intravenously, while bispecific antibodies can be administered intravenously or by a subcutaneous injection.

Bispecifics, as of July of 2024, require repeated treatment cycles (continuous therapy), whereas CAR-T is a one-and-done procedure, often not followed by any maintenance medication.

To learn more about CAR T-cell therapy, check our HealthTree University unit on CAR-T basics.