On May 13th, as part of HealthTree’s CLL Webinar Program, CLL specialist Dr. Adam Kittai from the Icahn School of Medicine at Mount Sinai shared an enlightening presentation on the potential of bispecific antibodies in treating chronic lymphocytic leukemia (CLL). Watch the event's recording below or read the summary.
You may be familiar with monoclonal antibodies used in CLL treatment, such as rituximab (Rituxan) and obinutuzumab (Gazyva). Monoclonal antibodies target one protein on the surface of cancerous B-cells like CLL, called CD20. Binding to this surface protein signals the immune system to target and destroy cancer cells.
Bispecific antibodies attach to two targets. One is the CD20 surface protein on CLL cells, and the second is a surface protein on cancer-killing T-cells. By binding to both targets, the bispecific antibodies act as a bridge, connecting the T-cells to the cancer cell, thereby allowing the T-cells to attack the cancer cell.
This mechanism of action is helpful as T-cells often have difficulty finding and killing CLL cells on their own.
Although several bispecific antibodies are FDA-approved for other types of non-Hodgkin lymphomas, they are still under review for CLL. Dr. Kittai stated the main reasons are that CLL dampens T-cell activity more than other cancers and tends to circulate widely in the blood, creating concerns about treatment efficacy and increased toxicity.
Despite these challenges, the promise of bispecific antibodies in CLL remains high, with several clinical trials exploring combinations of bispecific antibodies with therapies such as venetoclax and lenalidomide to enhance T-cell efficacy and overall treatment outcomes.
The FDA-approved bispecific antibodies for other types of non-Hodgkin lymphomas include epcoritamab (Epkinly), glofitamab (Columvi), and mosunetuzumab (Lunsumio).
CLL patients who would like to receive treatment with a bispecific antibody can do so through the following clinical trials:
To learn more about CLL clinical trials, click here. If you have questions regarding signing up for a clinical trial, click the “Begin Now” button for HealthTree Patient Navigators to assist you.
The main differences between epcoritamab, glofitamab, and mosunetuzumab are how they are administered and for how long.
Bispecific antibodies show a favorable safety profile compared to CAR T-cell therapies. The primary concern with bispecific antibodies is cytokine release syndrome (CRS), which occurs when the activated T-cells release a high level of inflammatory molecules called cytokines during the treatment process.
CRS typically presents with symptoms like fever, which can escalate to more severe conditions such as low blood pressure and high heart rate. Despite its potential severity, CRS can often be managed at home with over-the-counter remedies like Tylenol and prescribed steroids as initial treatments. However, hospital admission is recommended for more severe or persistent symptoms.
Another notable side effect of bispecific antibodies is neurotoxicity, although it occurs less often than with CAR T-cell therapy, affecting fewer than 10% of patients. In more severe cases, this side effect may manifest as confusion or decreased responsiveness.
Other risks include infections and prolonged low counts of various blood cells (cytopenias), which are generally less frequent but require careful monitoring.
Encouragingly, recent studies and clinical trials indicate that even patients with significant comorbidities can tolerate bispecific antibodies well, with no deaths attributed to CRS reported in these studies. As such, while bispecific antibodies share some toxicities with other cancer therapies, their rapid availability and ease of administration over extended periods make them an important option in managing cancers.
In conclusion, Dr. Kittai's presentation reflects a cautious yet optimistic view toward bispecific antibodies in CLL treatment. As research progresses, these therapies may soon offer new hope for patients, especially those who have exhausted other treatment options. The ongoing trials and studies will be crucial in determining the efficacy and safety of bispecific antibodies for CLL, potentially leading to their approval and widespread use in the near future.
During the event, Dr. Kittai answered several patient questions. Some of these included:
To listen to these questions’ answers, we invite you to watch the event recording by clicking here.
We invite you to click the button below to subscribe to the HealthTree for CLL newsletter and stay updated on the latest advancements in CLL.
On May 13th, as part of HealthTree’s CLL Webinar Program, CLL specialist Dr. Adam Kittai from the Icahn School of Medicine at Mount Sinai shared an enlightening presentation on the potential of bispecific antibodies in treating chronic lymphocytic leukemia (CLL). Watch the event's recording below or read the summary.
You may be familiar with monoclonal antibodies used in CLL treatment, such as rituximab (Rituxan) and obinutuzumab (Gazyva). Monoclonal antibodies target one protein on the surface of cancerous B-cells like CLL, called CD20. Binding to this surface protein signals the immune system to target and destroy cancer cells.
Bispecific antibodies attach to two targets. One is the CD20 surface protein on CLL cells, and the second is a surface protein on cancer-killing T-cells. By binding to both targets, the bispecific antibodies act as a bridge, connecting the T-cells to the cancer cell, thereby allowing the T-cells to attack the cancer cell.
This mechanism of action is helpful as T-cells often have difficulty finding and killing CLL cells on their own.
Although several bispecific antibodies are FDA-approved for other types of non-Hodgkin lymphomas, they are still under review for CLL. Dr. Kittai stated the main reasons are that CLL dampens T-cell activity more than other cancers and tends to circulate widely in the blood, creating concerns about treatment efficacy and increased toxicity.
Despite these challenges, the promise of bispecific antibodies in CLL remains high, with several clinical trials exploring combinations of bispecific antibodies with therapies such as venetoclax and lenalidomide to enhance T-cell efficacy and overall treatment outcomes.
The FDA-approved bispecific antibodies for other types of non-Hodgkin lymphomas include epcoritamab (Epkinly), glofitamab (Columvi), and mosunetuzumab (Lunsumio).
CLL patients who would like to receive treatment with a bispecific antibody can do so through the following clinical trials:
To learn more about CLL clinical trials, click here. If you have questions regarding signing up for a clinical trial, click the “Begin Now” button for HealthTree Patient Navigators to assist you.
The main differences between epcoritamab, glofitamab, and mosunetuzumab are how they are administered and for how long.
Bispecific antibodies show a favorable safety profile compared to CAR T-cell therapies. The primary concern with bispecific antibodies is cytokine release syndrome (CRS), which occurs when the activated T-cells release a high level of inflammatory molecules called cytokines during the treatment process.
CRS typically presents with symptoms like fever, which can escalate to more severe conditions such as low blood pressure and high heart rate. Despite its potential severity, CRS can often be managed at home with over-the-counter remedies like Tylenol and prescribed steroids as initial treatments. However, hospital admission is recommended for more severe or persistent symptoms.
Another notable side effect of bispecific antibodies is neurotoxicity, although it occurs less often than with CAR T-cell therapy, affecting fewer than 10% of patients. In more severe cases, this side effect may manifest as confusion or decreased responsiveness.
Other risks include infections and prolonged low counts of various blood cells (cytopenias), which are generally less frequent but require careful monitoring.
Encouragingly, recent studies and clinical trials indicate that even patients with significant comorbidities can tolerate bispecific antibodies well, with no deaths attributed to CRS reported in these studies. As such, while bispecific antibodies share some toxicities with other cancer therapies, their rapid availability and ease of administration over extended periods make them an important option in managing cancers.
In conclusion, Dr. Kittai's presentation reflects a cautious yet optimistic view toward bispecific antibodies in CLL treatment. As research progresses, these therapies may soon offer new hope for patients, especially those who have exhausted other treatment options. The ongoing trials and studies will be crucial in determining the efficacy and safety of bispecific antibodies for CLL, potentially leading to their approval and widespread use in the near future.
During the event, Dr. Kittai answered several patient questions. Some of these included:
To listen to these questions’ answers, we invite you to watch the event recording by clicking here.
We invite you to click the button below to subscribe to the HealthTree for CLL newsletter and stay updated on the latest advancements in CLL.
about the author
Megan Heaps
Megan joined HealthTree in 2022. As a writer and the daughter of a blood cancer patient, she is dedicated to helping patients and their caregivers understand the various aspects of their disease. This understanding enables them to better advocate for themselves and improve their treatment outcomes. In her spare time, she enjoys spending time with her family.
Subscribe to the weekly newsletter for news, stories, clinical trial updates, and helpful resources and events with cancer experts.