EHA-SWG 2017 | Rare Lymphomas: Bispecific antibodies (BITES)

On March 12^th, at the EHA-SWG Rare Lymphomas Scientific Meeting 2017 in Barcelona, Spain, Marie José Kersten chaired a scientific session on ‘Fighting Lymphoma with T-cells’. The second presentation of this session was given by Andreas Viardot, from the University Hospital, Ulm, Germany, on the topic of ‘Bispecific Antibodies’. Below are the key highlights from this presentation:

• Bispecific antibodies are a diverse group of engineered molecules which combine two or more monoclonal antibody variable regions
• In cancer, Bispecific T-cell Engagers (BiTEs) can work by recruiting a T-cell to a cancer cell to bring about tumor lysis through T-cell activation
• Blinatumomab (CD19xCD3) has recently been given FDA and EMA approval in R/R Acute Lymphoblastic Leukemia

• Treatment typically requires a constant level of antibody to be maintained in the blood, therefore constant IV infusion for a sustained period of time is necessary
• Bispecific antibody treatment can result in early CRS, which transiently spikes; can be quickly mitigated by reducing dose due to the antibody’s short half-life in addition to other methods

• Recent phase I study results in NHL which treated patients with continuous IV blinatumomab (CD19xCD3) for 4–8 weeks

• Phase II study in R/R DLBCL: ITT ORR = 36%, CR = 16%, PR = 20%

• Potential new strategies for improving BiTEs in lymphoma
  • New CNS mitigation strategies
  • Modifying the sequence of treatment i.e. pre-conditioning or alternating BiTE and chemotherapy
  • Combining BiTE therapy with checkpoint inhibitors (ongoing trials)
• A Newer range of CD20xCD3 antibodies are currently being trialed in lymphoma:

• Conclusions: