Bispecifics

The Bispecific drug Mosunetuzumab was approved for the treatment of follicular lymphoma in the USA in 2022. Bispecifics are now used in the NHS for lymphoma, Glofitamab is used for diffuse large B cell, but they are not used for follicular lymphoma as yet.

Bispecific antibodies have proved to be a significant advance in the treatment and management of follicular lymphoma. The response rates are high, and they are well-tolerated. They are already having an impact and basically they have the potential to revolutionise the treatment of follicular lymphoma. This is extremely exciting.

The antibodies work by attaching themselves to both a cancer cell antigen and an immune system T-cell antigen. So instead of just making it easier for the immune system to recognise the cancer cells, they bring the T-cells directly into contact with the cancer cells, basically joining them together, so that improves the chances of the T-cell destroying the cancer cell.

The main advantage of Bispecifics over CAR-T is that the antibodies are made in the laboratory without needing any of the patient's existing cells. There is no need for the collection and manufacturing process of CAR-T, they are off-the-shelf drugs that can be administered much more quickly. That also makes it a much cheaper treatment option.