Bispecific Antibodies

In the swiftly evolving field of immuno-oncology, T-cell redirecting bispecific antibodies (TRBAs), a type of antibody that can bind to two different antigens simultaneously, are a newly emerging platform in immunotherapy for cancer.¹ To date, only the BiTE^®,* (bispecific T-cell engager) molecule blinatumomab has received U.S. FDA approval for a hematological cancer.² More than 50 bispecific antibodies are currently in clinical trials.³

Like CAR T-cells, TRBAs are engineered to specifically target tumor-associated antigens on the surface of cancer cells. However, currently approved autologous CAR T-cell therapies require taking blood from the cancer patient, processing their white cells, engineering them to attack the patient's specific cancer, and reinfusing the CAR T-cells into the patient where they grow and kill the cancer. By contrast, the bispecific antibody technology that is currently FDA-approved is “off-the-shelf” and requires no ex vivo manipulation. Thus, TRBAs may be viewed as simpler and faster to produce cellular anti-cancer immunotherapy.^3,4

At present, TRBAs fall into two main groups: small, short-half-life bispecific antibodies, like the commercially available BiTE® molecule blinatumomab, and half-life extended (HLE) bispecific antibodies. Agents with a shorter half-life require continuous infusion, while HLE agents allow for less frequent infusions given their longer biologic half-life.³

Learn how the Association of Cancer Care Centers is preparing care teams for the use of bispecific antibodies as treatment for cancer and explore how programs and practices can safely integrate therapies, optimize care coordination for patients receiving bispecific antibodies, and manage adverse events associated with treatment.

For more information on this project, please contact the ACCC Provider Education department.

References

1. National Cancer Institute. Bispecific antibodies. Definition of Cancer Terms. Last accessed May 20, 2020.
2. FDA Approves BLINCYTO™ (Blinatumomab) Immunotherapy for the Treatment of Relapsed or Refractory B-Cell Precursor Acute Lymphoblastic Leukemia. Amgen. December 3, 2014.
3. Strohl WR, Naso M. Bispecific T-Cell redirection versus chimeric antigen receptor (CAR)-T cells as approaches to kill cancer cells. Antibodies (Basel). 2019;8(3):41. Published online 2019 Jul 3.
4. Helwick C. Bispecific antibodies: successes and challenges. ASCO Post. April 20, 2020. Last accessed May 20, 2020.

* BiTE® is a registered trademark of Amgen, Inc.