Novel Bispecific T-Cell Engagers for the Treatment of Relapsed B Cell Non-Hodgkin Lymphomas: Current Knowledge and Treatment Considerations

Ben Varon,1 Netanel A Horowitz,1,2 Hazim Khatib1 1Department of Hematology and Bone Marrow Transplantation, Rambam Healthcare Campus, Haifa 3109601, Israel; 2Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, IsraelCorrespondence: Ben Varon, Department of Hematology and Bone Marrow Transplantation, Rambam Healthcare Campus, Haifa, 3109601, Israel, Tel +972-4-7778026, Email [email protected]: This article provides an overview of the novel treatments focusing on the class of bispecific T cell engagers (BiTEs) for the treatment of diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL), the two most prevalent subtypes of B cell non-Hodgkin lymphomas (B-NHL). After a brief outline of these diseases, the difficulties in the management of relapsed or refractory (R/R) disease are highlighted. There are currently 4 main BiTEs showing promise in treating R/R B-NHL—glofitamab, epcoritamab, mosunetuzumab, and odronextamab. Although the rational of their mechanism of action is similar, there are significant differences in their respective clinical trial design, reported outcomes, and the final FDA approvals. Considerations for selecting a specific BiTE therapy, including treatment duration, cost, administration route, adverse effects, and impact on quality of life, are also discussed. Patient preferences and shared decision making should be acknowledged by healthcare providers. Finally, the importance of personalized treatment strategies and ongoing research to optimize outcomes in the evolving landscape of R/R B-NHL therapy cannot be overstated.Keywords: bispecific, BiTE, glofitamab, epcoritamab, mosunetuzumab, odronextamab