A Review of Bispecific T-cell Engagers (BiTEs): A Promising Strategy in the Evolving Landscape of Cancer Immunotherapy

Abstract Bispecific antibodies (BsAbs) targeting two distinct antigens have emerged with the advent of knobs-into-holes technology of 1996 as a significant advancement in antibody-based immunotherapy. This dual-targeting capability and strategy is of immense value in the field of oncology. Bispecific T-cell engagers (BiTEs) are BsAbs engineered to activate and bridge T-cells through the CD3 receptor with cancer cell antigens (tumor-associated antigen, TAA) triggering a cytotoxic immune response. BiTEs as readily available, “off-the-shelf” active immunotherapies circumvent some of the logistical and biological challenges associated with charismatic chimeric antigen receptor (CAR) T-cell therapies. This is an unmet need highlighting the importance of alternative or sequential therapies. Next-generation BiTEs are emerging as highly active agents in relapsed–refractory (R/R) diffuse large B-cell lymphoma (DLBCL) and many other malignancies. Hence, BiTEs are rapidly establishing themselves as a versatile and potent class of immunotherapies, offering a readily available, and potentially less toxic, therapeutic option for a broad patient population, including those who have exhausted other treatment options.