Bispecific antibody therapy is emerging as a promising option for patients with advanced cancer. Lee Pendleton, PharmD, from Arizona Oncology, helps patients and their families better understand how this innovative therapy works, its potential benefits, and what to expect.
How Does Bispecific Antibody Therapy Work?
Bispecific antibodies either work to stimulate the immune system, deliver a therapeutic payload, bind to a specific cell receptor, and, in some cases, a combination of all three. Antibodies are shaped like the letter “Y,” and scientists have learned how to manipulate them so that each end of the “Y” becomes a site of therapeutic activity. Traditional antibody therapies only utilize one of the three ends of the “Y”. The multi-functionality of bispecific antibodies make them a versatile tool in cancer treatment.
Some bispecific antibodies carry a therapeutic payload on one of the ends of the “Y” while one of the other ends of the “Y” binds to a specific cell membrane binding site. Once bound, the therapeutic agent is able to pass through the cell membrane directly into the cancer cell to arrest its growth and replication.
How Effective is It?
Bispecific therapy is currently being used to treat cancers like multiple myeloma, diffuse large B-cell lymphoma, follicular lymphoma, non-small cell lung cancer, and renal cell cancer. Additional types of solid tumors are being evaluated in clinical trials.
What is exciting about these therapies is that significant responses are being seen in patients with advanced disease who have already been treated with two and three lines of chemotherapy, immunotherapy or a combination of the two. These therapies offer hope, especially for those with advanced disease where traditional treatments may not have been effective.
Lee Pendleton points out that, as a clinician, the “complete molecular response” being seen with these therapies is the most encouraging part. Clinical findings are similar to that of some HIV medications, which are so effective that HIV cannot be detected while the patient is taking the medication. While that does not necessarily mean cancer patients will experience the same result, Pendleton states that in 30 years of work as a clinician, he never expected to see these types of results in patients with advanced disease who are three and four lines of therapy into treatment.
Because of its newness, bispecific antibody therapy is usually reserved for patients who have exhausted other treatment options and is typically used as a standalone treatment. However, as it becomes part of earlier lines of therapy, combinations with chemotherapy or other treatments may become more common.
While there’s not enough data to confirm how bispecific antibody therapy affects recurrence rates, early results are already pointing to better long-term outcomes for patients with advanced and heavily treated cancers.
What To Expect
Bispecific antibody therapies that have passed FDA approval are typically covered by insurance, based on the approved indications and relevant guidelines. Most new patients will need to commit to anywhere from thirty to sixty days of intense monitoring and visits to the office, ranging anywhere from one to six hours. As the disease is brought under control, the frequency of visits goes down as well as the time required for each visit. Current research is attempting to determine what type of follow-up might be necessary after treatment.
While bispecific antibody therapy is associated with some of the same side effects as chemotherapy, the effects tend to be less severe, resulting in an improved quality of life while the patient is receiving treatment. As patients respond to treatment, side effects may lessen over time.
The Future of Cancer Treatment
Bispecific antibody therapy is redefining what’s possible in cancer treatment, providing new hope for many patients and improving quality of life along the way. Arizona Oncology is evaluating its ability to start patients on bispecific therapies from the first dose at its Prescott, Arizona location.