Improving the outcomes of transplantation with bispecific antibodies

Hermann Einsele, MD, from the University Hospital Würzburg, Würzburg, Germany, discusses the use of bispecific antibodies before and after allogeneic stem cell transplantation at the 2017 annual meeting of the European Society for Blood and Marrow Transplantation (EBMT) in Marseille, France. He explains that the main issue in stem cell transplantation is the problem of relapse. He therefore argues that disease control needs to be improved. According to Prof. Einsele, the use of bispecific antibodies is an interesting strategy to both reduce the tumor load prior to transplantation, but also to consolidate the patient after transplant if there is still residual disease. Bispecific antibodies are small molecules which connect immune cells with tumor cells and induce a direct lysis of tumor cells. He explains that for acute lymphoblastic leukemia (ALL), the bispecific antibody blinatumomab, is already mostly accepted by the regulators in both the US and in Europe, and is therefore available to treat patients with residual disease prior to allogeneic stem cell transplantation or patients who are relapsing. He also speaks about new indications which are in development, including lymphoma and chronic lymphoblastic leukemia (CLL), where CD19-directed bispecific antibodies are likely to play a major role. In addition, new bispecifc antibodies are being explored in early clinical trials for multiple myeloma (MM) and acute myeloid leukemia (AML), as well as solid tumors.

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