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SOHO 2025 | Bispecifics and CAR T-cell therapy in lymphoma: sequencing strategies and considerations
Tycel Phillips, MD, City of Hope, Duarte, CA, shares his thoughts on the potential role of bispecific antibodies in patients with lymphoma, particularly in relation to CAR T-cell therapy. Dr Phillips highlights that bispecifics may be a viable option for patients post-CAR-T, as long as the disease still expresses CD20. He also notes that introducing bispecifics before CAR T-cell therapy may be a feasible option for some patients, especially in community settings with limited access to CAR-T. This interview took place at the 13th Annual Meeting of the Society of Hematologic Oncology (SOHO 2025) in Houston, TX.
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Transcript
There’s some data that came out of the second part first. There’s some data that has come out of the French group that looks impressive to say that bispecifics in patients post-CAR-T seem to be the best option as far as salvage. So I do think based on that and the MCL data and what we saw with large cell lymphoma that there will be a role for the bispecifics post-CAR-T, as long as the disease still expresses CD20...
There’s some data that came out of the second part first. There’s some data that has come out of the French group that looks impressive to say that bispecifics in patients post-CAR-T seem to be the best option as far as salvage. So I do think based on that and the MCL data and what we saw with large cell lymphoma that there will be a role for the bispecifics post-CAR-T, as long as the disease still expresses CD20. Now, if we go into a basically T-cell naive patient population, you know, there will be obviously some discussion and we’ll need a longer follow-up whether there needs to be sort of a role one before the other. But, you know, unlike what we see in large cell lymphoma, unfortunately, CAR-T isn’t a cure for mantle cell lymphoma. And so in that situation, it does raise the question of whether you can introduce the bispecifics, especially with the data that more recently came out of ICML with the mosunetuzumab and polatuzumab, whether this may be a more feasible option for some patients versus going to CAR T-cell therapy, especially if we look at community settings, which obviously don’t have access to CAR-T, and patients, at least in the U.S., that may not be willing to come to CAR T-cell centers to receive these medications. So I think over the next couple of years, there will be a lot of jockeying back and forth, and maybe there doesn’t have to be a complete sequence, and maybe we just make adjustments based on our patients’ preferences and where we’re located to determine which of these agents we give first or second. But I do think, at least from what we have right now, giving one before the other does not preclude us from giving the other one at relapse and allows us to hopefully allow for more durability of response for these patients, given that we can sequence these two T cell therapies irrespective of which one goes first.
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