Abstract

Bispecific antibodies (BsAbs) are designed to recognize and bind to two different antigens or epitopes. In the last few decades, BsAbs have been developed within the context of cancer therapies and in particular for the treatment of hematologic B-cell malignancies. To date, more than one hundred different BsAb formats exist, including bispecific T-cell engagers (BiTEs), and new constructs are constantly emerging. Advances in protein engineering have enabled the creation of BsAbs with specific mechanisms of action and clinical applications. Moreover, a better understanding of resistance and evasion mechanisms, as well as advances in the protein engineering and in immunology, will help generating a greater variety of BsAbs to treat various cancer types. This review focuses on T-cell-engaging BsAbs and more precisely on the various BsAb formats currently being studied in the context of B-cell malignancies, on ongoing clinical trials and on the clinical concerns to be taken into account in the development of new BsAbs.

Highlights

  • The idea of bispecific antibodies (BsAbs) was initially launched in the early 1960s and the first examples were constructed in 1985 [1]

  • Three main BsAbs have been developed for the treatment of B-cell acute lymphoblastic leukemia (ALL): Blinatumumab, AMG103 (BiTE), MGD011 and AFM11 (Tandem diabody: Tandem diabodies (TandAb))

  • The preclinical results in murine non-Hodgkin’s lymphoma (NHL) models was promising, the clinical development of MGD011 was discontinued early due to high levels of neurotoxicity observed in a Phase I study on the treatment of B-cell malignancies (NHL, Chronic lymphocytic leukemia (CLL), and NCT02743546) [85]

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Summary

Introduction

The idea of bispecific antibodies (BsAbs) was initially launched in the early 1960s and the first examples were constructed in 1985 [1]. BsAbs in B-Cell Malignancies development resulting in more than 100 different formats that have been designed [6].

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