Bispecific Antibody Immunotherapy

Bispecific antibody drugs are a newer type of immunotherapy. Immunotherapy drugs work with the immune system and make it stronger. These drugs help the cells in the immune system find, attack, and kill cancer cells more effectively. Like most immunotherapy drugs, bispecific antibody drugs are given through an IV infusion in your vein.

Bispecific antibody drugs offer a promising treatment breakthrough for patients with certain types of cancer. The Food and Drug Administration approved the first bispecific antibody drug in March 2018. Currently, bispecific antibody drugs are approved to treat some patients with acute lymphoblastic leukemia (ALL) and non-small cell lung cancer (NSCLC). Many more bispecific antibody drugs are in clinical trials to treat more types of cancers. 

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How Do Bispecific Antibody Drugs Work?

Bispecific antibody drugs harness the power of the immune system to fight cancer cells.

Most immunotherapy drugs are made of antibody protein molecules with 1 receptor. These molecules can attach to only 1 target. What makes bispecific antibody drugs different is that their molecules have 2 receptors. These molecules can bind to 2 distinct antigens, such as cancer cells, at the same time. Or they can bind to 2 areas on the same antigen at the same time. This can be helpful when treating complex cancers.

All bispecific antibody drugs have 2 receptors, but they work in different ways. Here are 3 ways these drugs work to attack cancer cells:

  • Most bispecific antibody drugs help T cells find and destroy cancer cells. T cells are a type of white blood cell and are the immune system’s “fighters.” Bispecific antibody immunotherapies bind to a T cell and a cancer cell at the same time. The drugs bring a cancer cell and an immune fighter cell together so that the patient’s immune system can fight the cancer on a cellular level.
  • Some bispecific antibody drugs may block signals that help cancer cells grow and spread. Drugs that work this way are most often used to treat solid tumors rather than blood cancers.
  • Some of these drugs bring together a cancer cell with an anticancer drug therapy on a cellular level.

Learn more about immunotherapy

Are These Drugs Right for You?

Bispecific antibody drugs show promise in some patients. But they may not work for everyone who tries them. They also are not used for all types of cancer at this time.

The FDA has approved the use of bispecific antibody drugs in certain patients with ALL. Some bispecific antibody drugs are also approved for patients with NSCLC who have a rare type of mutation. This mutation involves high levels of the biomarker epidermal growth factor receptor and exon 20 insertion mutations. Before the approval of a bispecific antibody drug, there were no targeted therapies for this type of NSCLC.

If you want to know more, start with your health care team. Ask about bispecific antibody drugs that are approved or undergoing clinical trials and whether they are an option for you. Some questions you can ask your team are:

  • What is the goal of treatment with this drug?
  • What are the potential benefits and risks?
  • Is a clinical trial a good choice for you?
  • What are possible side effects? How can you and your team manage them?

You may need to have some tests to see if these drugs may help you.

Are There Side Effects?

The side effects people may have with bispecific antibody drugs can differ. Some can be serious. So, it is vital that you let your health care team know right away if you have any side effects. Your health care team can also help you monitor and manage any side effects.

One potential side effect is cytokine release syndrome (CRS). This may occur when the immune cells affected by the drug rapidly release many cytokines into the blood. CRS can cause fever, nausea, headache, rash, fast heartbeat, low blood pressure, and trouble breathing. This is a common side effect in other immunotherapy treatments like CAR T-cell therapy. Most patients have a mild response. But at times CRS can cause severe or life-threatening symptoms.

Other side effects may include:

Managing Treatment Costs

Bispecific antibody drugs, like other immunotherapies, can be costly. It’s a good idea to address financial concerns before you start treatment with these drugs. These tips can help:

  • Ask if you can get this therapy as part of a clinical trial where the drug cost is covered.
  • Call your health care plan before you start treatment. Ask what the plan will cover and what your costs will be.
  • Ask your health care team if they have resources to help you. Some centers can help you access health insurance or programs that can help pay the costs of treatment. They also may have financial counselors who can walk you through your options.
  • Call our Cancer Support Helpline at 888-793-9355 for information about coping with the costs of cancer treatment.

Learn more about managing cancer costs

Understanding the Costs of Cancer Care
  • The most common medical-related costs for cancer care
  • Practical questions to ask as you learn about cancer care costs
  • Information about resources that can help
Managing Out of Pocket Costs

Hear from guest speakers Joanna Morales and Angie Santangelo about stress due to financial issues, tips to reduce stress, out-of-pocket costs, and unexpected costs.

Learn More About Lowering the Costs of Cancer Care