T-Cell Redirecting Strategies in Large B-Cell Lymphoma and Follicular Lymphoma

The advent of chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment landscape of relapsed/refractory large B-cell lymphoma (LBCL). After achieving regulatory approval in third line (3L+), randomized trials confirmed superiority over standard-of-care salvage chemoimmunotherapy (CIT) and autologous stem-cell transplantation in patients experiencing progressive disease within 12 months of first-line treatment. On the other hand, bispecific antibodies (BsAbs) are approved in the 3L+, while trials are exploring their potential in an earlier setting, usually in combination with CIT. In follicular lymphoma (FL), both T-cell redirecting strategies are approved in 3L+. The higher response rate with CAR T cells in FL comes at the cost of an increased toxicity risk and logistical barriers, in comparison with off-the-shelf BsAbs. This review focuses on the role of CAR T cells and BsAbs in LBCL and FL, paying special attention to available results and sequencing approaches.