Efficacy of bispecific T-cell engagers after CAR T-cell therapy failure in aggressive large B-cell lymphoma

No recognized standard of care exists at the present time for treatment for large B-cell non-Hodgkin lymphoma that relapses or progresses after chimeric antigen receptor T-cell (CAR T-cell) therapy. Bispecific T-cell engagers (BiTEs) have emerged as an effective treatment for patients with relapsed or refractory (R/R) LBCL. The purpose of this systematic review and meta-analysis is to appraise the totality of evidence on the role of BiTEs as treatment for LBCL after CAR T-cell therapy failure. Results showed that pooled overall response rate of all BiTEs is 51 %, and the pooled complete remission rate is 31 %. The pooled rates for progression-free and overall survival are 31 % and 48 %, respectively. The pooled non-relapse mortality rate is 4 %, emphasizing the relative safety of BiTEs in this population. Available data did not permit a comparative assessment across different BiTE products. Therefore, future research, specifically prospective head-to-head randomized controlled trials, would be necessary to make definitive comparisons.