Varon Ben, Horowitz Netanel A, Khatib Hazim
Department of Hematology and Bone Marrow Transplantation, Rambam Healthcare Campus, Haifa 3109601, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel.
Patient Prefer Adherence. 2024 Oct 26;18:2159-2167. doi: 10.2147/PPA.S485838. eCollection 2024.
This article provides an overview of the novel treatments focusing on the class of bispecific T cell engagers (BiTEs) for the treatment of diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL), the two most prevalent subtypes of B cell non-Hodgkin lymphomas (B-NHL). After a brief outline of these diseases, the difficulties in the management of relapsed or refractory (R/R) disease are highlighted. There are currently 4 main BiTEs showing promise in treating R/R B-NHL-glofitamab, epcoritamab, mosunetuzumab, and odronextamab. Although the rational of their mechanism of action is similar, there are significant differences in their respective clinical trial design, reported outcomes, and the final FDA approvals. Considerations for selecting a specific BiTE therapy, including treatment duration, cost, administration route, adverse effects, and impact on quality of life, are also discussed. Patient preferences and shared decision making should be acknowledged by healthcare providers. Finally, the importance of personalized treatment strategies and ongoing research to optimize outcomes in the evolving landscape of R/R B-NHL therapy cannot be overstated.
本文概述了针对双特异性T细胞衔接器（BiTEs）类药物的新型治疗方法，这些方法用于治疗弥漫性大B细胞淋巴瘤（DLBCL）和滤泡性淋巴瘤（FL），这是B细胞非霍奇金淋巴瘤（B-NHL）中两种最常见的亚型。在简要概述这些疾病后，强调了复发或难治性（R/R）疾病管理中的困难。目前有4种主要的BiTEs在治疗R/R B-NHL方面显示出前景——吉妥昔单抗、依泊妥单抗、莫苏奈妥珠单抗和奥多奈单抗。尽管它们作用机制的原理相似，但各自的临床试验设计、报告的结果以及最终获得美国食品药品监督管理局（FDA）的批准存在显著差异。还讨论了选择特定BiTE治疗的考虑因素，包括治疗持续时间、成本、给药途径、不良反应以及对生活质量的影响。医疗保健提供者应考虑患者的偏好并进行共同决策。最后，在R/R B-NHL治疗不断发展的形势下，个性化治疗策略和正在进行的研究对于优化治疗结果的重要性再怎么强调也不为过。
