# Bispecific Antibodies for Blood Cancers: What a Major Review of 36 Studies Found About Benefits and Safety

A systematic review of 36 clinical studies covering 19 different bispecific antibodies (BsAbs) found that these engineered immune drugs have established, meaningful activity in three blood cancers: B-cell precursor acute lymphoblastic leukemia (BCP-ALL), B-cell non-Hodgkin lymphoma (NHL), and multiple myeloma (MM). Blinatumomab remains the most studied agent in relapsed or refractory BCP-ALL, with complete response (CR) rates of 31.11% to 64.00% and measurable residual disease (MRD) clearance rates of 70.45% to 88.00%. In contrast, bispecific antibodies in acute myeloid leukemia (AML), Hodgkin lymphoma (HL), and T-cell lymphoma (TCL) remain early-phase with limited efficacy and no regulatory approvals to date. Safety is the main trade-off: cytokine release syndrome (CRS) occurred in 1.59% to 82.61% of patients across studies, and neurologic events exceeded 50% in several Blinatumomab trials, while cytopenias (low blood cell counts) and infections remain major challenges in multiple myeloma.

# Bispecific Antibodies for Blood Cancers: What a Major Review of 36 Studies Found About Benefits and Safety

## Table of Contents

- Key Points
- Background: Why This Research Matters
- How the Researchers Conducted the Review
- How Many Studies Were Included
- What the Included Studies Looked Like
- Which Bispecific Antibodies Are Approved Today
- Key Findings: Leukemia
- Key Findings: Lymphoma
- Key Findings: Multiple Myeloma
- Safety: The Overall Side Effect Picture
- Safety: Cytokine Release Syndrome
- Safety: Neurotoxicity, Cytopenias, and Infections
- Clinical Implications: What This Means for Patients
- Limitations: What This Review Could Not Prove
- Recommendations and What to Ask Your Care Team
- Frequently Asked Questions
- Source Information

## Key Points

- A review of 36 studies found bispecific antibodies have established activity in B-cell precursor ALL, B-cell non-Hodgkin lymphoma, and multiple myeloma, but not yet in AML, Hodgkin lymphoma, or T-cell lymphoma.
- In relapsed or refractory B-cell precursor ALL, Blinatumomab produced complete response rates of 31.11% to 64.00% and MRD clearance rates of 70.45% to 88.00% across the studies reviewed.
- Cytokine release syndrome occurred in 1.59% to 82.61% of patients; most cases were grade 1 to 2, typically appearing within 1 to 2 days and resolving within 2 to 3 days.
- Neurologic events occurred in more than 50% of patients in several Blinatumomab studies, making neurologic monitoring a central part of care for anyone receiving these drugs.
- Bispecific antibodies are off-the-shelf therapies that do not require the personalized manufacturing of CAR-T therapy, which can allow faster treatment initiation and broader patient access.

## Background: Why This Research Matters

Hematologic neoplasms (cancers that start in the blood, bone marrow, or lymphatic system) are a growing global health problem. Doctors classify them by where they begin: leukemias arise in the blood, lymphomas develop in the lymph nodes, and myelomas originate in the bone marrow.

Among leukemias, **acute myeloid leukemia (AML)** is the most common acute leukemia in adults. AML is marked by significant genetic and clonal heterogeneity — meaning the cancer cells are not all identical, and this variety is one reason the disease resists treatment.

Lymphomas are split into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). NHL represents about **90% of all lymphoma cases** and arises from lymphocytes (a type of white blood cell) at different stages of development. **Multiple myeloma (MM)** accounts for roughly **10% of all hematologic neoplasms**. It remains incurable and typically follows an asymptomatic precursor state, meaning patients often have abnormal blood proteins for years before symptoms appear.

The burden of these diseases has climbed over the last three decades. Both new cases (incidence) and deaths (mortality) have risen, especially in older populations. Patients with blood cancers also face higher risks of treatment-related complications and higher death rates compared with patients who have solid tumors, such as lung or breast cancer. The median age at diagnosis is **70.8 years**, and overall **5-year relative survival is 69.2%** — a figure that reflects real progress in treatment.

That progress includes chemotherapy, monoclonal antibodies (mAbs, laboratory-made immune proteins that target one specific marker), and chimeric antigen receptor T (CAR-T) cell therapy (a treatment where a patient's own T cells are genetically reprogrammed to attack cancer). Even so, many patients still experience treatment failure because of relapse, resistance, or simply a shortage of good options.

Bispecific antibodies (BsAbs) are a newer answer to that problem. These engineered molecules can bind two different targets (epitopes) at the same time. That dual targeting increases specificity and helps overcome drug resistance.

Why does dual targeting matter? Traditional monoclonal antibodies and CAR-T therapies often fail when tumor cells lose the antigen (the surface marker) the treatment is aiming at. Two well-known examples are **CD19 loss** in B-cell cancers and **B-cell maturation antigen (BCMA) loss** in multiple myeloma. When the target disappears, the treatment stops working. Bispecific antibodies get around this by engaging multiple antigens or multiple immune effectors at once — for instance, simultaneously grabbing a tumor marker such as CD19, CD20, or BCMA while also grabbing an immune trigger such as CD3 on T cells or CD16A on natural killer cells. This ensures the tumor cell keeps being recognized and destroyed.

There is a practical advantage, too. CAR-T therapy requires personalized manufacturing and long processing times, which can take weeks. Bispecific antibodies are off-the-shelf therapies, meaning they are pre-made and ready to give. That allows rapid treatment initiation and broader patient access.

Among bispecific antibodies, **bispecific T-cell engagers (BiTEs)** — molecules that physically link T cells to cancer cells — have shown the most promise in blood cancers. This has led to several recent FDA approvals, including Blinatumomab for Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (Ph-negative R/R BCP-ALL), Mosunetuzumab for relapsed or refractory follicular lymphoma (R/R FL), and Epcoritamab for diffuse large B-cell lymphoma (DLBCL).

Despite this rapid expansion, no comprehensive systematic review had evaluated the safety and efficacy of bispecific antibodies across *all* hematologic neoplasms. That is the gap this review set out to fill.

## How the Researchers Conducted the Review

The authors followed the PRISMA 2020 guidelines, an internationally accepted standard for reporting systematic reviews. They registered their protocol in advance with PROSPERO, the international prospective register of systematic reviews (registration number CRD42023467556). Registering a protocol in advance means the researchers committed to their methods before seeing the results, which reduces the chance of bias.

The team searched four major bibliographic databases: PubMed, Scopus, Web of Science, and EMBASE. They also searched ClinicalTrials.gov, the U.S. registry of clinical trials. Search terms and eligibility criteria were built around the PICO strategy (Population, Intervention, Comparator, Outcomes):

-
**Population:** Adults with hematologic neoplasms — leukemia, lymphoma, and multiple myeloma.
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**Intervention:** Bispecific antibodies that engage CD3 and those that do not, with no formal comparator required.
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**Efficacy outcomes:** Measurable residual disease (MRD), very good partial response (VGPR), overall response rate (ORR), complete response (CR), stringent complete response (sCR), progression-free survival (PFS), and overall survival (OS).
-
**Safety outcomes:** Serious adverse events (SAEs), grade ≥3 adverse events, treatment discontinuation, treatment-related mortality, cytokine release syndrome (CRS), neurotoxicity/immune effector cell-associated neurotoxicity syndrome (ICANS), cytopenias (low blood cell counts), infections, and hypogammaglobulinemia (low levels of protective antibodies).

The search covered database inception through **20 June 2026**. Importantly, the team applied no language or publication date filters, so they captured the full span of bispecific antibody research in blood cancers. They also performed backward and forward citation tracking — checking the reference lists of included studies and looking for later papers that cited them — and ran an updated search one month before submitting the manuscript.

Two researchers screened all retrieved titles and abstracts independently, then reviewed full texts independently to confirm eligibility. Any disagreements were settled through discussion or by consulting a third reviewer. Data were extracted using a standardized, pre-piloted form in Microsoft Excel.

For quality assessment, the team used two validated tools. The **ROBINS-I** tool (Risk Of Bias In Non-randomized Studies – of Interventions) was applied to non-randomized phase I–II studies. The **Cochrane RoB2** tool was applied to phase III randomized trials. For single-arm dose-escalation studies, the researchers adapted ROBINS-I V2 to focus on bias domains relevant to safety and dose-finding signals, with emphasis on confounding, participant selection, missing data, and selective reporting. Judgments were made separately for each key outcome.

A planned meta-analysis (a statistical technique that pools results from multiple studies into one combined estimate) turned out to be unfeasible. The studies were too heterogeneous — too different in design, patient populations, and dosing — and the available data were too limited. The authors therefore summarized the results qualitatively, describing patterns rather than calculating a single pooled number.

Two final notes on method: patients and the public were not involved in designing, conducting, reporting, or disseminating this research. And because the study did not involve human participants or animals directly, research ethics approval was not applicable.

## How Many Studies Were Included

The search process was extensive. The researchers identified **10,847 references** in total, broken down as follows:

- PubMed: 2,733 references
- Embase: 1,888 references
- Scopus: 2,365 references
- Web of Science: 3,861 references

After removing 6,209 duplicate references, **4,638 publications** went through title and abstract screening. Of these, 3,130 records were excluded, and 6 references could not be retrieved in full text. That left 1,502 publications evaluated by full text. A further 1,466 publications were excluded for various reasons. In the end, **36 articles** were included in the qualitative and quantitative data synthesis.

## What the Included Studies Looked Like

All 36 trials were published between **2014 and 2026**. They covered three predominant tumor types: leukemia, lymphoma, and multiple myeloma — with lymphoma being the most prevalent category.

The median age of patients in the studies ranged from **32 to 70 years**, and most participants were male. Just one publication involved newly diagnosed patients (a study by Katz and colleagues published in 2022 in DLBCL). Every other study focused on people with relapsed or refractory disease — meaning the cancer had come back or had stopped responding to prior treatment.

These were heavily pretreated patients. The median number of prior lines of therapy ranged from **one to seven**. The 19 bispecific antibodies in the review were given either by intravenous (IV) infusion into a vein or by subcutaneous injection under the skin.

## Which Bispecific Antibodies Are Approved Today

The review paints a clear picture of where the field stands by disease type.

**In leukemia, CD3–CD19 bispecific antibodies — particularly intravenous Blinatumomab — are the most clinically mature.** The drug has completed four phase II trials and one phase III trial, and it holds regulatory approvals for relapsed or refractory B-cell precursor ALL from 2014 and 2024. A subcutaneous formulation of Blinatumomab was recently evaluated in a phase I/II trial. Meanwhile, CD3–CD123 antibodies in AML — APVO436, Flotetuzumab, and JNJ-63709178 — remain in early-phase development, and none has received regulatory approval. Two more agents, the CD3–CD33 antibody AMG 330 and the CD3–HLA-A2–WT1 antibody RO7283420, were studied in phase I trials. AMG 330 was terminated, while RO7283420 completed phase I evaluation in 2023.

**In lymphoma, CD3–CD20 antibodies have become the dominant class**, building on earlier experience with CD3–CD19 agents. Multiple candidates have completed phase I and II trials, and several phase III studies are ongoing. Beyond CD3–CD20 and CD3–CD19 agents, a CD20–CD37 bispecific antibody was evaluated in a phase Ia study. CD16A–CD30 antibodies were first tested in Hodgkin lymphoma, with limited clinical development for a period, until more recent studies extended their use to peripheral T-cell lymphoma (PTCL).

Two lymphoma approvals stand out. Epcoritamab received FDA approval for relapsed or refractory follicular lymphoma in combination with lenalidomide and rituximab in 2025. Mosunetuzumab expanded from its previously approved intravenous formulation to include a subcutaneous formulation the same year.

**In multiple myeloma, the story has moved fastest.**

1.
**2022:** Teclistamab became the first BCMA-targeting bispecific antibody to receive FDA approval.
1.
**2023:** The GPRC5D-targeting antibody Talquetamab and the BCMA-targeting antibody Elranatamab were approved.
1.
**July 2025:** The BCMA-targeting antibody Linvoseltamab received accelerated FDA approval.
1.
**March 2026:** Teclistamab received approval in combination with daratumumab hyaluronidase-fihj.
1. Teclistamab was also the only agent with an active (not recruiting) phase III trial.

## Key Findings: Leukemia

Thirty-four studies were included in the efficacy analysis. The authors excluded two studies — one by Boyiadzis and colleagues and one by Plesner and colleagues — because those publications reported no efficacy data.

In relapsed or refractory B-cell precursor ALL, Blinatumomab showed substantial clinical activity:

-
**Complete response (CR) rates:** 31.11% to 64.00% (roughly 3 in 10 to 6 in 10 patients)
-
**MRD response rates:** 70.45% to 88.00% (about 7 in 10 to nearly 9 in 10 patients)
-
**HSCT bridging rates:** 20.00% to 67.27% (hematopoietic stem cell transplant — the share of patients who went on to transplant)
-
**Median progression-free survival (PFS):** 5.00 to 18.90 months
-
**Median overall survival (OS):** 6.10 to 36.50 months

MRD response rates were consistently high across studies, including in the trial evaluating the subcutaneous formulation. MRD negativity is important because it means no detectable cancer cells remain on sensitive testing.

Across studies, higher HSCT bridging rates were generally reported alongside longer PFS and OS. The authors caution, however, that this observation should be interpreted carefully. Study populations and designs differed, so it is not possible to conclude that transplant itself caused the longer survival.

Data in Philadelphia chromosome-positive (Ph+) ALL remain more limited. In the Ph+ ALL study included, Blinatumomab achieved an MRD negativity rate of **87.50%**, an HSCT bridging rate of **20.00%**, a median PFS of **6.8 months**, and a median OS of **9.0 months**. These results must be read in the context of distinct disease biology, prior therapies, and the growing use of tyrosine kinase inhibitors (TKIs) in combination strategies.

In AML, results were far more modest. Bispecific antibodies targeting CD3–CD123, CD3–CD33, and CD3–HLA-A2–WT1 showed only preliminary antileukemic activity:

-
**HSCT rates:** 2.38% to 25.00%
-
**CR rates:** 5.00% to 11.36%
-
**Median OS:** 3.2 to 5.93 months

## Key Findings: Lymphoma

In B-cell non-Hodgkin lymphoma, CD3–CD20 bispecific antibodies showed substantial antitumor activity, though response rates varied by lymphoma subtype.

In relapsed or refractory DLBCL (diffuse large B-cell lymphoma) or large B-cell lymphoma, the antibodies produced clinically meaningful activity:

-
**Overall response rate (ORR):** 51.97% to 68.31% (about 5 in 10 to 7 in 10 patients)
-
**Complete response (CR) rate:** 31.50% to 58.47%
-
**Median duration of response (DoR):** 10.20 to 12.00 months
-
**Median PFS:** 4.40 to 13.80 months
-
**Median OS:** 9.20 to 25.50 months

Results in relapsed or refractory follicular lymphoma (FL) were even stronger:

-
**Overall response rate:** 80.00% to 95.06% (8 in 10 to more than 9 in 10 patients)
-
**Complete response rate:** 60.00% to 82.72%
-
**Median duration of response:** 18.00 to 22.80 months
-
**Median PFS:** 17.90 months, reported in one study

Overall, the authors observed considerable heterogeneity — wide variation — in response rates, response depth, and how long responses lasted. In contrast, therapeutic activity in AML, Hodgkin lymphoma, and peripheral T-cell lymphoma remained limited.

## Key Findings: Multiple Myeloma

In multiple myeloma, CD3–BCMA and CD3–GPRC5D bispecific antibodies demonstrated substantial clinical activity across a broad range of measures.

-
**Overall response rate:** 30.95% to 84.46% (about 3 in 10 to 8 in 10 patients)
-
**Very good partial response (VGPR) rates:** 4.76% to 32.41%
-
**Stringent complete response (sCR) rates:** 3.85% to 53.72%
-
**MRD response rates (among studies reporting MRD):** 7.69% to 92.86%
-
**Median duration of response:** 5.50 to 29.40 months
-
**Median PFS:** 2.83 to 11.30 months
-
**Median OS:** 16.00 to 31.40 months

Deep responses — including VGPR and stringent complete response — were a notable feature of this drug class in myeloma. As with lymphoma, however, the range across studies was wide, reflecting differences in patient populations, prior treatments, and antibody targets.

## Safety: The Overall Side Effect Picture

Safety remains a major challenge in bispecific antibody therapy across blood cancers. The toxicity profile varied according to the antibody construct, the target antigen, the disease type, and the dosing strategy.

Across studies, the numbers were striking:

-
**Serious adverse events (SAEs):** 12.17% to 91.30% of patients
-
**Grade ≥3 adverse events (severe side effects):** 27.42% to 95.65% of patients

Despite these high toxicity rates, **treatment discontinuation generally remained below 20%** across studies, and treatment-related mortality was uncommon. In other words, side effects were frequent and sometimes severe, but most patients and their doctors chose to continue treatment.

There were two notable exceptions. A phase I study of a CD3–HLA-A2–WT1 bispecific antibody in AML reported a treatment discontinuation rate of **34.21%**. And a phase III study of Glofitamab in DLBCL reported a discontinuation rate of **57.92%** — the highest in the review. Overall, the authors conclude that severe adverse events were frequent, while treatment discontinuation and treatment-related mortality remained low.

## Safety: Cytokine Release Syndrome

Cytokine release syndrome (CRS) was the most common immune-mediated toxicity of CD3-engaging bispecific antibodies. CRS happens when immune cells release a flood of inflammatory signaling molecules (cytokines) after treatment, causing fever, chills, low blood pressure, and sometimes breathing difficulty.

Across studies, CRS incidence ranged from **1.59% to 82.61%** — an enormous range that reflects differences in antibody targets, dosing, and how aggressively CRS was monitored and reported.

The reassuring news is in the details. Most CRS events were **grade 1–2**, meaning mild to moderate. They typically developed within **1 to 2 days** after treatment initiation and resolved within **2 to 3 days**. This timing pattern matters for patients and care teams, because it means the highest-risk window is short and predictable.

Teclistamab (CD3–BCMA) and Talquetamab (CD3–GPRC5D) were associated with frequent CRS, and neurotoxicity was also reported with these agents. In multiple myeloma specifically, hematologic toxicity (blood-related side effects) and infections remain major challenges.

## Safety: Neurotoxicity, Cytopenias, and Infections

Neurotoxicity — damage or dysfunction in the nervous system — was the other dominant toxicity of CD3-engaging agents. In several Blinatumomab studies, **neurologic events occurred in more than 50% of patients**. This makes neurologic monitoring a central part of care for anyone receiving these drugs.

Beyond CRS, neurotoxicity, cytopenias, and infections were identified as key safety considerations across the field. Cytopenias refer to low counts of blood cells — red cells, white cells, or platelets — and they can lead to fatigue, infection risk, and bleeding problems. The review also tracked hypogammaglobulinemia (low levels of protective antibodies), which can increase susceptibility to infections.

The authors note that the toxicity profile was not uniform. It varied according to the specific bispecific antibody construct, the target antigen, the underlying disease, and the dosing schedule used.

## Clinical Implications: What This Means for Patients

The practical takeaway is that bispecific antibodies now have an established place in three blood cancers — B-cell precursor ALL, B-cell non-Hodgkin lymphoma, and multiple myeloma — but not yet in AML, Hodgkin lymphoma, or T-cell lymphoma.

For patients with relapsed or refractory B-cell precursor ALL, Blinatumomab offers a well-documented path to deep responses and, for many, a bridge to stem cell transplant. For patients with follicular lymphoma, response rates above 80% are notable. For patients with multiple myeloma who have been through several prior lines of therapy, BCMA- and GPRC5D-targeting antibodies can produce deep responses, including MRD negativity, in a substantial proportion of patients.

For patients with AML, Hodgkin lymphoma, or T-cell lymphoma, the picture is different. These antibodies remain under investigation, and the review found limited efficacy and no approvals to date.

Safety management is not a side issue — it is central to treatment. The predictable timing of CRS (usually within 1 to 2 days) and the fact that most cases are grade 1–2 and resolve within 2 to 3 days are useful facts for patients preparing for treatment.

## Limitations: What This Review Could Not Prove

Several limitations are worth understanding.

-
**No pooled analysis was possible.** The authors planned a meta-analysis but could not perform one because the studies were too heterogeneous and the data too limited. That means no single combined estimate of benefit or risk exists across the whole field.
-
**Wide ranges instead of precise numbers.** When results vary as much as they do here (for example, CRS rates from 1.59% to 82.61%), it is difficult to predict an individual patient's experience from the published literature.
-
**Most studies enrolled relapsed or refractory patients.** Only one included study involved newly diagnosed patients, so the findings largely describe patients whose cancer had already returned or stopped responding.
-
**Heavily pretreated populations.** Patients had received a median of one to seven prior lines of therapy, which affects both response rates and tolerability.
-
**Comparison across studies is imperfect.** The authors specifically caution that the link between higher transplant bridging rates and longer survival should be read carefully, because study populations and designs differed.

The authors also note that data in Philadelphia chromosome-positive ALL remain more limited and should be interpreted in the context of distinct disease biology, prior therapy, and the increasing use of tyrosine kinase inhibitors in combination strategies.

## Recommendations and What to Ask Your Care Team

The review's authors conclude that further studies should optimize treatment strategies and evaluate emerging targets, including non-CD3-engaging bispecific antibodies. Based on the findings, here are practical steps and questions for patients and families:

1.
**Ask whether a bispecific antibody is approved for your specific cancer type and setting.** Approvals currently exist in B-cell precursor ALL, certain B-cell lymphomas, and multiple myeloma — not in AML, Hodgkin lymphoma, or T-cell lymphoma.
1.
**Ask about your target antigen.** Whether your cancer expresses CD19, CD20, BCMA, or GPRC5D determines which agents are relevant to you.
1.
**Ask about CRS monitoring and mitigation.** CRS typically appears within 1 to 2 days of treatment and resolves within 2 to 3 days. Ask what monitoring, step-up dosing, or premedication your center uses.
1.
**Ask about neurologic monitoring.** Neurologic events occurred in more than half of patients in several Blinatumomab studies. Report any confusion, tremor, difficulty speaking, or weakness immediately.
1.
**Ask about infection prevention.** Cytopenias and infections remain major challenges, particularly in multiple myeloma. Discuss vaccination, immunoglobulin levels, and infection precautions.
1.
**Ask about clinical trials.** If you have AML, Hodgkin lymphoma, or T-cell lymphoma, a trial may be the most relevant route to these therapies.
1.
**Ask about the treatment-free advantages.** Bispecific antibodies are off-the-shelf and do not require the personalized manufacturing that CAR-T therapy does, which can allow faster treatment initiation.

Ask your care team how these findings apply to your individual situation. Response rates and side effect profiles vary widely by disease, prior treatment, and antibody target — and this review describes group-level patterns, not individual predictions.

## Frequently Asked Questions

### Which blood cancers can bispecific antibodies treat today?

A review of 36 studies found established activity in three blood cancers: B-cell precursor acute lymphoblastic leukemia, B-cell non-Hodgkin lymphoma, and multiple myeloma. In acute myeloid leukemia, Hodgkin lymphoma, and T-cell lymphoma, these drugs remain early-phase with limited efficacy and no regulatory approvals to date. Ask your care team whether an approved bispecific antibody exists for your specific cancer type and setting.

### What response rates did Blinatumomab achieve in relapsed or refractory B-cell precursor ALL?

Across the studies reviewed, Blinatumomab produced complete response rates of 31.11% to 64.00% and measurable residual disease clearance rates of 70.45% to 88.00% in relapsed or refractory B-cell precursor acute lymphoblastic leukemia. Median progression-free survival ranged from 5.00 to 18.90 months, and median overall survival from 6.10 to 36.50 months. These are group-level ranges, not individual predictions.

### What is cytokine release syndrome and when does it happen?

Cytokine release syndrome happens when immune cells release a flood of inflammatory signaling molecules after treatment, causing fever, chills, low blood pressure, and sometimes breathing difficulty. Across the studies reviewed, it occurred in 1.59% to 82.61% of patients. Most cases were grade 1 to 2, typically appearing within 1 to 2 days of treatment and resolving within 2 to 3 days. Ask your center about monitoring and premedication.

### How common are neurologic side effects with these drugs?

Neurologic events occurred in more than 50% of patients in several Blinatumomab studies, making neurologic monitoring a central part of care for anyone receiving these drugs. Report confusion, tremor, difficulty speaking, or weakness immediately. Neurotoxicity was also reported with Teclistamab and Talquetamab. The overall toxicity profile varied by antibody construct, target antigen, disease type, and dosing schedule, so ask your care team what to expect in your situation.

### Do bispecific antibodies require the same manufacturing wait as CAR-T therapy?

No. Bispecific antibodies are off-the-shelf therapies, meaning they are pre-made and ready to give, which allows rapid treatment initiation and broader patient access. CAR-T therapy requires personalized manufacturing and long processing times that can take weeks. This practical difference may matter if you need treatment quickly. Ask your care team whether a bispecific antibody is an option for your cancer type and setting.

### What response rates were seen in relapsed or refractory follicular lymphoma?

In relapsed or refractory follicular lymphoma, CD3-CD20 bispecific antibodies produced overall response rates of 80.00% to 95.06% and complete response rates of 60.00% to 82.72%. Median duration of response ranged from 18.00 to 22.80 months, and median progression-free survival was 17.90 months in one study. Response rates varied widely across lymphoma subtypes, so ask your care team how these group-level findings apply to you.

### How severe are the side effects, and do most patients stop treatment?

Serious adverse events occurred in 12.17% to 91.30% of patients, and grade 3 or higher adverse events in 27.42% to 95.65%. Despite this, treatment discontinuation generally remained below 20% across studies, and treatment-related mortality was uncommon. Two exceptions stood out: a phase I AML study reported 34.21% discontinuation, and a phase III DLBCL study reported 57.92%. Ask your care team how these ranges relate to your situation.

### When should a patient with relapsed or refractory B-cell precursor ALL, lymphoma, or multiple myeloma seek a second opinion about bispecific antibody treatment?

A second opinion is worth considering when the cancer type or setting is unclear. Bispecific antibodies have established activity in B-cell precursor ALL, B-cell non-Hodgkin lymphoma, and multiple myeloma, but not in AML, Hodgkin lymphoma, or T-cell lymphoma, where they remain investigational with no approvals. Because response rates and side effects vary widely by target antigen, prior therapy, and disease, confirming which agent fits your CD19, CD20, BCMA, or GPRC5D profile matters. Diagnostic Detectives Network provides independent expert second opinions.

## Source Information

**Original article title:** Safety and efficacy of bispecific antibodies in hematologic neoplasms: a systematic review.

**Authors:** Lommuang K, Taychakhoonavudh S.

**Journal:** Frontiers in Immunology, Volume 17, Article 1815519

**Article type:** Systematic Review

**Publication date:** 11 August 2026

**DOI:** 10.3389/fimmu.2026.1815519

**Systematic review registration:** PROSPERO, identifier CRD42023467556 (https://www.crd.york.ac.uk/PROSPERO/)

**Key words:** bispecific antibodies, efficacy, hematologic neoplasms, safety, systematic review

*This patient-friendly article is based on peer-reviewed research. It is intended for educational purposes and does not replace personalized medical advice from your healthcare team.*


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