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Dr Amitkumar Mehta: CAR T-Cell and Bispecific Therapy Are Complementary, Not Competitors


Amitkumar Mehta, MD, MBA, University of Alabama at Birmingham, notes the long-term data and potential curative effects of chimeric antigen receptor (CAR) T-cell therapy, while expressing optimism about bispecific therapy with ongoing evolution and the chance of significant patient responses.

Amitkumar Mehta, MD, MBA, associate professor of medicine and director of the lymphoma and chimeric antigen receptor (CAR) T-cell therapy programs, University of Alabama at Birmingham, highlights the synergy between CAR T-cell therapy and bispecifics in oncology.

Mehta delved into the topic more during the panel discussion, "Which Comes First? Bispecifics, CAR T-Cell Therapy, and Cost Consideration in Sequencing," at the Patient-Centered Oncology Care® (PCOC) 2023 meeting.


Can you highlight some of the major points from your panel on bispecifics and CAR T-cell therapy?

I don't see CAR T and bispecifics as competing with each other, so they both are, in a way, complementary. Both of them [are] amazing advances in the treatments of oncology, as a matter of fact, and obviously lymphoma and myeloma kind of lead that growth. Now, all the solid tumors are also looking at that technology of bispecific antibody as well as CAR T-cell therapy.

When I look at both the therapies—as a matter of fact, for any therapies—I ask 1 question: whether this therapy can be potentially curative. The way we will know is if we have a longer follow-up and what proportion of patients have not needed treatment after therapy. So that is a key question. The longest data that we have is on CAR T-cell therapy, and as we all know, about 40% to 50% of patients may not need treatment afterwards. Whether we can say that those patients are potentially cured, maybe. That's why CAR T has more long-term data, more robust data in that setting.

Now, bispecific [therapy is] evolving. We are not seeing that proportion of patients staying in remission that long term. But with further follow-up, we might see that maybe some portion of patients [are] not requiring treatment afterwards. But they're also complementary. What I mean by that [is], if you get CAR T-cell therapy and if you progress, still you can get bispecific, and then you will still respond. There is a good bit of chance of response, and so is the other way around.

If you got bispecific and if you progress, then you can get CAR T and still may have a response. They both target different targets. Bispecific targets CD20 and CAR T-cell targets CD19, so that's a unique difference of, so to speak, an attack on the cancer. So they're kind of complementary to each other.

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