CD20×CD3 Bispecific Antibodies in B‐NHL: A Review of Translational Science, Pharmacokinetics, Pharmacodynamics, and Dose Strategy in Clinical Research

ABSTRACT Despite advancements in treatment for B‐cell non‐Hodgkin lymphoma (B‐NHL) in recent decades, many patients still relapse or are refractory to treatment, which represents a high unmet medical need. Novel CD20 × CD3 T‐cell–engaging bispecific antibodies (bsAbs) have created a new paradigm for...

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Main Authors: Min Zhu, Xiaowen Guan, Samit Ganguly, Erik Welf, John D. Davis
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Clinical and Translational Science
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Online Access:https://doi.org/10.1111/cts.70250
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author Min Zhu
Xiaowen Guan
Samit Ganguly
Erik Welf
John D. Davis
author_facet Min Zhu
Xiaowen Guan
Samit Ganguly
Erik Welf
John D. Davis
author_sort Min Zhu
collection DOAJ
description ABSTRACT Despite advancements in treatment for B‐cell non‐Hodgkin lymphoma (B‐NHL) in recent decades, many patients still relapse or are refractory to treatment, which represents a high unmet medical need. Novel CD20 × CD3 T‐cell–engaging bispecific antibodies (bsAbs) have created a new paradigm for the treatment of B‐NHL. Pivotal studies of four CD20 × CD3 bsAbs, mosunetuzumab, glofitamab, epcoritamab, and odronextamab, as monotherapy, have demonstrated robust responses with generally manageable safety profiles in patients with relapsed or refractory follicular lymphoma and diffuse large B‐cell lymphoma after ≥ 2 lines of systemic therapy. These agents have presented unique challenges (e.g., cytokine release syndrome [CRS]), which have required different strategies to overcome. This review provides a comprehensive overview of the clinical development of these four CD20 × CD3 bsAbs that have been investigated for the treatment of B‐NHL, with a specific focus on translational assessments to select starting doses in first‐in‐human studies, management of CRS, application of modeling and simulation approaches to aid dose escalation and optimization/selection, and strategies used in the design of phase I–III clinical trials. By highlighting learnings and experiences from these four bsAbs assessed, which have not been summarized collectively elsewhere, we aim to promote more efficient study design for novel bsAbs in B‐NHL in the future.
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spelling doaj-art-8d99b2e94e9b4c45b7a54f688ae106ab2025-06-26T13:31:16ZengWileyClinical and Translational Science1752-80541752-80622025-06-01186n/an/a10.1111/cts.70250CD20×CD3 Bispecific Antibodies in B‐NHL: A Review of Translational Science, Pharmacokinetics, Pharmacodynamics, and Dose Strategy in Clinical ResearchMin Zhu0Xiaowen Guan1Samit Ganguly2Erik Welf3John D. Davis4Regeneron Pharmaceuticals, Inc. Tarrytown New York USARegeneron Pharmaceuticals, Inc. Tarrytown New York USARegeneron Pharmaceuticals, Inc. Tarrytown New York USARegeneron Pharmaceuticals, Inc. Tarrytown New York USARegeneron Pharmaceuticals, Inc. Tarrytown New York USAABSTRACT Despite advancements in treatment for B‐cell non‐Hodgkin lymphoma (B‐NHL) in recent decades, many patients still relapse or are refractory to treatment, which represents a high unmet medical need. Novel CD20 × CD3 T‐cell–engaging bispecific antibodies (bsAbs) have created a new paradigm for the treatment of B‐NHL. Pivotal studies of four CD20 × CD3 bsAbs, mosunetuzumab, glofitamab, epcoritamab, and odronextamab, as monotherapy, have demonstrated robust responses with generally manageable safety profiles in patients with relapsed or refractory follicular lymphoma and diffuse large B‐cell lymphoma after ≥ 2 lines of systemic therapy. These agents have presented unique challenges (e.g., cytokine release syndrome [CRS]), which have required different strategies to overcome. This review provides a comprehensive overview of the clinical development of these four CD20 × CD3 bsAbs that have been investigated for the treatment of B‐NHL, with a specific focus on translational assessments to select starting doses in first‐in‐human studies, management of CRS, application of modeling and simulation approaches to aid dose escalation and optimization/selection, and strategies used in the design of phase I–III clinical trials. By highlighting learnings and experiences from these four bsAbs assessed, which have not been summarized collectively elsewhere, we aim to promote more efficient study design for novel bsAbs in B‐NHL in the future.https://doi.org/10.1111/cts.70250clinical trialsdosedrug developmentexposure responsehematologymodel‐based drug development
spellingShingle Min Zhu
Xiaowen Guan
Samit Ganguly
Erik Welf
John D. Davis
CD20×CD3 Bispecific Antibodies in B‐NHL: A Review of Translational Science, Pharmacokinetics, Pharmacodynamics, and Dose Strategy in Clinical Research
Clinical and Translational Science
clinical trials
dose
drug development
exposure response
hematology
model‐based drug development
title CD20×CD3 Bispecific Antibodies in B‐NHL: A Review of Translational Science, Pharmacokinetics, Pharmacodynamics, and Dose Strategy in Clinical Research
title_full CD20×CD3 Bispecific Antibodies in B‐NHL: A Review of Translational Science, Pharmacokinetics, Pharmacodynamics, and Dose Strategy in Clinical Research
title_fullStr CD20×CD3 Bispecific Antibodies in B‐NHL: A Review of Translational Science, Pharmacokinetics, Pharmacodynamics, and Dose Strategy in Clinical Research
title_full_unstemmed CD20×CD3 Bispecific Antibodies in B‐NHL: A Review of Translational Science, Pharmacokinetics, Pharmacodynamics, and Dose Strategy in Clinical Research
title_short CD20×CD3 Bispecific Antibodies in B‐NHL: A Review of Translational Science, Pharmacokinetics, Pharmacodynamics, and Dose Strategy in Clinical Research
title_sort cd20 cd3 bispecific antibodies in b nhl a review of translational science pharmacokinetics pharmacodynamics and dose strategy in clinical research
topic clinical trials
dose
drug development
exposure response
hematology
model‐based drug development
url https://doi.org/10.1111/cts.70250
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