Safety landscape of bispecific antibody therapy in non-Hodgkin lymphoma: a meta-analysis

Rodrigo Fonseca , Alex J. Liu , Blake T. Langlais , Diana Almader-Douglas , Holenarasipur R. Vikram , Talal Hilal
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Abstract

Bispecific antibodies (BsAbs) have emerged as a novel immunotherapy option for the treatment of non-Hodgkin lymphoma; however; their safety profiles remain underexplored. We conducted a systematic review and meta-analysis to better delineate the safety profiles of BsAbs, focusing on the prevalence and rates of infection, neutropenia, cytokine release syndrome (CRS), and immune effector cell–associated neurotoxicity syndrome (ICANS). A comprehensive literature search led to the inclusion of 32 trials, with a total of 2192 patients. Median age of participants was 66 years (range, 55-84) with a median of 2 prior lines of therapy (range, 0-5). At a median follow-up of 9.4 months (range, 2.8-32 , the pooled prevalence of all-grade and grade ≥3 neutropenia was 38% and 26%, respectively, with all-grade and grade ≥3 infections occurring at a rate of 38% and 12%, respectively. The prevalence of all grade CRS was 48% but only 2% was grade ≥3, whereas ICANS was infrequent (5% all grade). Stratification revealed both increased all-grade neutropenia and infection rates with combination therapy in comparison to BsAbs monotherapy. Despite these variations, BsAbs demonstrated an overall manageable safety profile, suggesting their viability as a treatment option in the relapsed/refractory setting. Standardized safety reporting and vigilant monitoring are essential to optimize their clinical use and improve patient outcomes.
双特异性抗体治疗非霍奇金淋巴瘤的安全性:一项meta分析
摘要双特异性抗体(BsAbs)已成为治疗非霍奇金淋巴瘤的一种新的免疫治疗选择;然而;它们的安全性仍未得到充分研究。我们进行了一项系统回顾和荟萃分析,以更好地描述bsab的安全性,重点关注感染、中性粒细胞减少、细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征(ICANS)的患病率和发病率。通过全面的文献检索,纳入了32项试验,共计2192例患者。参与者的中位年龄为66岁(范围,55-84岁),既往治疗中位数为2行(范围,0-5)。在中位随访9.4个月(范围2.8-32)时,全级别和≥3级中性粒细胞减少症的总患病率分别为38%和26%,全级别和≥3级感染的发生率分别为38%和12%。所有级别CRS的患病率为48%,但只有2%为≥3级,而ICANS并不常见(所有级别为5%)。分层显示,与bsab单药治疗相比,联合治疗增加了全级别中性粒细胞减少症和感染率。尽管存在这些差异,但bsab显示出总体可控的安全性,表明它们作为复发/难治性治疗方案的可行性。标准化的安全报告和警惕监测对于优化其临床使用和改善患者预后至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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