For people living with follicular lymphoma, the treatment landscape has changed dramatically over recent years. New therapies are providing more options than ever before, creating fresh opportunities but also raising new questions. One area generating significant interest is a type of immunotherapy known as a bispecific antibody.
In a previous Follicular Lymphoma Foundation webinar lymphoma specialist Dr Jonathon Cohen explored what bispecific antibodies are, how they work, and what patients and families should know about their potential benefits and challenges.
Bispecific antibodies are a form of immunotherapy, meaning they work by helping the immune system recognise and attack cancer cells.
To understand how they work, it can help to think of them as a bridge. One end of the antibody attaches to lymphoma cells, while the other attaches to immune cells called T cells. By bringing these cells together, bispecific antibodies help direct the body’s own immune system to find and destroy lymphoma cells.
“What we're trying to do is utilise your own immune system to attack and eliminate the lymphoma.”
Unlike traditional chemotherapy, this approach focuses on harnessing the body’s natural defences to fight disease. Several bispecific antibodies are now approved in different settings, and researchers continue to learn more about how best to use them.
A key message from Dr Cohen is that there is no single “best” treatment pathway for follicular lymphoma. People’s experiences with the disease can vary widely. Some individuals may need treatment soon after diagnosis, while others can be monitored for years before treatment becomes necessary.
Likewise, treatment decisions after relapse depend on many factors, including previous treatments, overall health, personal preferences, lifestyle and treatment goals. Age, other medical conditions, the extent of the lymphoma and previous treatment experiences can all influence which option may be most appropriate.
Bispecific antibodies are one of a growing number of treatment options available to people with follicular lymphoma. For this reason, decisions about treatment should always be made in partnership with a healthcare team that understands a person’s individual circumstances.
Early studies of bispecific antibodies have produced encouraging results, with many patients experiencing meaningful reductions in their lymphoma. Some patients achieve what doctors call a complete response, where no signs of active disease can be detected on scans. Researchers are continuing to study how long these responses may last and which patients are most likely to benefit.
Like all treatments, however, bispecific antibodies can cause side effects:
Less commonly, some patients may experience temporary neurological side effects that affect thinking, concentration, or memory. There is also an increased risk of infection because these therapies can suppress parts of the immune system. Fortunately, treatment teams have developed strategies to recognise and manage these side effects effectively.
Practical considerations matter too
Choosing a treatment is not just about effectiveness. Practical considerations can also play an important role in decision-making.
The first doses of a bispecific antibody are often given at specialist centres with experience managing potential side effects. Some patients may need a short period of observation, and additional appointments may be required during the early stages of treatment.
Travel distance, transport arrangements, work commitments, caring responsibilities, and available support from family or friends can all influence what treatment feels manageable. These factors are important topics to discuss openly with your healthcare team when weighing up different options.
Research into bispecific antibodies is moving quickly. Scientists are exploring whether combining these therapies with other treatments could improve outcomes further, while also working to reduce side effects and make treatment more convenient for patients. Researchers are also investigating whether bispecific antibodies could play a role earlier in the treatment journey for some people with follicular lymphoma.
“This is a very exciting new type of therapy, and we're still learning how best to use it.”
The pace of progress in follicular lymphoma research is encouraging. While important questions remain, advances in immunotherapy are expanding the treatment toolbox and creating new possibilities for patients and families.
Watch our webinar on bispecific treatments for a more detailed discussion of treatment options, side effects, patient questions, and the latest developments in follicular lymphoma research.
