CD20×CD3 Bispecific Antibodies in Relapsed/Refractory B-Cell Lymphomas: Recent Phase III Evidence Durability, and Safety

Arwa Arebee

doi:10.51984/szn7cg42

Authors

Arwa Arebee Independent Researcher, Sahl al-Jafara

DOI:

https://doi.org/10.51984/szn7cg42

Keywords:

Bispecific antibody, T-cell engager, CD20×CD3, Lymphoma, Diffuse large B-cell lymphoma, Cytokine release syndrome

Abstract

CD20×CD3 bispecific antibodies (bsAbs) epcoritamab, glofitamab, mosunetuzumab, and odronextamab have become important treatment options in selected relapsed/refractory (R/R) B-cell lymphoma settings. This narrative review synthesizes trial evidence through August 2026, emphasizing randomized phase 3 data. In R/R diffuse large B-cell lymphoma (DLBCL), glofitamab plus chemotherapy improved overall survival versus chemoimmunotherapy in the randomized STARGLO trial (3-year median OS 25.5 vs 12.5 months; hazard ratio [HR] 0.60); epcoritamab improved progression-free survival but not overall survival versus chemoimmunotherapy in the EPCORE DLBCL-1 topline results. In R/R follicular lymphoma (FL), adding epcoritamab to lenalidomide-rituximab (R2) improved progression-free survival (HR 0.21) and response rates versus R2 alone in the randomized EPCORE FL-1 trial. Single-arm phase 1/2 data show substantial but less certain activity for these agents and for odronextamab in DLBCL and FL. Cytokine release syndrome is the dominant early toxicity, generally low-grade with step-up dosing; immune effector cell-associated neurotoxicity syndrome (ICANS) is less frequent but has been associated with fatal events in the epcoritamab DLBCL registrational population. Infection risk, including fatal infection, is clinically important with prolonged exposure. This is a narrative, non-systematic review; single-arm and uncontrolled results should not be read as directly comparable across agents.

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Author Biography

Arwa Arebee, Independent Researcher, Sahl al-Jafara

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