A relatively new form of immunotherapy is changing the way some cancers are treated and expanding options for patients who have exhausted traditional treatments.
Bispecific antibody therapy is gaining attention in the oncology world for its targeted approach to fighting cancer.
Dr. Tejas Karawadia, a hematologist and oncologist with Cancer Specialists of North Florida, is helping bring this treatment to patients across the region.
What is bispecific antibody therapy?
The treatment works by using the body’s own immune system to identify and destroy cancer cells.
“Bispecific antibody, just by the name of it, is a protein. It has two ends to it,” Karawadia said. “One end binds to a cancer cell, other end binds with an immune cell, and it activates immune system to kill the cancer cells.”
That targeted mechanism sets it apart from conventional chemotherapy, which affects all rapidly dividing cells, not just cancerous ones. Karawadia said the precision of bispecific antibody therapy can lead to stronger and longer-lasting results.
“The responses are better, more durable, because it’s our own immune system trying to attack the cancer cells unlike an outside drug or a chemical,” he said.
Who is eligible for treatment?
The U.S. Food and Drug Administration has approved bispecific antibody therapy for several cancer types, including small cell lung cancer, multiple myeloma, lymphoma and acute lymphoblastic leukemia.
Karawadia said the treatment is currently approved for patients who have already tried other therapies.
“Currently it is approved as second or third or fourth line if the patients have already gone through certain other treatments,” he said.
Eligibility is largely based on a patient’s overall health and functional status, rather than age.
“Mostly if patients are doing well, and then they’re able to walk and doing well, then they can get this treatment,” Karawadia said.
Research is underway to explore whether bispecific antibody therapy could be offered as a first-line treatment at the time of diagnosis. Karawadia said expanded approvals for additional cancer types, including colon cancer and prostate cancer, are likely on the horizon.
How is it administered?
The treatment is delivered intravenously, with dosing schedules that shift over time.
“It starts with once a week and then gradually goes to twice a week, depending on the cancer type you have,” Karawadia said.
Side effects, monitoring
Like all cancer treatments, bispecific antibody therapy carries potential side effects. Because the therapy activates the immune system, it can sometimes trigger an overstimulation response.
“Symptoms like fever or low blood pressure can come as a side effect,” Karawadia said. “But most of the times, if you diagnose or monitor them closely and treat them early, then those can prevent further complications.”
Karawadia said Cancer Specialists of North Florida has developed a structured monitoring program to stay ahead of potential complications.
“We had a practice actually of a robust monitoring program where we monitor every patient who got this treatment,” he said. “And if they have these symptoms, you call in and then try to give them the treatments or avoid further complications.”
Local access to treatment
One of the biggest challenges patients face with bispecific antibody therapy is simply getting to it. Karawadia said his practice has worked to address that barrier directly.
“The biggest access issue with this kind of treatment or struggle or challenge patients have is the access to treatment,” he said. “What we have done with these four sites is that we can give these treatments closer to their home in a safe and comfortable environment.”
Cancer Specialists of North Florida currently offers bispecific antibody therapy at four locations: Riverside, Southpoint, St. Augustine and a Clay County site where Karawadia practices.