An evaluation of odronextamab for the treatment of multiple subtypes of relapsed/refractory B-cell non-hodgkin lymphoma.

in Expert opinion on biological therapy by Elena Bayly-McCredie, Henry Miles Prince, Costas Kleanthes Yannakou, Salvatore Fiorenza

TLDR

  • Odronextamab, a bispecific antibody, shows promising efficacy and manageable safety in relapsed/refractory B-cell non-Hodgkin lymphoma (B-NHL), with potential as a salvage therapy.

Abstract

Patients with relapsed/refractory B-cell non-Hodgkin lymphoma (B-NHL) have a poor median survival rate when treated with traditional salvage therapies. Bispecific antibodies (BsAbs) are an emerging class of 'off-the-shelf' immunotherapies that show promising efficacy in this population. Odronextamab is a CD20×CD3 targeting bispecific antibody that is being investigated in multiple subtypes of relapsed/refractory B-NHL. This article describes the development of odronextamab from pre-clinical work through to ongoing clinical trials in relapsed/refractory B-NHL. The structure, safety, efficacy and administration of odronextamab are discussed. Studies were selected for inclusion by performing a search in PubMed, EMBASE, Cochrane Library and relevant conference abstracts from 2014 to 2024. The clinicaltrials.gov website and reference lists of the included studies were also reviewed. Odronextamab has demonstrated manageable safety and promising efficacy in multiple subtypes of relapsed/refractory B-NHL. The low rates of immune effector cell-associated neurotoxicity syndrome ;(ICANS) and high response rates in rare aggressive subtypes of B-NHL are particularly noteworthy. High rates of severe infections remain a challenge with BsAbs, with further prophylactic efforts required to reduce the risk. Clinical trials of combination therapies with odronextamab are required to improve the utility of this BsAb across a wider range of settings and subtypes of B-NHL.

Overview

  • The study focuses on the development and clinical trials of odronextamab, a CD20×CD3 targeting bispecific antibody for relapsed/refractory B-cell non-Hodgkin lymphoma (B-NHL).
  • The study explores the safety, efficacy, and administration of odronextamab, with a focus on its manageable safety profile and promising efficacy in rare aggressive subtypes of B-NHL.
  • The primary objective of the study is to summarize the available data on odronextamab and highlight its potential as a salvage therapy for patients with relapsed/refractory B-NHL.

Comparative Analysis & Findings

  • Odronextamab has demonstrated manageable safety, with low rates of immune effector cell-associated neurotoxicity syndrome (ICANS) and a favorable toxicity profile.
  • The study shows promising efficacy of odronextamab in multiple subtypes of relapsed/refractory B-NHL, with high response rates in rare aggressive subtypes.
  • However, high rates of severe infections remain a challenge with bispecific antibodies (BsAbs) like odronextamab, highlighting the need for further prophylactic efforts to reduce the risk.

Implications and Future Directions

  • The study emphasizes the importance of clinical trials exploring combination therapies with odronextamab to improve its utility across a wider range of settings and subtypes of B-NHL.
  • Further research is needed to address the challenge of severe infections associated with BsAbs, with a focus on developing prophylactic measures to reduce the risk.
  • The findings of this study have implications for the treatment of relapsed/refractory B-NHL, highlighting the potential of odronextamab as a salvage therapy for patients with poor median survival rates.
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