Bispecific antibodies: design, therapy, perspectives

Sedykh, Sergey E; Prinz, Victor V; Buneva, Valentina N; Nevinsky, Georgy A

Sedykh et al and occur due to specific mechanisms of action: use of cytotoxic T cells as effectors. Minimizing cytokine-release syndrome is possible with a low initial dose of the drug in combination with subsequent high doses, 54 as well as corticosteroid (dexamethasone) 40 and antihistamine 55 premedication. The most common side effects during blinatumomab treatment are hepatotoxicity, leukopenia, lymphopenia, thrombocytopenia, CRP increase, chills, fever, pyrexia, nausea, and vomiting. 44 There are also noted neurological and psychiatric side effects, which are completely reversible after the end of therapy. 56 In catumaxomab treatment, the most frequent adverse events are cytokine release-related symptoms, which may have some predictive value for treatment efficacy. Some disorders of liver parameters and white blood cells are often observed, but usually these changes are reversible. 40 Adverse events in cases of Mus110 (BiTEs BsAb anti-EpCAM and anti-CD3) are in general due to activation of T cells. During treatment with MEDI565 (AMG211, MT111: BiTEs BsAb anti-CEA and anti-CD3), the most common side effects are nausea, vomiting, abdominal pain, and fatigue. Significant increases in antidrug Abs are detected in the blood of half the patients. 57 The main adverse event during TF2 (anti-CEA Fabs and anti-histamine-succinyl-glycine Fab) therapy is bone-marrow toxicity. 57