Expanding the Role of Immunotherapy in Lymphoma

Non-Hodgkin lymphoma treatment is evolving rapidly, with bispecific antibodies, chimeric antigen receptor (CAR) T-cell therapy, targeted agents, and antibody-drug conjugates reshaping treatment strategies across multiple disease subtypes. In an interview with Targeted Oncology, Jeff Sharman, MD, of Sarah Cannon Research Institute at Willamette Valley Cancer Institute, discusses how these technologies are changing the treatment landscape and where they may fit in the years ahead.

Sharman highlights the growing role of bispecific antibodies, which engage T cells to target malignant B cells and are currently being used in relapsed disease. With multiple studies evaluating these agents in earlier lines of treatment, he discusses the potential for bispecifics to move into the frontline setting and bring newer forms of immunotherapy to patients earlier in their treatment course.

CAR T-cell therapy has also become increasingly important, particularly in diffuse large B-cell lymphoma (DLBCL), where access continues to expand and additional indications have emerged. Sharman considers how earlier use of CAR T-cell therapy could improve outcomes for patients at high risk of relapse, while also discussing the potential of allogeneic CAR T-cell approaches that could be manufactured in advance rather than individually for each patient.

The conversation also covers targeted therapies, including Bruton tyrosine kinase (BTK) and BCL2 inhibitors, as well as antibody-drug conjugates such as polatuzumab vedotin (Polivy). Although substantial progress has been made across lymphoma subtypes, Sharman emphasizes that opportunities remain to improve cure rates in DLBCL and outcomes in lower-grade lymphomas.

Looking ahead, Sharman points to measurable residual disease (MRD) testing as a potential tool for identifying patients who may benefit from consolidation strategies, along with expanding applications for bispecific antibodies, CAR T-cell therapy, and other emerging approaches.