{
  "abstract": "Background Chimeric antigen receptor T-cell (CAR-T) therapy and bispecific antibodies (BsAbs) represent two major advances in the immunotherapeutic landscape of relapsed/refractory B-cell lymphomas. Both approaches have demonstrated transformative potential across aggressive and indolent subtypes, yet significant differences exist in their mechanisms of action, long-term efficacy, toxicity profiles, and delivery logistics. CAR-T therapies involve autologous cell manufacturing and intensive inpatient monitoring, while BsAbs are readily available and often administered in outpatient settings. As BsAbs gain traction as a more accessible alternative to CAR-T, a robust comparative analysis is crucial to inform evidence-based, patient-centered treatment decisionsMethods We conducted a comprehensive literature review of meta-analyses, pivotal trials, long-term follow-up studies, and real-world data published upto mid 2025. Studies were selected based on relevance to CAR-T or BsAb therapy in large B-cell lymphoma (LBCL) and follicular lymphoma (FL), with priority given to those reporting complete response (CR), progression-free survival (PFS), duration of response, overall survival (OS), and treatment-related adverse events.Results In LBCL, pooled data show higher CR rates with CAR-T (51%) compared to BsAbs (36%), alongside superior 1-year PFS (44% vs. 32%). In FL, CAR-T products such as axicabtagene ciloleucel and lisocabtagene maraleucel achieve CR rates up to 94%, with median durations of remission exceeding three years. BsAbs, including mosunetuzumab and glofitamab, demonstrate meaningful responses but require continuous dosing to sustain benefit, and long-term durability data are still emerging. Toxicity profiles differ substantially: CAR-T therapy is associated with higher rates of severe cytokine release syndrome (CRS ≥ grade 3: 8%) and neurotoxicity (11%), along with delayed complications including hypogammaglobulinemia, prolonged cytopenias, opportunistic infections, and rare secondary malignancies. BsAbs exhibit a more favorable safety profile (CRS ≥ grade 3:2%; neurotoxicity:1%) and better outpatient feasibility. However, their relapse risk post-discontinuation and optimal treatment duration remain unresolved.Conclusions This review underscores the importance of individualized treatment strategies in B-cell lymphomas. While CAR-T offers deeper and potentially curative responses, it is limited by toxicity and complexity. BsAbs provide a safer, more accessible alternative with promising efficacy. Head-to-head comparisons integrating long-term outcomes, safety, and patient-specific factors should guide future clinical decision-making.",
  "authors": [
    {
      "affiliations": [
        "University of Arkansas, Fayeville, AR, USA"
      ],
      "name": "Chinemerem M Emeasoba"
    },
    {
      "affiliations": [
        "Northeast Georgia Medical Center, Atlanta, GA, USA"
      ],
      "name": "Chiugo Okoye"
    },
    {
      "affiliations": [
        "UAMS, Fayettville, AR, USA"
      ],
      "name": "Cade Richesin"
    },
    {
      "affiliations": [
        "UAMS, Fayettville, AR, USA"
      ],
      "name": "Hannah M Jensen"
    }
  ],
  "title": "1073 Battle of the biologics a head to head review of CAR T cell therapy versus bispecific antibodies in B cell lymphomas balancing long term efficacy durability safety and toxicity profiles",
  "uid": "d910b22c-bf33-56e4-91d0-42a9dd007884"
}