Bispecific T-cell Engager (BiTE) Therapy

Bispecific T-cell engager (BiTE) therapy is a type of immunotherapy. It boosts your immune system’s ability to fight cancer.

BiTE therapy helps cancer-killing immune system cells find and destroy cancer cells. The acronym outlines how bispecific T-cell engager therapy works:

• Bispecific: BiTE therapy uses lab-made antibodies that hit two targets at the same time. Antibodies defend us against invaders. They recognize proteins (antigens) that shouldn’t be in our bodies. In this treatment, T-cells and cancer cells come together when one antibody recognizes and binds to T-cells and another one recognizes and binds to cancer cells.
• T-cell: Your T-cells are one of the many types of immune cells that constantly patrol your bloodstream for invaders and cells that appear abnormal. When a T-cell finds and recognizes a cancer cell, it becomes activated and kills it. But cancer cells can be hard to detect, much less corner. That’s where the engager part of the therapy comes in.
• Engager: Here, the lab-made combined antibodies engage or connect to T-cells and cancer cells. This brings them close enough for the T-cell to recognize the cancer cell as an invader and kill it.

The activated T-cell releases cytokines. These are proteins in your immune system. They rally other immune cells to become activated and attack the cancer cell. These cells release proteins that break through the cancer cell surface. Once inside, the proteins can set off a reaction in the cancer cell so it self-destructs.

What conditions does BiTE therapy treat?

If other treatments don’t work, BiTE therapy may be a treatment for:

• Acute lymphoblastic leukemia
• Lymphoma
• Multiple myeloma
• Lung cancer
• Melanoma

What happens during BiTE therapy?

You may get a shot or receive the medication via an IV line. Your healthcare provider will start the medication with low doses that increase over a few days until you’re receiving the dosage that’s right for your situation.

You may need to stay overnight or for a few days after your first treatment. Your stay in the hospital depends on factors like the BiTE medication type and how your body reacts to the medication. This allows your healthcare providers to watch for side effects, including cytokine release syndrome (CRS) and immune effector-cell associated neurotoxicity (ICANS):

• CRS: This side effect happens when your immune system releases large amounts of cytokines into your bloodstream. Common symptoms are chills and fever, joint and muscle pain, and nausea and vomiting.
• ICANS: This is when the same immune system reaction to cancer causes confusion, difficulty speaking, weakness and paralysis.

When should I call my healthcare provider?

Contact your provider right away if you have CRS or ICANS symptoms. These symptoms can develop right after treatment or a few weeks after your first treatment.

What’s the success rate for this treatment?

There’s no single success rate for BiTE therapy because there are different lab-made medications for each cancer type.

One study showed the therapy improved conditions for people living with multiple myeloma when other treatments didn’t work. It put the disease into remission for nearly 4 out of 10 people, who remained in remission for almost a year.

Now, researchers are testing this treatment for prostate cancer and some forms of digestive system cancer.

What’s the difference between BiTE and CAR-T cell therapy?

BiTE therapy uses a lab-made antibody that targets T-cells and specific proteins on the surface of cancer cells. CAR-T-cell therapy adds a lab-made gene to your T-cells.