The next wave of CLL research is moving beyond a standard one-year fixed duration. Ongoing studies now use Minimal Residual Disease (MRD) results to tailor treatment length, personalizing care by potentially shortening, extending, or adding therapies based on a patient's individual depth of response.

When choosing a bispecific antibody for follicular lymphoma, a major practical difference is the treatment duration. Mosunetuzumab is a time-limited therapy stopped after achieving a complete response, while Epcoritamab is given indefinitely until progression. This distinction heavily influences selection, especially for elderly patients.

An exploratory strategy for DLBCL patients involves using ctDNA to detect minimal residual disease after CAR T-cell therapy. This allows for early intervention with bispecific antibodies when the disease burden is low, potentially preventing full clinical progression, a shift from reactive to proactive treatment.

To manage infection risk and improve quality of life, experts are quickly reducing bispecific antibody dosing frequency (e.g., to monthly) once a response is achieved. This real-world practice deviates from rigid trial schedules to optimize patient outcomes.

Three-year data for odronextumab, given until progression in follicular lymphoma, reveals a high rate of severe (Grade 3+) infections (45%), including fatal events. This highlights a critical safety concern with continuous dosing and strengthens the clinical argument for using fixed-duration bispecific regimens to mitigate long-term toxicity.

An expert treating DLBCL states they no longer use bispecific antibodies as monotherapy. Combining them with partners like chemotherapy (GemOx) or ADCs (Polatuzumab) raises the complete response rate by 15-20%, offering a better chance of benefit for patients.

The optimal duration for ADC maintenance therapy is a major unanswered question, with current trials using fixed timeframes like 12 or 24 months. Experts suggest that future practice may rely on biomarkers like ctDNA to personalize treatment duration, stopping therapy when molecular remission is achieved to minimize toxicity and tailor care.

In clinical practice for relapsed large cell lymphoma, glofitumab is a preferred bispecific antibody. Clinicians favor it over epcoritamab because it is time-limited (vs. indefinite treatment) and has a more patient-friendly every-three-week schedule, while also being more active than mosunetuzumab.

Long-term follow-up from the pivotal epcoritamab trial reveals that 46% of DLBCL patients who achieve a complete remission maintain it at four years. This durability provides strong evidence that bispecific monotherapy, not just CAR-T, can be a curative treatment for a subset of patients.