After observing deep, MRD-negative responses at their starting dose, Colonia Therapeutics unconventionally tested a lower dose level. This counter-intuitive strategy aims to identify the minimum effective dose, which is crucial for maximizing the safety profile (the therapeutic window) and improving commercial viability through lower manufacturing costs.

Corvus Pharmaceuticals is already planning frontline combination trials for its T-cell lymphoma drug. The drug's favorable safety profile is the critical enabler, allowing it to be paired with chemotherapy and used as a long-term maintenance therapy to prolong remissions—a strategy unavailable to more toxic drugs.

Real-world data suggests that using one antibody-drug conjugate (ADC) immediately after another is often ineffective. A potential strategy to overcome this resistance is to administer a different class of chemotherapy before starting the second ADC.

Beyond efficacy, new therapies like bispecifics require significant institutional support. Clinicians need training for unfamiliar side effects like CRS, and facilities need resources like observation units and admission protocols, creating a steep implementation curve for clinical practice.

Beyond approving the triplet combination, the positive Epcor FL1 trial data had a significant ripple effect. It solidified the drug's overall profile, leading to the conversion of its prior provisional (accelerated) approvals for monotherapy in follicular lymphoma and DLBCL into full, traditional approvals.

When efficacy and safety profiles are comparable between ADCs like sacituzumab and datopotamab, the final choice can be guided by patient logistics. Factors include infusion frequency (Day 1 & 8 vs. every 3 weeks) and total time spent at the infusion center.

Perioperative enfortumab vedotin-pembrolizumab (EV-Pembro) is surprisingly well-tolerated on a per-cycle basis compared to the traditional GEMSYS chemotherapy regimen. This challenges preconceived notions about the toxicity of this powerful combination, though cumulative toxicity over longer durations remains a key factor.

The regimen's profound success in relapsed/refractory patients is not an endpoint, but a launchpad. It provides the rationale for the ongoing Epcor FL2 trial, which directly challenges standard chemoimmunotherapy and could establish a chemotherapy-free, bispecific-based combination as the new first-line standard of care.

To manage hypogammaglobulinemia from bispecific antibodies, clinicians are adopting a more proactive approach. Following the model from myeloma care, they are initiating IVIG therapy earlier to prevent infections, rather than waiting for recurrent infections to occur as was standard with rituximab.