Objective:

To evaluate breakthroughs and challenges in CAR-T cell therapy and bispecific antibodies, emphasizing the transition to earlier treatment lines to enhance patient outcomes.

Approach:

• Literature Review: A systematic search was conducted across PubMed, Embase, and Google Scholar to synthesize recent literature on CAR-T cell therapy and bispecific antibodies.
• Clinical Evidence Analysis: The review analyzes clinical data on overall survival and progression-free survival to propose a framework for sequential therapy and toxicity management.

Key Findings:

• CAR-T cell therapy and bispecific antibodies show extraordinary efficacy in hematological cancers but face significant challenges in solid tumors due to the immunosuppressive tumor microenvironment.
• Transitioning these therapies to earlier lines of treatment may help preserve T-cell fitness and prevent immune exhaustion.
• Innovative molecular engineering, such as armored CARs and multi-specific engagers, is essential to enhance efficacy against solid tumors.

Interpretation:

The review discusses the importance of strategic timing and combination therapies to enhance the efficacy of CAR-T and bispecific antibodies in treating refractory malignancies.

Limitations:

• The review primarily focuses on recent literature, which may not encompass all relevant studies and perspectives.
• Challenges specific to solid tumors and the complexities of treatment sequencing require further exploration.

Conclusion:

The integration of CAR-T cell therapy and bispecific antibodies into earlier treatment lines, along with innovative molecular designs, may enhance treatment outcomes in precision immuno-oncology.