Debate Round 3: CAR-T vs Bispecifics in Relapsed LBCL – “Cure” vs Access
ByMegan Melody, MD,Matthew Cortese, MD, MPH,Marco Davila, MD, PhD,Chelsea Peterson, DO,Lorenzo Falchi, MD,Lori Leslie, MD,Samuel Yamshon, MD The teams debate whether CAR-T or bispecific antibodies should be prioritized as the treatment paradigm evolves in relapsed large B-cell lymphoma, with Team NYC centering the argument on “cure” and the curative-intent potential/plateau of CAR-T outcomes. Team Roswell agrees cure is the goal but argues that real-world access barriers and “off-the-shelf” availability make bispecifics, and especially emerging combination strategies, crucial for patients who cannot reliably reach or complete CAR-T. The discussion highlights a key tradeoff: CAR T as a one-time, time-limited intervention vs bispecifics requiring ongoing dosing and infrastructure, with durability, infection risk, and sequencing still actively evolving.