Bispecific T-cell engagers

Antibodies with two arms: one grabs CD3 on the patient's T cells, the other a tumour antigen, so the T cell kills the cancer cell. Watch for CRS and ICANS.

Updated Nov 1, 2026

What they are

Engineered antibodies that bind two different targets at once. One arm binds CD3 on T cells; the other binds a tumour antigen, for example CD19 (blinatumomab, in B-cell leukaemia) or BCMA (teclistamab, in multiple myeloma). Unlike CAR T cells they are ready-made («off the shelf»), but they need repeated doses.

Mechanism of action

By bridging a T cell and a tumour cell the drug forms an artificial immune synapse, independent of MHC. The T cell releases perforin and granzymes and kills the target, then proliferates and releases cytokines. Doses are increased in steps (step-up dosing) to blunt the first wave of cytokine release.

Target: CD3 on T cells plus a tumour antigen (for example BCMA or CD19)

Drugs in this class

TeclistamabBispecific antibody that links CD3 on T cells to BCMA on myeloma cells; for relapsed multiple myeloma. Boxed risks…BCMA (B-cell maturation antigen, TNFRSF17) on myeloma cells, and CD3 on T cells

Others in the class

elranatamab
talquetamab
epcoritamab
glofitamab
mosunetuzumab
tarlatamab

Test yourself

Think of the answer, then tap the question to see it.

Which T-cell molecule does almost every bispecific T-cell engager bind?

CD3, part of the T-cell receptor complex.

Why are the first doses of a bispecific given in steps?

To reduce the risk and severity of cytokine release syndrome.

What is one practical advantage of a bispecific over a CAR T-cell product?

It is ready-made and does not require collecting and engineering the patient's own cells.

Add to my cards (3)