CAR T vs BiTEs: Understanding Your Options for Advanced Blood Cancers
When facing a serious or relapsed blood cancer, knowing your treatment options can make all the difference. Today, two advanced immunotherapies, CAR T-cell therapy and BiTEs (bispecific T-cell engagers), are giving patients new hope. Both use the power of the immune system to find and destroy cancer cells. But they work in different ways, and understanding those differences can help you and your care team make the best decision for your situation.
How CAR T and BITES Work
Both treatments are forms of immunotherapy, but their approaches are unique.
CAR T-cell therapy is a personalized treatment made from your own T cells. Doctors collect these cells and engineer them in a lab to recognize your specific cancer before infusing them back into your body. Because it’s tailored to each person, CAR T takes more time to manufacture and is typically given at a specialized cancer center like Moffitt.
BiTEs, a type of bispecific antibody, are “off-the-shelf” drugs designed to connect T cells directly to cancer cells. They can be given more quickly, often through an infusion or injection. BiTEs are less complex to produce, making them generally more accessible and lower in upfront cost.
Who Might Benefit More from the Long-Term Effects of CAR T?
For some people, CAR T offers a chance at remission when other therapies have stopped working. Studies have shown that, in select cases, responses can be durable for years after treatment.
If you’ve relapsed after chemotherapy, targeted therapy, or BiTEs, CAR T should be your next move. Getting a second opinion from a comprehensive cancer center like Moffitt can ensure you’re not missing an option that could change your outcome.
World Leader in CAR T Therapy
Request an AppointmentWhy Might My Doctor Recommend Bispecifics over CAR T?
Because Bispecifics can be more convenient and easier to administer in an outpatient setting, many physicians have access to them for a variety of reasons, which often make them a more appealing choice for some clinics.
However, what’s most convenient isn’t always what’s best, especially if your cancer has come back or is resistant to other treatments. If other treatments such as chemotherapy haven’t worked or weren’t an option, CAR T may still be effective. In many cases, patients whose cancer stopped responding to other therapies have achieved strong, lasting results with CAR T.
Who Might Benefit More from BiTEs?
BiTEs may be a good option for patients who are not eligible for CAR T or who need treatment more quickly. Because these therapies are available “off the shelf,” they can often be started within days rather than weeks. For some patients, that speed can make a critical difference.
BiTEs are also well suited for people whose immune systems or overall health make it difficult to undergo the cell collection process required for CAR T. They are given as infusions or injections, sometimes in an outpatient setting, and can help control disease or bridge patients to another therapy, including CAR T.
While BiTEs therapy may not always lead to the long-term remissions seen with CAR T, they play an important role in managing certain blood cancers and expanding access to immunotherapy for more people.
Both treatments represent major advances in cancer care, but knowing which one is right for you begins with getting a second opinion at a comprehensive cancer center like Moffitt where specialists can review your history, evaluate every option, and help you make the most informed decision for your care.
When deciding between BiTEs and CAR T, discuss these key points with your care team:
- Ask if you qualify for CAR T therapy. It requires specific health criteria, but even if you’ve been told no elsewhere, a center like Moffitt may offer additional options or clinical trials.
- Timing matters. CAR T takes time to prepare. Getting evaluated early, before your cancer progresses, can expand your options.
- Know your insurance coverage. Moffitt’s financial counselors can help navigate pre-authorization and out-of-pocket questions.
- Think long-term. While Bispecifics may offer faster access, CAR T may provide a longer response and reduce the need for ongoing treatments.
Advocating for Yourself or a Loved One
You are your own best advocate. If you or your loved one is receiving BiTEs or another therapy but have not been offered a consultation for CAR T, it’s reasonable and important to ask why. You can say:
“I’d like to understand all of my options. Should I get a second opinion about CAR T therapy?”
Your physician or care team should welcome that conversation. Community oncologists and primary care providers can help facilitate referrals to Moffitt, where a multidisciplinary team will review your full medical history and help determine whether CAR T or another advanced therapy is right for you.
When to Seek a Second Opinion
If your disease has relapsed or stopped responding to treatment, or if you’ve only been offered BiTEs without discussion of CAR T, it’s time to get another perspective. Even if you ultimately continue your current therapy, a second opinion gives peace of mind, and sometimes, a life-changing alternative.
Call us at 1-844-304-8636 or request a second opinion online at Moffitt Cancer Center. Our experts in cellular immunotherapy will review your case and explain all available options, including clinical trials that may not be available elsewhere. As Moffitt continues to expand access to innovative treatments, look for enhanced opportunities to receive CAR T in an outpatient setting in the coming year.