Considering Time Burden Across Bispecific Antibody Treatment Approaches in Non-Hodgkin Lymphoma

Key Takeaways:

• Among patients with relapsed or refractory follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL), fixed-duration bispecific antibodies (BsAbs) were associated with lower all-cause and cancer-related health care utilization than treat-to-progression therapies.
• Patients receiving fixed-duration treatments spent less hours in treatment- and disease-related visits than those receiving treat-to-progression therapies.
• Over 92% of survey participants showed preference for fixed-duration regimens due to less frequent dosing and lower time burden.

“Time toxicity” refers to the amount of time patients spend interacting with the health care system. This includes clinical and emergency visits, procedures, lab testing, hospitalizations, appointment scheduling, and travel time.

Differences in treatment may impact time toxicity, especially for patients with non-Hodgkin lymphoma (NHL) who may experience significant disease burden.

Study Methods and Outcomes

Researchers conducted a real-world online survey to compare time toxicity and patient preferences for different BsAbs for relapsed or refractory FL and DLBCL.

A total of 120 patients, 60 with FL and 60 with DLCBL, completed the survey between April and July 2025. Participants reported patient characteristics and caregiver status, all-cause and cancer-related health care resource utilization in the past 30 days, the impact of treatment on daily activity, and preference for either fixed-duration or treat-to-progression therapy.

Time Toxicity for FL

Among the 60 participants with FL, 30 were receiving mosunetuzumab and 30 were receiving epcoritamab.

Overall, average time spent on cancer-related health care utilization per-patient-per-month (PPPM) for all FL participants was 46.5 hours. Patients receiving fixed-duration mosunetuzumab spent 49.7% less time on cancer-related health care utilization than those with treat-to-progression epcoritamab, 31.2 vs 61.9 hours, respectively.

Mosunetuzumab was associated with significantly lower mean all-cause health care visits than epcoritamab, 1.7 vs 3.3, respectively.

Patients receiving epcoritamab had shorter treatment-related visits than those receiving mosunetuzumab, 5.1 vs 4.3 hours, respectively.

Time Toxicity for DLBCL

Among the 60 participants with DLBCL, 32 were receiving glofitamab and 28 were receiving epcoritamab.

Overall, average time spent on cancer-related health care utilization PPPM for all DLBCL participants was 63.8 hours. Patients receiving fixed-duration glofitamab spent 51.0% less time on cancer-related health care utilization than those with treat-to-progression epcoritamab, 43.0 vs 87.7 hours, respectively.

Glofitamab was associated with significantly lower mean all-cause health care visits than epcoritamab, 2.2 vs 3.0, respectively.

Patients receiving glofitamab had shorter disease-related visits than those receiving epcoritamab, 1.5 vs 2.4 hours, respectively.

Implications for Managed Care

When asked to choose between fixed-duration and treat-to-progression regimens, over 92% of patients preferred fixed-duration therapies due to their greater convenience, highlighting time as an importance consideration for treating NHL.

The authors said, “Our real-world data, including novel aspects of time toxicity, demonstrate clinically meaningful differences in time burden associated with BsAbs and emphasize the importance of incorporating patient convenience and preference into shared decision-making in NHL.”

Reference

Major A, Ma E, Masaquel A, et al. Patient-reported time toxicity with bispecific antibody therapies in relapsed/refractory follicular lymphoma and diffuse large B-cell lymphoma. Oncologist. 2026;31(7):oyag202. doi:10.1093/oncolo/oyag202