Haemato-oncology · London
Bispecific antibody therapy, private in London.
Off-the-shelf T-cell engagers for relapsed myeloma, lymphoma and uveal melanoma. Delivered by a consultant haemato-oncologist in a JACIE-equivalent centre, with a full cytokine release syndrome pathway from day one.
Why patients choose us
- 01
A named haemato-oncologist in a bispecifics-experienced centre
Not a general infusion suite. A consultant with a high volume of teclistamab, glofitamab or tebentafusp cases, in a unit set up for step-up dosing and cytokine release syndrome monitoring.
- 02
The right agent for your disease and prior lines
BCMA, GPRC5D, CD20 and gp100 targets each have their place. We match the bispecific to the tumour, the prior therapy sequence and the fitness of the patient before you commit.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
What they are
Two arms, one job: drag T cells onto tumour cells.
Bispecific antibodies are engineered proteins that bind two different targets at once. In cancer they almost always bind CD3 on a T cell with one arm, and a tumour antigen with the other, so the patient's own T cells are pulled directly onto the malignant cell and instructed to kill it.
Two-armed antibody
Unlike a standard monoclonal antibody, which binds one target, a bispecific has two different antigen-binding sites and behaves like a physical bridge between two cells.
T-cell engagers (TCE)
The dominant class in oncology. One arm binds CD3 on the T cell. The other binds BCMA, GPRC5D, CD20, CD19 or gp100 on the tumour cell.
BiTE, DuoBody, TandAb
BiTE (Bispecific T-cell Engager) is one construct format, of which blinatumomab is the archetype. Newer bispecifics use full IgG-like backbones for a longer half-life and easier dosing.
Indicative cost per cycle
What a private bispecific antibody costs in London.
Indicative ranges across our partner units. Send us your diagnosis and prior lines and we quote firm figures across two or three options.
In short
Typical annual on-treatment cost: £120,000 to £220,000, depending on agent, dose schedule and duration.
| Item | Indicative range | Interval | Turnaround |
|---|---|---|---|
| Multidisciplinary review and treatment plan | £450-£850 | 45-60 min | 48 hours |
| Baseline work-up (echo, virology, imaging, marrow) | £2,400-£4,800 | 1-2 weeks | 5-10 days |
| Teclistamab (Tecvayli), monthly on-treatment cost | £11,500-£14,000 | per cycle | Ongoing |
| Talquetamab (Talvey), monthly on-treatment cost | £11,000-£13,500 | per cycle | Ongoing |
| Glofitamab (Columvi), fixed 12-cycle course | £8,500-£12,000 | per cycle | Ongoing |
| Tebentafusp (Kimmtrak), weekly for uveal melanoma | £9,500-£12,500 | per week | Ongoing |
| Cycle-one inpatient admission for step-up dosing | £6,500-£12,000 | 3-7 nights | Same admission |
Drug cost is the dominant component. Facility fees, cycle-one admission, tocilizumab and monthly IVIG add materially to the total. We come back with a firm quote within one working day.
Where treatment is given
A small number of London centres deliver bispecifics privately.
Bispecific antibody therapy is offered in JACIE-accredited or equivalent cell therapy centres with a dedicated cytokine release syndrome pathway. Introductions are made privately, once we understand your case.
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King's College Hospital Private
Established myeloma and lymphoma cellular therapy programme in south London.
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University College London Hospitals Private
Comprehensive haemato-oncology and cell therapy service on Euston Road.
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The Royal Marsden Private
Specialist cancer centre with strong bispecific and CAR-T experience in Chelsea and Sutton.
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The Christie Private Care
Manchester-based specialist cancer centre for patients unable to travel to London.
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HCA London Bridge Hospital
HCA haemato-oncology suite with links to cellular therapy partner units.
Bispecifics vs CAR-T
Off-the-shelf, immediate, weekly. Or one-time, engineered, unique.
Both work through T cells. The difference is availability, delivery and durability of response, which is what drives the choice for a given patient.
Bispecific antibodies
- Off-the-shelf, available in days.
- Weekly or fortnightly dosing (some fixed duration).
- Multiple licensed agents per indication.
- Retreatment and sequencing possible.
- Lower rates of higher-grade CRS and ICANS than CAR-T.
CAR-T cell therapy
- One-time engineered infusion of autologous T cells.
- Apheresis, manufacturing and 3 to 6 week wait.
- Usually one licensed product per indication.
- Deep, durable remissions in a subset of patients.
- Higher rates of significant CRS and ICANS.
Response rates
What the pivotal trials actually show.
Rounded figures from the pivotal trials, in patients who had already exhausted standard options. Your own likely response depends on prior lines, disease burden and cytogenetics.
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Teclistamab in myeloma
Overall response rate around 63% after four or more prior lines (MajesTEC-1). Median duration of response around 22 months in responders.
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Talquetamab in myeloma
Overall response rate around 74% at the recommended weekly dose (MonumenTAL-1), including in patients previously treated with a BCMA-directed therapy.
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Elranatamab in myeloma
Overall response rate around 61% in triple-class exposed patients (MagnetisMM-3), with a similar tolerability profile to teclistamab.
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Glofitamab in DLBCL
Overall response rate around 52% (complete response 39%) in relapsed / refractory DLBCL after two or more prior lines, including post-CAR-T (NP30179).
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Epcoritamab in DLBCL
Overall response rate around 63% (complete response 39%) in DLBCL after two prior lines (EPCORE NHL-1).
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Tebentafusp in uveal melanoma
The first agent to show an overall survival benefit in metastatic uveal melanoma, roughly 22 vs 16 months versus investigator choice (IMCgp100-202).
The journey
From referral to maintenance, what happens, in order.
One team from first message through step-up dosing, response assessment and maintenance.
Phase 1 · Before treatment
Concierge, off-stage for you
Phase 2 · On treatment
Step-up and weekly dosing
Phase 3 · After
Response and follow-up
- 01
Before
You send us your history and molecular profile
A short, confidential form. Diagnosis, prior lines of therapy, current bloods, imaging and any myeloma or lymphoma flow cytometry or FISH results.
- 02
Before
We come back with a recommendation
Within one working day: which bispecific fits your disease and prior lines, indicative cost per cycle, and whether CAR-T or an antibody-drug conjugate might sit better.
- 03
Before
We arrange baseline work-up and admission
Baseline echo, virology, immunoglobulin levels and infection screen. Inpatient bed booked for the step-up doses in cycle one.
- 04
On treatment
Step-up dosing, inpatient
The first two or three doses are given as an inpatient over 3 to 7 nights, with tocilizumab and dexamethasone on standby for cytokine release syndrome.
- 05
On treatment
Full-dose weekly treatment
Once past the step-up, most doses move to outpatient day-case, subcutaneous or short IV infusion, roughly 60 to 90 minutes on unit.
- 06
On treatment
Move to maintenance schedule
Weekly dosing is typically de-escalated to fortnightly, then monthly, once a deep response is confirmed on imaging or marrow.
- 07
After
Response assessment and long-term follow-up
PET-CT or marrow at defined intervals, plus monthly IVIG for hypogammaglobulinaemia and infection prophylaxis for as long as you remain on treatment.
Typical time to start: 2 to 3 weeks. Cycle one admission: 3 to 7 nights. Response assessment: every 3 months.
Licensed indications, UK 2025
Who bispecifics are for, and who they are not for.
Myeloma, lymphoma and uveal melanoma cover almost every UK bispecific antibody licence in 2025. B-ALL is treated with blinatumomab in cellular therapy centres.
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Relapsed / refractory multiple myeloma
Teclistamab (Tecvayli), talquetamab (Talvey) or elranatamab (Elrexfio) after three or more prior lines including a PI, IMiD and anti-CD38.
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Diffuse large B-cell lymphoma post-CAR-T
Glofitamab (Columvi) or epcoritamab (Epkinly) for DLBCL that has progressed after CAR-T or when CAR-T is not an option.
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Follicular lymphoma, third line and beyond
Mosunetuzumab (Lunsumio), an off-the-shelf CD20xCD3 bispecific, as a fixed-duration outpatient course for relapsed FL.
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Metastatic uveal melanoma, HLA-A*02:01 positive
Tebentafusp (Kimmtrak) gp100xCD3, the first agent to improve overall survival in metastatic uveal melanoma.
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B-cell acute lymphoblastic leukaemia
Blinatumomab (Blincyto) CD19xCD3, in MRD-positive or relapsed B-ALL as a bridge to transplant or CAR-T.
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Bridge before or after CAR-T cell therapy
Bispecifics can hold disease while CAR-T cells are manufactured, or salvage a patient whose CAR-T has failed.
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Patients unfit or unable to travel for CAR-T
Off-the-shelf availability and weekly outpatient dosing suit patients who cannot manage a CAR-T pathway or apheresis logistics.
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Red flag: active infection or severe cytopenias
Uncontrolled infection, neutrophils under 1.0 or platelets under 50 usually mean deferring treatment. We are honest before you commit.
The agents
Eight bispecifics, four disease groups, one framework.
What each licensed agent actually is, its target, the schedule and how it is chosen in practice.
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Teclistamab (Tecvayli), BCMAxCD3
The first BCMA bispecific licensed for relapsed myeloma. Weekly subcutaneous injection after a 3-dose inpatient step-up. Overall response rate around 63% after four prior lines.
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Talquetamab (Talvey), GPRC5DxCD3
A non-BCMA target for patients who have already failed BCMA-directed therapy. Skin, nail and taste side effects are distinctive and manageable with dose adjustment.
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Elranatamab (Elrexfio), BCMAxCD3
A second BCMA bispecific with a comparable response profile to teclistamab. Useful when supply or scheduling favours one over the other.
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Glofitamab (Columvi), CD20xCD3
Fixed 12-cycle course for relapsed DLBCL, with obinutuzumab pre-treatment to blunt cytokine release syndrome. Off-the-shelf and does not need apheresis.
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Epcoritamab (Epkinly), CD20xCD3
Subcutaneous CD20xCD3 for DLBCL and follicular lymphoma. Continuous weekly, then fortnightly, then monthly dosing until progression.
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Mosunetuzumab (Lunsumio), CD20xCD3
IV, fixed-duration course of 8 cycles for relapsed follicular lymphoma. Lower rates of higher-grade cytokine release syndrome than the other CD20xCD3 agents.
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Tebentafusp (Kimmtrak), gp100xCD3
An immunocytokine-style TCR bispecific for HLA-A*02:01 positive metastatic uveal melanoma. Weekly IV infusion in a monitored day unit.
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Blinatumomab (Blincyto), CD19xCD3
A first-generation BiTE for B-ALL, delivered as a 28-day continuous IV infusion via a portable pump. Requires close inpatient supervision at initiation.
Our vetted UK network
A small panel of haemato-oncologists, we picked them.
Consultants with high bispecific case volumes, in JACIE-accredited or equivalent cell therapy units. Not listed publicly. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every consultant in our network.
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Consultant haemato-oncologists with a high volume of bispecific antibody cases
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JACIE-accredited or equivalent cell therapy units with 24/7 cytokine release syndrome pathways
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On-site tocilizumab, intensive care access and neurology input for immune effector cell neurotoxicity
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Multidisciplinary review including cellular therapy, transplant and radiology at every decision point
Safety and cytokine release syndrome
What to expect, honestly.
Cytokine release syndrome is the defining side effect of any T-cell engager. With modern step-up dosing and premedication, most CRS is mild and manageable, but the safety pathway is built around it from day one.
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Cytokine release syndrome (CRS)
Most patients get some CRS in cycle one, usually grade 1 or 2 (fever, tachycardia, mild hypotension). Managed with tocilizumab and dexamethasone. Higher-grade CRS is uncommon after step-up dosing.
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Immune effector cell neurotoxicity (ICANS)
Confusion, tremor or dysphasia within the first cycle. Uncommon with bispecifics compared with CAR-T but taken seriously, with daily ICE score checks on the ward.
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Infection risk and hypogammaglobulinaemia
B-cell and plasma-cell depletion leaves you at risk of bacterial, viral and PJP infections. Monthly IVIG, aciclovir and co-trimoxazole prophylaxis are standard.
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Cytopenias
Neutropenia, anaemia and thrombocytopenia are common in the first three cycles. G-CSF, transfusions and dose delays are used to keep you safe.
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Skin, nail and taste changes (talquetamab)
GPRC5D is expressed on skin and nail keratinocytes and taste buds. Rash, dry mouth, weight loss and dysgeusia can develop, usually manageable with dose interval adjustment.
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Injection site or infusion reactions
Subcutaneous injections can cause local redness. IV infusions can cause fevers and rigors, especially in the first cycles, managed with premedication.
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Hospital admission for step-up dosing
The first two or three doses are given as an inpatient over 3 to 7 nights so that CRS and ICANS can be watched for and treated early.
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Long-term monitoring
Monthly bloods, imaging every 3 months and marrow or PET at response milestones. Immunoglobulin replacement continues as long as levels stay low.
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Red flags between visits
A fever over 38, sudden confusion or new severe headache, breathlessness, or a rash with mucosal involvement means calling the unit or attending A&E the same day.
Reading your treatment summary
Your bispecific plan in four parts. Read the last one first.
Whichever agent is chosen, the summary the consultant sends you keeps to the same shape.
A quiet reminder
Haemato-oncology language is precise and can read coldly. We translate it for you.
If you would like us to talk you through the plan before your review, just ask.
- 01 Header
Diagnosis, prior lines and molecular profile
What tumour, how many prior lines, and any BCMA, CD20, GPRC5D, HLA-A*02:01 or FISH data that drove the choice of bispecific.
- 02 Regimen
Agent, step-up schedule and cycle plan
Which bispecific, the step-up dose schedule for cycle one, dose escalations, and the planned duration (fixed course versus continuous until progression).
- 03 Findings
CRS, ICANS and toxicity summary
Grades of CRS, tocilizumab use, any ICANS, cytopenias and infections. The endpoint that matters here is safety across step-up dosing.
- 04 Impression
Response, next dose and follow-up plan
Read this first: response to date on PET or marrow, whether de-escalation is due, and when the next appointment, IVIG and imaging are booked.
Recognised by major UK insurers
Cover for bispecific antibody therapy varies by insurer, agent and indication. We confirm cover before booking.
Frequently asked
Everything we get asked about bispecifics.
Quick answers on outpatient care, insurance, CRS, sequencing with CAR-T, duration and MDT review.
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Is bispecific antibody therapy outpatient or inpatient?
Cycle one, including the step-up dosing, is given as an inpatient over 3 to 7 nights so that cytokine release syndrome and neurotoxicity can be watched for and treated early. From cycle two onwards, most bispecifics move to outpatient subcutaneous or short IV dosing, weekly at first and then de-escalating to fortnightly or monthly.
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Will my private health insurance cover a bispecific antibody?
Cover varies. Most UK insurers will fund a bispecific when it holds an MHRA licence for your indication and when NICE or a specific policy supports it. Teclistamab, glofitamab, mosunetuzumab and tebentafusp are the ones most commonly reimbursed. We confirm cover with your insurer before booking, and where cover is refused we help you understand the self-pay pathway.
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What is the risk of cytokine release syndrome?
Most patients get some CRS in cycle one, but it is usually grade 1 or 2 (fever and tachycardia, sometimes mild hypotension). Higher-grade CRS is uncommon with modern step-up dosing and premedication. Tocilizumab and dexamethasone are given at the first sign of significant CRS. Serious ICU-level CRS is now rare.
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How does a bispecific fit with CAR-T cell therapy?
Bispecifics can be used before CAR-T (to hold disease while cells are manufactured), instead of CAR-T (when apheresis, travel or timing is not workable), or after CAR-T (as salvage when the CAR-T has failed). For DLBCL, glofitamab and epcoritamab have data specifically in post-CAR-T patients.
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How long will I be on treatment?
It depends on the agent. Glofitamab and mosunetuzumab are fixed-duration courses (12 and 8 cycles respectively). Teclistamab, talquetamab, elranatamab, epcoritamab and tebentafusp are given continuously until disease progression or unacceptable toxicity. In practice most patients settle onto monthly dosing once a deep response is confirmed.
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Will my case go through a multidisciplinary team?
Yes. Every bispecific antibody case in our network is discussed at a haemato-oncology MDT with cellular therapy, radiology and transplant input, both before starting and at every response milestone. This is a JACIE and BSH standard, not an optional extra.
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Bispecific antibody therapy, London
Send your case. We come back within one working day.
A named haemato-oncologist, a bispecifics-experienced London centre, and a firm quote across two or three options. No obligation, no fee to you.