MABs can work in multiple ways: 1. They can mark a tumour for the immune system to recognise 2. Some are bi-specific which can mark a tumour but then act as a bridge for T-cells (see elranatamab which is being developed by Pfizer) 3. Some are bi-specific to two antigens in a tumour which can induce apoptosis (see BI's CDH-17 product).
They've been engineered to be used in many different settings, hence, they're popularity (they're also used to control Cytokine Release Syndrome in Car-T patients). They do struggle to penetrate through the TME in solid tumours as well but they're not as inihbited as CAR-T as some still show efficacy. They're manufacturing is a lot easier though and is mature so there will be more accessibility. The use case for CAR-Ts will be dependent on whether they offer durability in response, and efficacy rates or else they will be limited by other competing treatments. There will be no point in spending money on CAR-T if another treatments provides better treatment outcomes that have simpler manufacturing or less logistical issues.
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