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Bispecific Antibody Therapies in Multiple Myeloma: Revolutionizing Treatment : Episode 2

Navigating Novel Therapies: ADCs, BsAbs, and CAR T in RRMM

September 30, 2025
By Ajai Chari, MD
Adriana C. Rossi, MD
  • Amrita Y. Krishnan, MD
  • Larry Anderson, MD, PhD

Opinion
Video

Panelists discuss how bispecifics are reversing the historical paradigm of diminishing returns in relapsed/refractory multiple myeloma, achieving 60% to 70% response rates lasting over a year in heavily pretreated patients.

EP: 1.Treatment Decision-Making in Multiple Myeloma at First and Subsequent Relapses

Now Viewing

EP: 2.Navigating Novel Therapies: ADCs, BsAbs, and CAR T in RRMM

The emergence of multiple therapeutic modalities targeting similar antigens has created new opportunities and challenges for patients with relapsed/refractory multiple myeloma. Both BCMA and GPRC5D can be approached through different treatment platforms including chimeric antigen receptor (CAR) T cells, bispecific antibodies, and antibody-drug conjugates, requiring careful consideration of sequencing strategies. The current approach favors using BCMA-directed CAR T-cell therapy before bispecific antibodies when feasible, as patients who relapse after CAR T-cell therapy can still achieve meaningful responses to bispecifics, while the reverse sequence appears less effective.

Patient selection between modalities depends on several critical factors, including disease aggressiveness, manufacturing timelines, and individual patient characteristics. Rapidly progressive disease may necessitate off-the-shelf bispecific therapy due to the immediate availability compared with the weeks required for CAR T-cell manufacturing. Patients with central nervous system concerns or those requiring dose flexibility may benefit from bispecific approaches, as these therapies can be held, dose-reduced, or discontinued if complications arise, unlike CAR T-cell therapy, where cellular products cannot be recalled once infused.

Geographic accessibility and caregiver support significantly influence treatment selection, particularly for patients living far from specialized centers. While CAR T-cell therapy requires extended stays near treatment facilities, bispecific antibodies can potentially be administered closer to patients’ homes after initial step-up dosing. However, the learning curve associated with these novel therapies mirrors the early experience with monoclonal antibodies, with improved safety profiles emerging as clinical experience grows and supportive care measures are optimized, suggesting broader implementation will become increasingly feasible for patients across diverse practice settings.

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In the analysis comparing D-VRd with other regimens for MRD-negative CR rate, there was an 81% probability that it was favorable vs Isa-VRd.

Which Therapy Has the Best Efficacy in Transplant-Ineligible NDMM?

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D-VRd had a 72% chance of providing superior PFS outcomes vs isatuximab plus VRd in patients with transplant-ineligible NDMM.


A panel of clinical pharmacists discussed strategies for mitigating toxicities across different multiple myeloma, lymphoma, and leukemia populations.

Navigating AE Management for Cellular Therapy Across Hematologic Cancers

Tiba Al Sagheer, PharmD, BCOP, BCACP;Rebecca Gonzalez, PharmD, BCOP, FASTCT;Syeda Saba Kareem PharmD, BCOP
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A panel of clinical pharmacists discussed strategies for mitigating toxicities across different multiple myeloma, lymphoma, and leukemia populations.


The Lived Experience of Talquetamab Therapy in a Patient With Multiple Myeloma

The Lived Experience of Talquetamab Therapy in a Patient With Multiple Myeloma

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September 27th 2025
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Karen Kehl shares her decade-long journey with multiple myeloma, discussing treatment options and the impact of bispecific antibodies like talquetamab with Binod Dhakal, MD.


1 expert in this video

Prolaris in Practice: Guiding ADT Benefits, Clinical Application, and Expert Insights From ACRO 2025

Steven Finkelstein, MD, DABR, FACRO
April 15th 2025
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Steven E. Finkelstein, MD, DABR, FACRO discuses how Prolaris distinguishes itself from other genomic biomarker platforms by providing uniquely actionable clinical information that quantifies the absolute benefit of androgen deprivation therapy when added to radiation therapy, offering clinicians a more precise tool for personalizing prostate cancer treatment strategies.


CEPHEUS Highlights Efficacious, Safe Regimen for Transplant-Ineligible/Deferred Multiple Myeloma

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Recent advancements in multiple myeloma treatment highlight the efficacy of daratumumab combined with VRd, showcasing improved outcomes and tolerability.


The investigators noted no new safety signals were reported in this trial.

Isa-VRd Meets Primary End Point in Transplant-Ineligible Newly Diagnosed Multiple Myeloma

Ariana Pelosci
September 20th 2025
Article

The VGPR or better rate was 87.8% in patients treated with Isa-VRd who had transplant-ineligible newly diagnosed multiple myeloma.

Related Content
Advertisement

In the analysis comparing D-VRd with other regimens for MRD-negative CR rate, there was an 81% probability that it was favorable vs Isa-VRd.

Which Therapy Has the Best Efficacy in Transplant-Ineligible NDMM?

Tim Cortese
October 1st 2025
Article

D-VRd had a 72% chance of providing superior PFS outcomes vs isatuximab plus VRd in patients with transplant-ineligible NDMM.


A panel of clinical pharmacists discussed strategies for mitigating toxicities across different multiple myeloma, lymphoma, and leukemia populations.

Navigating AE Management for Cellular Therapy Across Hematologic Cancers

Tiba Al Sagheer, PharmD, BCOP, BCACP;Rebecca Gonzalez, PharmD, BCOP, FASTCT;Syeda Saba Kareem PharmD, BCOP
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Podcast

A panel of clinical pharmacists discussed strategies for mitigating toxicities across different multiple myeloma, lymphoma, and leukemia populations.


The Lived Experience of Talquetamab Therapy in a Patient With Multiple Myeloma

The Lived Experience of Talquetamab Therapy in a Patient With Multiple Myeloma

ONCOLOGY Staff
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Article

Karen Kehl shares her decade-long journey with multiple myeloma, discussing treatment options and the impact of bispecific antibodies like talquetamab with Binod Dhakal, MD.


1 expert in this video

Prolaris in Practice: Guiding ADT Benefits, Clinical Application, and Expert Insights From ACRO 2025

Steven Finkelstein, MD, DABR, FACRO
April 15th 2025
Podcast

Steven E. Finkelstein, MD, DABR, FACRO discuses how Prolaris distinguishes itself from other genomic biomarker platforms by providing uniquely actionable clinical information that quantifies the absolute benefit of androgen deprivation therapy when added to radiation therapy, offering clinicians a more precise tool for personalizing prostate cancer treatment strategies.


CEPHEUS Highlights Efficacious, Safe Regimen for Transplant-Ineligible/Deferred Multiple Myeloma

CEPHEUS Highlights Efficacious, Safe Regimen for Transplant-Ineligible/Deferred Multiple Myeloma

ONCOLOGY Staff
September 21st 2025
Article

Recent advancements in multiple myeloma treatment highlight the efficacy of daratumumab combined with VRd, showcasing improved outcomes and tolerability.


The investigators noted no new safety signals were reported in this trial.

Isa-VRd Meets Primary End Point in Transplant-Ineligible Newly Diagnosed Multiple Myeloma

Ariana Pelosci
September 20th 2025
Article

The VGPR or better rate was 87.8% in patients treated with Isa-VRd who had transplant-ineligible newly diagnosed multiple myeloma.

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