Setting the Stage: The Rise of BCMA Bispecific Antibodies in Myeloma
Experts discuss the rapid advancements in BCMA-directed bispecific antibodies for relapsed/refractory multiple myeloma, highlighting improved response rates and treatment integration.
The program opens with introductions from Sundar Jagannath, MBBS, and an expert multidisciplinary panel representing academic, community, and advanced practice perspectives. Jagannath frames the discussion around the transformative emergence of BCMA-directed bispecific antibodies in relapsed/refractory multiple myeloma (RRMM). With 3 FDA-approved agents now available—teclistamab, elranatamab, and the most recent addition, linvoseltamab—the treatment landscape has expanded at an unprecedented pace. The panel agrees that clinicians are rapidly gaining real-world experience, making this conversation especially timely for understanding how these therapies are being integrated into practice.
The segment moves quickly into why bispecific antibodies have generated such profound excitement. Ajay Nooka, MD, MPH, FACP, describes the dramatic improvement these agents have brought: historically, response rates for heavily pretreated, late-line myeloma patients plateaued around 30%. BCMA bispecifics have more than doubled that, consistently reaching 60–70% overall response rates—even in triple-class refractory patients who have exhausted proteasome inhibitors, IMiDs, and anti-CD38 antibodies. This leap not only represents a numerical improvement but marks a paradigm shift in how clinicians think about immune-based therapies in myeloma.
The panel then outlines how the field arrived at BCMA as the leading target. Nooka reviews the evolution from CD38 and SLAMF7 monoclonal antibodies to BCMA, which fulfills the criteria of an ideal target: high expression on malignant plasma cells with limited off-tumor distribution. He further contrasts BCMA with emerging targets such as GPRC5D and FcRH5, the latter still in development.
