The Challenge of Making Bispecifics More Accessible in R/R Multiple Myeloma

A retrospective, observational cohort study shared at the 2025 American Society of Hematology (ASH) Annual Meeting and Expositiondemonstrated that the utilization of bispecific antibodies is expanding across community oncology settings in the wake of various regulatory approvals. Among these findings, it was noted that patients receiving bispecifics were slightly younger and had favorable ECOG performance statuses compared with patients receiving other therapies.

CancerNetwork® spoke with Ira Zackon, MD, senior medical director at Ontada, about this cohort study and how the observed differences in patient selection and access can be addressed. Zackon highlighted patient education, practice resources, and distance to community centers as some of the leading causes of these disparities.

The trial included patients with active relapsed/refractory multiple myeloma who received treatment with a bispecific antibody between October 1, 2022, and July 14, 2025. The median age of patients in the bispecifics group was 72 years (range, 39-92) compared with 74 years (range, 45-96) in the non-bispecifics group. Additionally, 18.3% and 22.8%, respectively, had ECOG performance statuses of 2.

Transcript:

CancerNetwork: What key barriers and disparities can be addressed to ensure equitable outcomes in the relapsed/refractory multiple myeloma field?

[It] begins with understanding the barriers to access and solving for those in order to facilitate the ability of patients to get on therapy. There are important components of patient education so that they really understand these therapy choices and the risks and benefits. Through an informed process of educating them, that’s important because they have to be a partner in this therapy. They have to report what’s going on with [their health] very well and early in order to mitigate some of these issues. Practice by practice, at the community level, you have to look at what your practice resources are and how much of a priority it is. It might depend on how close you are to other centers that might provide this care.

But with [multiple] myeloma, although currently it’s in 5 or more lines of therapy, that’s going to change. We know the direction is that bispecifics will be used earlier in lines of therapy because a lot of [multiple] myeloma therapy is moving earlier, [with] more impact early in this population. Practices need to be able to deliver this therapy like we’ve taken on many other therapies, [just] as the landscape has changed in solid tumors. Community oncologists are very adaptable, but [they] still have to learn the specifics of this and know that they can resource it. It’s an ongoing project, but [it is] imperative, and I am confident we’re going to see that change. This [treatment] will also move more outpatient, where you don’t have to admit your patient for this initial phase of treatment once that is delivered safely.

There already are practices and academic centers doing this to deliver the data and what’s needed. That will change both the ability to deliver it in the community setting safely, [with improved] quality of life for patients, and reduce the costs of delivering this care if you can remove the hospital component, only when it’s necessary. That’s the future, and we’ll see this expand over time as the field continues to progress.

Reference

Whitesell M, Su Z, Herms L, Espirito J, Paulas J, Zackon I. Evolving real-world uptake and patient characteristics of bispecific antibodies in relapsed/refractory multiple myeloma: Insights from a US community oncology network. Blood. 2025;146(suppl 1):5857. doi:10.1182/blood-2025-5857