Abstract Purpose The treatment landscape for relapsed or refractory multiple myeloma (RRMM) has evolved significantly with the introduction of T cell–redirecting therapies. This review details key pharmacology, clinical efficacy, and safety information for bispecific antibodies (bsAbs) approved or under investigation for RRMM. Summary Multiple myeloma eventually relapses in nearly all patients, necessitating the continuous development of novel therapeutics. The 3 main targets for bsAbs on multiple myeloma cells are B cell maturation antigen (BCMA), G-protein-coupled receptor family C group 5 member D (GPRC5D), and Fc receptor homolog 5 (FcRH5). Clinical trials have demonstrated robust single-agent efficacy in patient populations with difficult-to-treat RRMM, including in patients with penta-refractory disease. However, these therapies are associated with unique toxicities, including cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome, as well as significant infection risks. Risk can be reduced through close monitoring, optimized premedication regimens, and step-up dosing strategies. Conclusion The remarkable efficacy of bsAbs in RRMM combined with a maturing understanding of their toxicity profiles is fundamentally reshaping the RRMM treatment landscape.
Dawud Ellayan (Fri,) studied this question.
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