Dr Nooka on Integrating Bispecific Antibodies Into the Community Treatment Paradigm for Multiple Myeloma

Ajay K. Nooka, MD, MPH, FACP, hematologist/oncologist, associate professor, Division of Bone Marrow Transplant, associate director, Clinical Research, Winship Cancer Institute of Emory University, discusses the integration of bispecific antibodies into the treatment paradigm for multiple myeloma, particularly within the community oncology setting.

Bispecific antibodies, which have demonstrated impressive response rates in relapsed/refractory patient populations, are becoming increasingly recognized as a viable treatment option, Nooka begins. He emphasizes that bispecific therapies offer response rates of up to 60% in heavily pretreated patients, far surpassing the traditional 30% response rates seen with previous standards of care.

Additionally, progression-free survival (PFS) durations with bispecifics extend beyond 12 months compared with the 3-month PFS often observed in patients who have undergone multiple prior therapies, Nooka expands.

One of the key benefits of bispecific antibodies is their off-the-shelf availability, he says. This allows for the initiation of treatment much more quickly than with CAR T-cell therapy, which requires a more complex cell manufacturing process, Nooka reports. For patients with aggressive disease or limited organ reserve, oncologists are waiting for additional therapies. Where CAR T-cell therapy is not an option, bispecific antibodies provide a critical alternative, he adds

Nooka also highlights the importance of patient-shared decision-making, allowing patients to weigh the options between bispecific antibodies and CAR T-cell therapy based on their individual preferences and clinical needs.

Community oncologists must be prepared to manage the associated toxicities of bispecific therapies, including infections, cytokine release syndrome (CRS), neurotoxicity, and cytopenias, he explains. Having a robust plan in place to monitor and address these potential adverse effects is essential to ensuring the safe integration of bispecific antibodies into clinical practice, Nooka emphasizes

With proper safety measures, bispecific antibodies can serve as an effective and timely therapeutic option for patients with relapsed/refractory multiple myeloma in the community setting, Nooka concludes.