Perspectives on Anti-BCMA Bispecific Antibodies use in Multiple Myeloma-Experience from Asian Countries

Abstract

B-cell maturation antigen targeted bispecific antibodies have transformed the treatment landscape for heavily pre-treated relapsed/refractory myeloma in Asia, showing impressive efficacy despite limited access and adoption challenges; regional expert discussions highlight the need for ongoing research into response durability, toxicity and infection management, and patient selection to inform future clinical guidelines and optimize patient outcomes. Background: The management of relapsed / refractory myeloma particularly those who are heavily pretreated and penta-refractory has experienced a paradigm change with the advent of bispecific antibodies targeting B-cell maturation antigen (BCMA), offering new hope for these patients. The diverse experiences in the use of bispecific antibodies across Asian countries/regions underscore the complexities of integrating these therapies into clinical practice. With limited availability and varying access through clinical trials, compassionate access programmes and early commercial use, these agents are demonstrating impressive efficacy, yet present unique challenges in widespread adoption of these agents. Methods: A roundtable discussion among myeloma experts from Asia has highlighted consistent efficacy but also raised concerns about the durability of response and the management of associated toxicities and infections. Results: These discussions emphasize the need for ongoing research to better understand the nuances of treatment sequencing and patient selection. Conclusions: The insights gained will contribute to developing strategic frameworks and consensus guidelines that can effectively guide clinicians in optimizing outcomes for myeloma patients in diverse healthcare settings.