Debate: Class Effect Versus Meaningful Differences Among BCMA Bispecific Antibodies in Relapsed/Refractory Multiple Myeloma

The second FACE-OFF debate explores whether currently available BCMA bispecific antibodies should be considered a therapeutic class or whether meaningful clinical differences exist among individual agents used to treat relapsed/refractory multiple myeloma (R/R MM). Dr. Ridhi Gupta argues that teclistamab, elranatamab, and linvoseltamab share common mechanisms of action, efficacy, resistance patterns, and toxicity profiles that support a class effect. Dr. Gurbakhash Kaur counters that important differences in administration, dosing schedules, patient selection, and practical implementation influence how these agents are used in clinical practice. Dr. Cesar Rodriguez further discusses distinctions in molecular design, cytokine release syndrome risk, infection profiles, and emerging next-generation BCMA bispecific antibodies, while the panel considers the limitations of cross-trial comparisons and the impact of T-cell exhaustion on subsequent therapy. The debate concludes that although BCMA bispecific antibodies share many biological characteristics, individual agent attributes, patient-specific factors, and real-world treatment considerations continue to influence therapeutic decision-making in relapsed/refractory multiple myeloma.