Debate: The Future Role of BCMA Bispecific Antibodies in Later-Line Relapsed/Refractory Multiple Myeloma

The final FACE-OFF debate examines whether BCMA bispecific antibodies will retain a meaningful role in the management of relapsed/refractory multiple myeloma (R/R MM) as these therapies continue to move into earlier lines of treatment. Dr. Harsh Parmar argues that the role of BCMA bispecific antibodies in later-line disease will gradually diminish as earlier use, prior BCMA exposure, and emerging therapeutic options reduce opportunities for retreatment. In contrast, Dr. Cesar Rodriguez emphasizes that BCMA bispecific antibodies will continue to play an important role for selected patients, citing the potential for retreatment with alternative BCMA-directed agents, combination strategies that enhance T-cell fitness, and individualized sequencing approaches. During the discussion, the faculty also consider the impact of T-cell exhaustion, antigen escape, attrition across successive lines of therapy, expanding treatment options targeting alternative antigens, and differences in treatment accessibility between academic and community settings. The debate concludes that although BCMA bispecific antibodies are expected to move earlier in the treatment paradigm, their future role in later-line relapsed/refractory multiple myeloma will continue to evolve alongside new evidence, novel therapeutic targets, and personalized sequencing strategies.