Expert Opinion on Modern Availability of Several Agents

EP: 1.MonumenTAL-1: Outcomes From the Extended Median Follow-Up Data

EP: 2.MonumenTAL-1: Outcomes From the Extended Median Follow-Up Data (Part 2)

EP: 3.Data Review of Teclistamab and Elranatamab in R/R MM

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EP: 4.Expert Opinion on Modern Availability of Several Agents

EP: 5.Future of R/R MM: Emerging Bispecifics and Trispecifics

EP: 6.Optimal Dosing of Talquetamab

Expert Opinion on Modern Availability of Several Agents

The bispecific antibody landscape is expanding with new agents entering the market, including a BCMA-targeted therapy with high-affinity binding that was presented at ASCO. This agent demonstrates promising early results from phase 1 trials with overall response rates of 54% or greater and expected duration of response, though complete data continue to mature. The enhanced binding affinity is anticipated to potentially offer advantages through improved efficacy and possibly reduced dosing requirements, adding to the growing arsenal of available bispecific therapies for patients with multiple myeloma.

The panel consensus supports having multiple bispecific options available, viewing competition as beneficial for driving down costs and improving patient access. With approximately 4 agents expected to be available in this space, including those already approved in Europe awaiting FDA approval, the increased competition should theoretically improve market dynamics. The experts evaluate therapeutic agents across 5 key variables: efficacy, safety, convenience, cost, and patient outcomes. Although cost discussions remain outside their immediate scope, they acknowledge their importance in treatment decision-making and patient accessibility.

Safety and efficacy profiles appear comparable across the available bispecific antibodies, with improved understanding and mitigation strategies for common adverse events. The infection risk, a notable concern with these therapies, can now be better managed through enhanced monitoring, immunoglobulin prophylaxis, antiviral prophylaxis, and antibacterial prophylaxis when appropriate. The recent recommendation for tocilizumab prophylaxis should help mitigate cytokine release syndrome, which typically presents as a grade 1 to 2 event. Looking forward, the availability of multiple agents will facilitate combination therapy development and provide flexibility in treatment sequencing, benefiting patients through increased accessibility and diverse therapeutic options tailored to individual patient needs and circumstances.