Positioning Bispecific Therapy in Early Relapse Multiple Myeloma

In this segment on early relapse multiple myeloma, Luciano Costa invites Carol Ann Huff to discuss how subgroup data and safety considerations inform treatment positioning. Dr. Huff highlights that patients previously exposed to anti-CD38 therapy represent a heterogeneous group, and that distinguishing between exposure and true refractoriness is critical when interpreting outcomes and selecting subsequent therapy. She notes that encouraging efficacy signals in these populations may support consideration of BCMA-directed approaches earlier in relapse. At the same time, she emphasizes that treatment decisions must incorporate a careful benefit-risk assessment, particularly in earlier lines where patients may have longer expected disease trajectories. Key factors include the risk of cytokine release syndrome, infection, and the need for monitoring, balanced against the potential for deep and durable responses. Overall, this discussion underscores the importance of individualized decision-making when integrating bispecific antibodies into multiple myeloma treatment strategies.