Safety Considerations for Bispecific Antibodies in Multiple Myeloma

In this segment on early relapse multiple myeloma, Luciano Costa asks Muhamed Baljevic to contextualize the safety profile of BCMA-directed bispecific antibodies and how these considerations may influence use earlier in the disease course. Dr. Baljevic discusses key toxicities, including cytokine release syndrome, infection risk, and cytopenias, noting that while many adverse events are manageable, they require careful monitoring and proactive management strategies. He emphasizes that patient selection is critical, particularly when considering therapy in earlier lines where individuals may have different risk tolerance compared with heavily pretreated populations. The discussion also highlights logistical considerations such as step-up dosing, monitoring requirements, and the importance of multidisciplinary care. Ultimately, the benefit-risk assessment is individualized, balancing the potential for deep and durable responses against safety considerations and patient-specific factors. This segment underscores the importance of thoughtful integration of bispecific antibodies into multiple myeloma treatment strategies.