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Bispecific Antibodies Challenge CAR T-Cell Therapy as Multiple Myeloma Treatment Contender

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June 14, 2021

Their off-the-shelf status makes them promising, but long-term follow-up is lacking

  • Bispecific antibodies have shown response rates of up to 70%, and complete response rates of up to 40% in patients with relapsed/refractory multiple myeloma
  • This off-the-shelf treatment is beneficial to patients who can’t afford to wait for CAR T-cell therapy
  • Evidence presented so far has been promising, but long-term follow-up is needed
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The latest buzzword in multiple myeloma is bispecifics. With response rates in the 70% range, and complete response rates of up to 40%, this investigational treatment is proving to be an attractive option, especially for patients who can’t afford to wait four to six weeks for a custom-designed therapy.

“I think that if these have PFS (progression free survival) that approaches a year or more, then it certainly would be a potential threat to CAR T cells, because of the fact that these are off-the-shelf products, [and are] logistically less challenging,” Dr. Ravi Vij, professor of medicine at Washington University School of Medicine in St. Louis, said during a virtual SurvivorNet Connect forum following the 2021 ASCO Annual Meeting.

Dr. Saad Usmani, director of clinical research at Levine Cancer Institute in Charlotte, North Carolina, believes bispecific antibodies “will find good utility in the clinic” because of their effects against targets such as BCMA and GPRC5D.

Although all the early signs point to good efficacy, longer follow-up is lacking. “What I’d like to see is durability of response,” Dr. Usmani says. “You need continuous engagement of the patient’s T cells.”

Another advantage to the bispecifics is their good safety profile. “It really is an attractive option for older patients,” says Dr. Amrita Krishnan, a hematologist-oncologist at City of Hope in Duarte, California.

Dr. Thomas Martin, a hematologist-oncologist at UCSF Medical Center, agrees. The oldest patient in his center’s bispecifics study is 88. “They’ve done fine,” he says.