What are the pros and cons of bispecific antibodies for multiple myeloma?
Jul 25, 2022
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Experts Roberto Mina and Andrzej J. Jakubowiak discuss the pros and cons of bispecific antibodies for multiple myeloma, highlighting MajesTEC-1 and MagnetisMM-1 trials, efficacy, response rates, challenges like infection risks, comparison to CAR T-cell therapies, and sequencing of therapies in myeloma treatment.
Bi-specific antibodies show promising efficacy comparable to CAR-T therapy in multiple myeloma treatment.
Careful monitoring is needed to manage infection risks and CRS challenges associated with bi-specific antibodies for multiple myeloma.
Deep dives
Efficacy and Response Rates of Bi-Specific Antibodies
Bi-specific antibodies show high efficacy with around two-thirds of patients responding and one-third achieving complete remission, even in heavily pre-treated populations. Results indicate promising efficacy comparable to CAR-T therapy, especially after previous BCMA targeting therapies. Alternative targeting strategies like GPRC5D also show promising activity, suggesting the potential for sequence or combination treatments.
Safety Profile and Challenges with Bi-Specific Antibodies
While bi-specific antibodies exhibit lower rates of toxicities compared to CAR-T therapy, challenges remain, such as CRS incidence of around 70-75%. The safety profile, although improved, still requires careful monitoring, particularly regarding infections and hospitalizations. Strategies like priming doses and pre-medications aim to mitigate risks like CRS, highlighting the need for continued evaluation and management.
Comparative Analysis and Future Considerations
Comparing bi-specific antibodies to CAR-T therapy reveals differences in efficacy and patient experience. While CAR-T therapy may show higher response rates, challenges with patient eligibility and manufacturing time exist. Bi-specific antibodies offer an off-the-shelf advantage and potential for combination therapies, with ongoing exploration on treatment duration and sequencing strategies to maximize efficacy and minimize risks, setting a path for future advancements in multiple myeloma treatment.
During the ASCO 2022 Congress, the Multiple Myeloma Hub was pleased to speak to Roberto Mina, University of Turin, Turin, IT, and Andrzej J. Jakubowiak, The University of Chicago, Chicago, US. We asked, What are the pros and cons of bispecific antibodies for multiple myeloma?
Mina and Jakubowiak discuss the MajesTEC-1 and MagnetisMM-1 trials, the efficacy and response rates of bispecific antibodies, and the challenges of using bispecific antibodies, such as infection risk. They also compare bispecific antibodies to CAR T-cell therapies and talk about the sequencing of therapies in myeloma treatment.