Optimizing Treatment Selection and Sequencing in Relapsed/Refractory Multiple Myeloma: The Expanding Role of BCMA-Directed Bispecific Antibodies and Antibody-Drug Conjugates

In this OncLive Peer Exchange®, a panel of experts discusses the evolving treatment landscape for relapsed/refractory multiple myeloma (RRMM), with a focus on the expanding role of BCMA-directed bispecific antibodies and antibody-drug conjugates. Dr. Hans Lee, Dr. Paul Richardson, Dr. Jing Christine Ye, and Dr. Douglas Sborov examine how these therapies compare with CAR T-cell therapy in terms of mechanism, administration, toxicity, and practical use. The discussion highlights longer-term efficacy and durability data from the LINKER-MM1 and DREAMM clinical programs, including response depth, progression-free survival, and outcomes in patients with high-risk disease features. The panel also explores how disease burden, treatment urgency, access, manufacturing timelines, patient preferences, and toxicity profiles influence treatment selection and sequencing in RRMM. Additional discussion addresses emerging combination and earlier-line strategies, management of treatment-related toxicities, outpatient implementation, real-world considerations, and the importance of balancing treatment efficacy with safety and patient quality of life.