Differentiating BCMA-Directed Bispecifics and Sequencing GPRC5D-Targeted Therapy in Relapsed/Refractory Multiple Myeloma

The panel discusses how clinicians may differentiate among BCMA-directed bispecific antibodies as the treatment landscape becomes increasingly crowded. Dr. Douglas Sborov notes that differences in administration, including subcutaneous versus intravenous delivery and step-up dosing requirements, are important operational considerations, while efficacy and longer-term data may increasingly distinguish therapies as they move into earlier lines and combination regimens. Dr. Hans Lee describes practical considerations for coordinating step-up dosing with outpatient clinic schedules and highlights the potential convenience of weekly upfront dosing with linvoseltamab. The discussion then shifts to GPRC5D as an alternative target for malignant plasma cells. Dr. Jing Christine Ye describes the role of GPRC5D-directed therapy in sequencing after BCMA-directed treatment and as a bridging strategy before CAR T-cell therapy. She also discusses emerging combination data in earlier relapse, including findings from the MonumenTAL-3 study, and highlights the potential treatment-related advantages of targeting GPRC5D. The segment emphasizes the growing range of targets and the need to consider efficacy, administration, sequencing, and patient-specific factors when selecting therapy.