Immunotherapies have significantly improved outcomes in patients with multiple myeloma yet maintaining a durable response in heavily pretreated patients remains challenging. Therapies that target B cell maturation antigen (BCMA) provide additional treatment options in patients whose disease becomes refractory to several drug classes in early lines of therapy. Clinical trial data from selected patient populations and controlled settings are complemented by real-world data (RWD) from actual clinical practice. In this podcast, the authors reviewed and discussed seven abstracts presented at the 65th Annual Meeting of the American Society of Hematology, focusing on BCMA-directed therapies, emphasizing the value of RWD in treatment decision-making, and suggesting how RWD can help advance multiple myeloma research. These abstracts include real-world outcome studies in patients with relapsed or refractory multiple myeloma with triple-class exposed or refractory disease (abstracts 542, 3358, and 6727); an analysis on disease burden associated with delayed diagnosis (abstract 3771); comparability of real-world outcomes vs clinical trial data (abstracts 91 and 545); and outcomes in patients with multiple myeloma who experienced early treatment failure after upfront quadruplet therapy (abstract 1989).Podcast available for this article.
Keywords: Bispecific antibodies; Multiple myeloma; Podcast; Real-world evidence; Triple-class exposed.
Multiple myeloma (MM) is a hematologic cancer that affects plasma cells in the bone marrow. Although there is no cure for MM, advances in treatment have improved survival outcomes in patients with MM. However, for many patients the disease will eventually relapse and become refractory to one or more early-line agents. Indeed, with increased use of triplet and quadruplet therapies, the myeloma of some patients will become triple-class refractory as early as their second or third line of therapy. Thus, additional treatment options that are mechanistically distinct from immunomodulatory drugs, proteasome inhibitors, and anti-CD38 antibodies are needed. Encouraging outcomes from several clinical trials enrolling patients with triple-class refractory MM have led to the recent regulatory approval of drugs that target B cell maturation antigen (BCMA), such as chimeric antigen receptor (CAR)-T cell therapies and BCMA–CD3 bispecific antibodies. Real-world evidence on the efficacy, safety, and usage of these BCMA-directed therapies from patients treated in clinical practice provides valuable evidence that complements the findings from clinical trials. At the 65th Annual Meeting of the American Society of Hematology held in December 2023 in San Diego, CA, researchers presented results from real-world studies of BCMA-targeting drugs in patients with relapsed or refractory MM (RRMM). In this podcast, two leading hematologists discuss how these drugs affect patient-reported outcomes, how the effectiveness and safety of these drugs compare with data from clinical trials, and how real-world studies shape how patients with RRMM may be treated in the future. Supplementary file1 (MP4 51,557 KB).
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