Bispecific Antibodies in Multiple Myeloma Trials: A Frontline Perspective

Bispecific antibodies (BsAbs) are redefining multiple myeloma treatment, offering an off-the-shelf immunotherapy option that links T-cells directly to cancer cells. Unlike CAR-T therapy, which requires time-intensive cell engineering, BsAbs are readily available, making them a powerful tool in late-stage and potentially front-line multiple myeloma treatment.

But while these therapies hold promise, bringing them into clinical trials requires careful navigation—from toxicity management to trial design and regulatory considerations.

We spoke with Liat Vidal, MD, Senior Medical Director at Syneos Health, to get an inside look at the challenges and opportunities shaping the future of BsAbs in multiple myeloma trials.

Q: What makes BsAbs such a game-changer in multiple myeloma treatment?

Dr. Vidal: Over the past two to three years, multiple myeloma treatment has relied on combination regimens—immunomodulatory drugs (IMiDs), proteasome inhibitors and anti-CD38 monoclonal antibodies. These extend survival, but resistance eventually develops. Bispecific antibodies change that equation by activating the immune system in a highly targeted way.

They bind to two sites: one on T-cells and one on myeloma cells, directing the immune system to attack the cancer more efficiently. We’re seeing real, durable responses in patients who previously had few options left. That’s huge.

Q: What are the biggest challenges in integrating BsAbs into treatment paths?

Dr. Vidal: The biggest hurdle is toxicity. Bispecific antibodies can trigger cytokine release syndrome (CRS) and neurotoxicity that may be severe, which means patients often need hospital-based care. That limits access—these aren’t yet therapies that community oncologists can easily administer.

We’re also exploring combination strategies—can pairing antispecific antibodies with IMiDs, with anti-CD38 monoclonal antibody or other standard multiple myeloma therapies enhance efficacy while reducing toxicity? That’s the next frontier, but we need large-scale trials to validate these approaches.

Read the full blog where Dr. Vidal shares what’s next for bispecific antibodies in multiple myeloma trials and provides a breakdown of key trial considerations.

Connect with our experts to explore how your next multiple myeloma trial can leverage bispecific antibodies effectively.