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Video

Bispecific Antibodies in CNS Myeloma: What Patients Should Know | Mahmoud Gaballa, MD

Posted by
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• December 22, 2025

Description

Dr. Mahmoud Gaballa, shares new research on the use of bispecific antibodies in patients with CNS myeloma—a rare form of multiple myeloma that affects the brain, spinal cord, or surrounding tissues. In a multicenter study of 24 patients, bispecific antibodies showed encouraging response rates both systemically and in the central nervous system, with durable responses in those who benefited. Importantly, treatment did not lead to increased neurologic side effects such as ICANS, easing safety concerns. While outcomes were somewhat lower than those seen with CAR-T therapy, this research suggests bispecific antibodies may be a safe option and could potentially serve as a bridge to CAR-T in this high-risk population.

Transcript

I am Doctor Mahmoud Gaballa, myeloma pecialist at MD Anderson Cancer Center. So my research, in this abstract, was about the use of bispecific antibodies in patients with myeloma that affects the brain. We will abbreviate that by calling it CNS myeloma, and by the brain, it's primarily the brain. But also our study included the brain, the spinal cord, and the covering around the spinal cord. So all of those represented what we call CNS myeloma.

It's a rare entity. But because we access through the consortium, which includes many academic US centers, we were able to include about 24 patients. And the systemic responses with this use was about 63%. And the CNS response was about 58%.

The duration of response, so those who responded, the duration of response, like how long it lasted, was actually unreached, which is reassuring. So once you see what is achieved response, the median duration is unreached. Median PFS was about five months, basically how long it took before the disease progresses. And so that was five months. And the median overall survival was about 12.2 months, or roughly about a year. And the manner of progression afterwards was a mixture between either CNS progression or systemic progression.

And those numbers of efficacy I just stated are a little bit worse than with the use of Car-T in CNS myeloma, which argues that perhaps trying to combine both modalities, trying to use perhaps bispecific antibodies as a bridge to Car-T, maybe that's one thing to be considered.

The other thing that we looked at is safety. One particular thing is ICANS because one particular concern is if you have a CNS myeloma that you would be concerned maybe there'll be excess ICANS. But we did not find that. We did not find any excess ICANS. The ICANS rates were about the usual of what you would expect with these products, which is encouraging.

So it basically tells physicians that you can use bispecific antibodies in patients with CNS myeloma without the fear of excessive side effects.

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