Can bispecific antibodies be used to treat newly diagnosed patients?

As of July 2024, the approved bispecific antibodies are used to treat multiple myeloma that has come back or stopped responding to other treatments (relapse and/or refractory disease). However, researchers are exploring if these powerful drugs can be used earlier in myeloma treatment, such as when a person is newly diagnosed.

While bispecific antibodies represent a major improvement compared to other options for patients with myeloma that has progressed through other treatments, it is currently unknown whether they offer any benefit over standard treatments in patients with newly diagnosed myeloma.

Clinical trials studying bispecifics in newly diagnosed myeloma are actively ongoing and will help determine whether bispecifics provide any advantages (listed below) compared to the current treatments we use today.

Why could earlier treatment be beneficial?

   Stopping cancer in its tracks: Treating myeloma sooner could potentially prevent it from spreading, becoming more aggressive, or irreversibly affecting other parts of the body.

  Longer remissions: Early treatment might lead to longer periods of time without the disease returning.

  Improved overall survival: By treating the myeloma early, patients may live longer.

While the idea of using bispecific antibodies earlier in treatment is exciting, there are challenges. These therapies can cause side effects, and finding the right dose, sequencing, and timing is crucial. Additionally, their high cost is a concern.

However, ongoing research is focused on overcoming these challenges. Scientists are testing different combinations of bispecific antibodies with other treatments to improve their effectiveness and reduce side effects. Some clinical trials with bispecific antibodies currently recruiting patients newly diagnosed with multiple myeloma are (July 2024): 

• NCT05828511: The aim of this clinical trial is to study if linvoseltamab has a role in the treatment of newly diagnosed multiple myeloma.
• NCT05317416: The purpose of this study is to evaluate whether elranatamab alone can provide clinical benefit compared to lenalidomide (control) in participants with newly diagnosed multiple myeloma after undergoing an autologous stem cell transplant.