Madrid, 2 September 2024. - Multiple myeloma is a bone marrow disease that accounts for 10% of hematological malignancies1. Currently there is no cure, but there are increasingly effective treatments that attempt to address the disease from different angles. Among the new therapeutic options, we would highlight the success of bispecific antibodies against B cell maturation antigen (BCMA) in managing to prolong patients' survival and improve their quality of life.
Dr. Rebeca Iglesias, head of the Multiple Myeloma and Gamma Diseases Unit at MD Anderson Cancer Center Madrid – Hospiten, informs us that the recent approval of this type of therapy has provided a great opportunity for patients refractory to classic treatments (proteasome inhibitors, immunomodulators and anti-CD38 monoclonal antibodies), a condition known as known as triple-class refractory.
“This type of therapy, which targets the BCMA antigen of plasma cells and the CD3 antigen of T lymphocytes, facilitating the immune response, has managed to prolong progression-free survival (PFS) among our patients, as well as improving the response rate (RR) and their quality of life”, says the specialist.
Natural History of Multiple Myeloma Patient
Multiple myeloma continues to be an incurable disease, with alternating periods of remission and relapses. For this reason, explains Dr. Iglesias, the current trend is to employ continuous treatments maintained until progression, with the aim of prolonging the response and delaying relapse. “As this strategy has generated resistance to the drugs used, new drugs with different action mechanisms have been developed to treat the resistant disease,” he said.
Recent advances in research and personalized medicine are increasingly helping us to understand this disease, usually diagnosed in patients over 65, and the use of bispecific antibodies represent an innovational rescue strategy based on a new action mechanism for those patients who had received the three previous treatments.
Indications for bispecific antibodies and the future for multiple myeloma treatment
Bispecific antibodies are drugs reserved for triple refractory patients. These are administered subcutaneously as a monotherapy until disease progression. Cytokine release syndrome, neurological toxicity and infections stand out as the most typical side effects.
“They have their own toxicity profile, with predictable and manageable side effects that require close monitoring, especially during the first cycles. This requires the supervision of a multidisciplinary team, and administration should always take place in hospitals that have an intensive care unit on hand to treat possible complications”, says the doctor.
Iglesias highlights the importance of incorporating this type of therapy into the current therapeutic arsenal to prolong survival and improve the quality of life of patients with multiple myeloma. He goes on to argue that, thanks to research and innovation, previously untended medical needs are now being met. “With the recent approval of CAR-T therapy against BCMA, and the pending results of clinical trials that combine anti-BCMA bispecific antibodies with anti-CD38 monoclonal antibodies and other anti-GPRC5D bispecific antibodies, the best for myeloma patients is yet to come,” concludes the MD Anderson Madrid – Hospiten expert.
References:
1. Multiple myeloma: Epidemiology. (n.d.). Available at: https://www.contraelcancer.es/es/todo-sobre-cancer/tipos-cancer/mieloma-multiple/epidemiolog%C3%ADa. Last access: August 2024.