Bispecific Antibodies for Multiple Myeloma in Community Oncology Are on the Rise: Ira Zackon, MD

A new retrospective observational cohort study using electronic health records from the US Oncology Network reveals a substantial increase in the adoption of bispecific antibodies among patients with relapsed/refractory multiple myeloma (MM) treated in community settings, says Ira Zackon, MD, senior medical director, Ontada.

The study was presented at the American Society of Hematology (ASH) 2025 meeting.

This transcript was lightly edited; captions were auto-generated.

Transcript

Can you provide a brief overview of the study, and what do the findings reveal about the real-world uptake of bispecific antibodies in relapsed/refractory MM since their approval?

We did a retrospective, observational cohort study using the electronic health record used across the US Oncology Network and some other practices. This is data from community-based oncology treatment of patients with multiple myeloma. We looked for patients between October 2022 and July 2025, so that's all since the first approval of bispecific antibodies, of which there are now several to treat myeloma patients. We identified 751 patients, and 405 of those received a bispecific antibody during that timeframe, and 346 at least clinically qualified, meaning they had at least 5 lines of therapy. We could have potentially used a bispecific antibody, because that's the current FDA indication. The important question we wanted to see is, well, what's happening with the adoption and use of bispecific antibodies for myeloma in the community oncology setting, specifically? What we did see, encouragingly, was there was a very steady and rapid uptake in increasing year-over-year use of the different bispecific antibodies.

For example, in 2022 only 5% of these potential patients received a bispecific; in 2023,that was already up to 39%; in 2024, it was up to 61%; and in 2025, which is only kind of halfway through the year, [based] on the data, it was already 73% of potentially eligible patients who were receiving a bispecific. Again, it's very encouraging to see that steady growth year over year in the community setting, because we know that for patients to have the full benefits, they need to have access to this therapy, and to achieve that broadly, we need to be able to deliver this in the community setting to complement that which is delivered in the academic and other hospital-based settings.

How do patient characteristics, such as age and performance status, influence the selection of bispecific antibody therapy in community oncology settings?

It's a good question. First, I would say that we saw patients in this real-world setting to be somewhat older than you would see in the clinical trials, and that's the importance of real-world research outside of the academic settings: generally, these are more reflective of the patients we see in the real world, at the community level. Within our study, in terms of how patients are selected, we did see that patients who received bispecifics tended to be younger, 72 years old on average compared to 74 years old. Whereas in clinical trials, the median age was often less than 70. We also saw that more patients who received bispecifics tended to have better performance status. Approximately 20% of our patients had an ECOG [Eastern Cooperative Oncology Group score] of 2 or greater, which means a significantly compromised day-to-day function level, whereas 30% treated without bispecifics had that. We do see this influence of still some selection of patients going on. But we should also note that receiving a bispecific in the outpatient setting also requires some logistical support to be able to do that for patients. Often they need a caregiver, kind of alongside them. They need to be able to have transportation to and from the sites of service or other social determinants that could potentially influence their ability to go on these therapies. I think we have more to learn about that aspect as well.