BCMA programs begin to find their niches

Safety will likely dictate where different anti-BCMA modalities fit in

As CAR Ts, bispecifics and ADCs targeting BCMA battle it out in multiple myeloma, the question is not which modality will win, but whether they can fill different niches in the treatment landscape.

The safety profile of each modality will most likely end up dictating when and where it is used.

Still, understanding how different anti-BCMA therapies might be combined or sequenced is going to need longer-term data from more patients.

This month, companies reported clinical data for at least eight anti-BCMA CAR T and bispecific programs -- most of which was presented at the American Society of Hematology (ASH) meeting in Orlando -- showing responses ranging from 6% to 100%. GlaxoSmithKline plc (LSE:GSK; NYSE:GSK), which is developing an antibody-drug conjugate (ADC) against BCMA, will likely be first-to-market among BCMA-targeting agents, but it has yet to disclose the detailed results from its pivotal DREAMM-2 study of belantamab mafodotin (GSK2857916); data are expected this month.

CAR Ts are likely to be reserved for patients who are younger, less frail, have less rapidly progressing disease and who receive their care at academic research centers. Bispecifics might find their place among sicker patients with more progressive disease, since early data suggest less severe cases of cytokine-release syndrome (CRS) and no neurotoxicity.

“I think that there is space for all of them

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