Quality-of-life considerations with BCMA‑directed therapies for MM

On March 5, 2026, the Multiple Myeloma Hub held a virtual symposium, titled Optimizing dosing of BCMA-directed therapies for improved quality of life in multiple myeloma. During the symposium, Rakesh Popat, University College London Hospital, London, UK, delivered a presentation on quality-of-life (QoL) considerations with B-cell maturation antigen (BCMA)-directed therapies in multiple myeloma (MM).

In this presentation, Popat discusses the importance of health-related QoL as a key clinical outcome in MM, particularly in the context of increasingly effective therapies. Popat emphasizes the need to balance efficacy and safety with QoL and outlines patient-, disease-, and treatment-related factors that influence QoL (Figure 1). Practical considerations, including treatment logistics, adverse events, and patient preferences, are also discussed, alongside approaches to assessing QoL (Figure 2) and incorporating shared decision-making into clinical practice.

Key points

• QoL is an important clinical outcome in MM, particularly as treatment efficacy has improved over time and patients are living longer. 
• Treatment decisions require balancing efficacy outcomes, including response rates, depth of response, and survival, with safety, tolerability and QoL. 
• Health-related QoL is commonly assessed using patient-reported outcome measures that capture symptom burden, physical function, and ability to perform activities of daily living.³
• Maintaining QoL and achieving symptom control have been identified as key goals by both patients and healthcare professionals. 
• Overall QoL is impacted by patient-, disease-, and treatment-related factors.
  • Patient-related factors include age, frailty, comorbidities, caregiver dependence, and individual treatment preferences. 
  • Disease-related factors include symptom burden, organ dysfunction, mobility limitations, and mental health. 
  • Treatment-related factors include frequency and duration of treatment visits, adverse events, and the need for monitoring and hospitalization. 
• Logistical considerations, including travel requirements and access to specialist centers, may also impact QoL and place additional burden on patients and caregivers. 
• Some BCMA-directed therapies require administration in specialized centers, which may necessitate prolonged stays near treatment sites and time away from usual activities.¹ 
• Adverse events associated with some BCMA-directed therapies, including cytokine release syndrome, neurotoxicity, infections, and ocular toxicity, may impact QoL and require monitoring or hospitalization.¹
• Treatment schedules and monitoring requirements may affect patients’ ability to work, maintain social activities, and manage caregiver responsibilities. 
• Patient preference research indicates that overall survival is a primary treatment goal, followed by maintaining QoL and minimizing treatment burden.⁴ 
• Frequent monitoring for adverse events has been identified as the most acceptable trade-off for patients receiving effective therapy, whereas increased burden on caregivers is considered less acceptable.⁴
• Shared decision-making is key to align treatment choices with patient preferences and to individualize care. 
• Multiple tools are available to assess QoL in clinical practice, and selection of the appropriate tool should be tailored to the clinical context.²

This independent educational activity was supported by GSK. All content was developed independently by SES in collaboration with the faculty. The funder was allowed no influence on the content of this activity.