Symposium | Future directions with novel and established BCMA-DT in the multiple myeloma treatment paradigm

On December 17, 2025, the Multiple Myeloma Hub held a virtual symposium, titled Integrating novel B-cell maturation antigen (BCMA)-directed therapies into clinical practice: Insights from real-world experience. During the symposium, Maria Victoria Mateos, University of Salamanca, Salamanca, ES, delivered a presentation covering future directions with novel and established BCMA-directed therapies in the multiple myeloma (MM) treatment paradigm.

In this presentation, Mateos discussed the impact of recent BCMA-directed therapy approvals and indication changes on the treatment paradigm for relapsed/refractory MM (RRMM) (Figure 1), as well as the earlier incorporation of BCMA-directed therapies in MM treatment and their potential for use in newly diagnosed MM (NDMM) (Figure 1). Optimization of dosing schedules, treatment delivery, and community integration of BCMA-directed therapies were highlighted. The importance of multidisciplinary toxicity management, as well as shared decision-making to align treatment plans with patient goals, was also reviewed. Finally, future perspectives with BCMA-directed therapies, including novel treatment strategies, were shared (Figure 2). 

Key points

• Recent approvals of BCMA-targeted treatments (chimeric antigen receptor [CAR] T-cell therapy, bispecific antibodies [BsAbs], and an antibody–drug conjugate [ADC]) have resulted in their rapid integration into clinical practice, increasing therapeutic options for RRMM while making sequencing decisions more complex.¹

• Real‑world and clinical data from the phase III DREAMM-7 and -8 studies support flexible dosing intervals for belantamab mafodotin-containing regimens (e.g. from every 3–4 weeks to 8–12 weeks) to reduce ocular toxicity; drug-specific dose optimization should be incorporated into clinical practice and trials.⁵

• Successful implementation of BCMA-directed treatment regimens requires multidisciplinary teams (hematologists, nurses, neurologists, ophthalmologists, primary care physicians, infectious disease specialists, and pharmacists), standardized pathways for monitoring adverse events, including ocular events, and long‑term safety surveillance.^6,7

• Clinicians should integrate patient‑reported outcomes, treatment burden, logistics, and individual preferences into treatment selection and sequencing decisions to maximize adherence, quality of life, and real‑world benefit.^1,8

• Numerous treatment combination strategies and novel dual-antigen targeting agents are being actively investigated for the treatment of MM, with the potential to increase efficacy, reduce duration of response, and mitigate resistance mechanisms.^2–4

• Early-phase clinical trials evaluating CAR approaches that program patients’ T cells directly could eliminate leukapheresis, ex‑vivo manufacturing, and possibly lymphodepletion, offering faster, more scalable, and potentially lower‑cost CAR T-cell options.⁹

• BCMA-directed therapies continue to evolve, with ongoing research refining how they are used across different stages of MM; shared decision-making remains central to treatment planning to ensure that therapy choices reflect both clinical considerations and individual patient preferences.

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.