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Symposium | Real-world insights and clinical experience with BCMA‑directed therapies
Featured:
Gordon CookDo you know... In real-world clinical practice, how does prior exposure to a BCMA-directed therapy generally affect outcomes with a subsequent BCMA-directed therapy?
On December 17, 2025, the Multiple Myeloma Hub held a virtual symposium, titled Integrating novel BCMA-directed therapies into clinical practice: Insights from real-world experience. During the symposium, Gordon Cook, University of Leeds, UK, delivered a presentation covering real-world insights and clinical experience with BCMA-directed therapies.
In this presentation, Cook examined how populations enrolled in pivotal trials of B-cell maturation antigen (BCMA)-directed therapies compare with patients treated in routine clinical practice. Key differences were highlighted, including age, performance status, comorbidities, and prior treatment exposure. Cook presented data for bispecific antibodies and CAR T-cell therapies, focusing on efficacy and safety outcomes in real-world populations, as well as the impact of prior BCMA exposure on response and durability of response. Real-world experience with management of adverse events, particularly infections and ocular complications, was also discussed, as were the implications of these findings for treatment sequencing as BCMA-directed therapies move into earlier lines of therapy.
Symposium | Real-world insights and clinical experience with BCMA‑directed therapies
Symposium | Real-world insights and clinical experience with BCMA‑directed therapies
Key points
- Patients enrolled in pivotal trials of BCMA-directed therapies are typically younger, fitter, and have fewer comorbidities than those treated in routine clinical practice, which may limit the applicability of trial outcomes to real-world settings.1–8
- Real-world analyses suggest that a substantial proportion of patients treated in clinical practice would not have met eligibility criteria for pivotal trials of BCMA-directed therapies, most commonly due to older age, poorer performance status, or impaired organ function (Figure 1).1–8
Figure 1. Characteristics of real-world populations treated with BCMA-directed therapies*
- Real-world efficacy outcomes with BCMA-directed bispecific antibodies and CAR T-cell therapies appear largely comparable with those reported in clinical trials, despite treatment of broader patient populations .1–4,7,8
- Prior exposure to BCMA-directed therapies has been associated with reduced response rates and shorter progression-free survival in real-world datasets, highlighting the potential impact of prior BCMA-exposure on subsequent treatment outcomes.1,3,7
- Real-world safety data suggest that rates of cytokine release syndrome and neurotoxicity are generally similar to, or slightly lower than, those reported in clinical trials, although infections remain a clinically significant complication requiring close monitoring and supportive care.1–4,7,8
- Experience from real-world use of belantamab mafodotin monotherapy indicates that flexible, patient-specific dosing and treatment delays may help manage ocular adverse events while maintaining efficacy (Figure 2).9–11
Figure 2. Real-world ocular monitoring and safety with belantamab mafodotin for RRMM*
- As BCMA-directed therapies move into earlier lines of treatment, real-world data will have an increasingly important role in informing treatment sequencing, strategies to mitigate adverse events, and optimization of long-term patient outcomes.7
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.
References
Tan C, Soori S, Huang CY, et al. Real-world evaluation of teclistamab for the treatment of relapsed/refractory multiple myeloma (RRMM): an International Myeloma Working Group Study. Blood Cancer J. 2025;15:53.DOI: 10.1038/s41408-025-01259-z
Moreau P, Garfall A, van de Donk N, et al. Teclistamab in relapsed or refractory multiple myeloma. N Engl J Med. 2022;387:495-505. DOI: 10.1056/NEJMoa2203478
Malard F, Bobin A, Labopin M, et al. Elranatamab monotherapy in the real-word setting in relapsed-refractory multiple myeloma: results of the French compassionate use program on behalf of the IFM. Blood Cancer J. 2024;14:219. DOI: 10.1038/s41408-024-01200-w
Lesokhin AM, Tomasson M, Arnulf B, et al. Elranatamab in relapsed or refractory multiple myeloma: phase 2 MagnetisMM-3 trial results. Nat Med. 2023;29: 2259-2267. DOI: 10.1038/s41591-023-02528-9
Kamboj I, Chang D, Habib A, et al. Real-world efficacy outcomes of ciltacabtagene autoleucel in relapsed refractory multiple myeloma: A comparative study with the Cartitude-1 trial. Blood. 2024;144(1):2411.2. DOI: 10.1182/blood-2024-199187
Berdeja J, Madduri D, Usmani S, et al. Ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T-cell therapy in patients with relapsed or refractory multiple myeloma (CARTITUDE-1): A phase 1b/2 open-label study. Lancet. 2021;398: 314-324. DOI: 10.1016/S0140-6736(21)00933-8
Hansen D, Sidana S, Peres L, et al. Idecabtagene vicleucel for relapsed/refractory multiple myeloma: Real-world experience from the Myeloma CAR T Consortium. J Clin Oncol. 2023;10;41(11):2087-2097. DOI: 10.1200/JCO.22.01365
Munshi N, Anderson L, Shah N, et al. Idecabtagene vicleucel in relapsed and refractory multiple myeloma. N Engl J Med. 2021;384:705-716. DOI: 10.1056/NEJMoa2024850
Cavo M, Dimopoulos MA, Delforge M, et al. Poster #PS1741. EHA 2025 Congress; Jun 12–15, 2025; Milan, IT
Schjesvold F, et al. Real-world effectiveness and safety of belantamab mafodotin (Belamaf) monotherapy in patients (pts) with relapsed/refractory multiple myeloma (RRMM) treated in Europe. Poster #PS1771. European Hematology Association 2025 Congress; Jun 12–15, 2025; Milan, IT
Terpos E, Trudel S, Mateos MV, et al. Practical guidance on clinical management of belantamab mafodotin-associated ocular events. Am J Hematol. 2025;100(10):1839-1850. DOI: 10.1002/ajh.70015
Belantamab mafodotin. Summary of Product Characteristics (EMA). 2025. Revised Sep 2025.
Belantamab mafodotin. Prescribing Information (FDA). 2020. Revised Oct 2025.
Mateos MV, et al. Modification of belantamab mafodotin dosing to balance efficacy and tolerability in the DREAMM-7 and DREAMM-8 trials. Blood Adv. 2025;9(22):5708-5719. DOI: 10.1182/bloodadvances.2025016949
Richardson P, et al. An exploratory analysis of health-related quality of life measures with belantamab mafodotin in combination with pomalidomide and dexamethasone (BPd) in patients with relapsed or refractory multiple myeloma (RRMM) enrolled in dreamm-8. Poster #2284. 67th American Society of Hematology Annual Meeting and Exposition; Dec 6–9, 2025; Orlando, US.
Lonial S, et al. Health-related quality of life with belantamab mafodotin in patients with relapsed or refractory multiple myeloma (RRMM): An exploratory analysis of overall quality of life in dreamm-7. Poster #4029. 67th American Society of Hematology Annual Meeting and Exposition; Dec 6–9, 2025; Orlando, US.
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