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IMS 2026 | Emerging strategies toward a functional cure in multiple myeloma
Rahul Banerjee, MD, FACP, Fred Hutchinson Cancer Center, Seattle, WA, discusses which emerging strategies may have the greatest potential to achieve a functional cure in multiple myeloma. He highlights the growing evidence for bispecific antibodies, including their potential for earlier use, treatment de-escalation and time-limited therapy, as well as their accessibility compared with CAR-T therapy. This interview took place at the 23rd International Myeloma Society (IMS) Annual Meeting in Glasgow, UK.
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Transcript
Here at the IMS meeting in Glasgow, I’ll actually be debating one of my very good friends, Dr Gurbakhash Kaur from Mount Sinai. She and I are normally friends, tomorrow we are enemies, trying to answer that question. Which modality, will it be CAR-T or bispecifics, will do a better job of functionally curing more patients? Note that I’m saying functionally cure, being on treatment will kind of count in that regard...
Here at the IMS meeting in Glasgow, I’ll actually be debating one of my very good friends, Dr Gurbakhash Kaur from Mount Sinai. She and I are normally friends, tomorrow we are enemies, trying to answer that question. Which modality, will it be CAR-T or bispecifics, will do a better job of functionally curing more patients? Note that I’m saying functionally cure, being on treatment will kind of count in that regard. I’m taking the side of bispecifics. I actually do agree with that. I use both CAR-T and bispecific antibodies liberally. The part of the U.S. where I practice, in the Pacific Northwest, I see patients from Idaho, Montana, Alaska, Oregon, and Hawaii. Idaho and Montana, outside of Boise, have no access to CAR-T. The entire state of Montana, which is bigger than my state, if I had to drive from one side to another, it would take eight hours, probably more. There is no CAR-T therapy there. There are bispecific antibodies there. So I think if you’re talking about what can actually move the needle for most patients, I think it will be bispecifics. I gave a talk earlier this year in Istanbul, Turkey, and honestly, some of the doctors there have done bispecific antibodies more than I’ve done bispecific antibodies because that’s all they have. And if you only have bispecific antibodies because CAR-T therapy is not practical, you go with what you have. And I think with the data we see now for early use of bispecific antibodies, early de-escalation of antibodies, and for BCMA bispecifics using IVIG from the beginning, primary IVIG prophylaxis to prevent infections, you are functionally curing many of those patients. I’ll even toss the ante even higher. If you are able to use time-limited bispecific antibodies, let’s say two years of treatment and stop, we don’t yet know if that’s curing our patients. For the patients where I’ve done that one way or the other, or the patient has asked to stop, you know, knock on wood, none of them have relapsed yet. And so I have accidentally cured many patients with bispecific antibodies so far, hopefully many more to come. So I think bispecific antibodies are uniquely positioned not just to functionally cure patients, but to cure patients, cure patients around the world.
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