COMy 2026 | Bispecific antibodies in myeloma: community care considerations & unmet needs

Bispecific antibodies are one of the best treatments that we can introduce in a patient with multiple myeloma. Currently, in my country, elranatamab and teclistamab and are approved, but linvoseltamab is going to arrive, and we have also seen in clinical trials how much this can change the current panorama of multiple myeloma. We know that sometimes it’s not simple to start with bispecific antibody, but I think that if we understand how to manage, we can also perform them in outpatient setting. And I think that the question is about a correct prophylaxis in terms of anti-infection drugs. We have to give to the patient antibiotics, antivirals, but particularly we have to protect them from hypogammaglobulinemia that is something that they counteract after some injection, after some administration. And I think that the replacement of immunoglobulin is something that is so important as the treatment. Also, in terms of prophylaxis, we have to care about how the patient has done also with recurrent infection in previous lines of treatment, and we have to understand how to manage with immunoglobulin. Also, the subcutaneous ones are really important because they are manageable. They avoid to the patient too many access to the hospital and I think that also in these terms the prophylaxis can be improved also impacting in a positive way on compliance and tolerability. In terms of hospitals, I think that there is no preclusion in this moment for community centers to perform with specific antibodies based treatments. I think that if the patient is going to have a CRS or eye cancer, they are really rare, particularly if the patient has not a big burden of disease, we know very well how to manage fever, how to use when indicated tocilizumab. And I think that is also important the networking with smaller institutions in order to make them understand how to manage this problem in a practical way. However, I think that also patients, also institutions that don’t have an inpatient department today, according to data coming also from the real world, can administer specific antibodies without any problem. And in general, we are speaking every day, also giving suggestions, referrals to these smaller institutions. So I think that now we are confident that they can go to offer the best to their patients.

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