New immunotherapies and new challenges for the multidisciplinary management of relapsed and refractory multiple myeloma: an update on bispecific antibodies targeting BCMA/CD3

So-called innovative immunotherapies targeting mainly the BCMA antigen have rapidly become established in the relapse setting for patients with multiple myeloma (MM). Elranatamab and t & eacute;clistamab, two bispecific antibodies that bring T lymphocytes closer to the tumor cell, are currently available for early access in France as fourth-line treatments. Today, these molecules are prescribed with great efficacy as monotherapy, which has become unprecedented in myeloma, but their place in the therapeutic strategy remains to be better defined. Ongoing trials are proposing combinations between two bispecifics or with more conventional treatments for MM, as well as trials in first-line treatment, whether in induction or after intensification (during maintenance, for example). The main side effects are the risk of cytokine release syndrome (CRS) and ICANS, which are uncommon, but also an increased risk of infection, which has led to specific recommendations.