Discovering the Greatest Setting for Bispecific T-Cell Engagers in A number of Myeloma

Shebli Atrash, MD, mentioned issues for optimizing T-cell engager efficacy in an interview with CancerCommunity® following his presentation on T-cell engagers in a number of myeloma that he gave on the 2025 Immune Cell Effector Therapy (ICE-T) Conference.

Atrash, medical oncologist at Levine Cancer Institute and scientific affiliate professor of Medicine at Wake Forest University, expressed that T-cell engager effectiveness is variable based mostly on the setting by which it used. To illustrate this, he defined that utilizing the T-cell engager talquetamab-tgvs (Talvey) previous to CAR T remedy might assist with lowering the incidence of cytokine launch syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).

On the opposite hand, he said that utilizing bispecifics for sufferers with quickly progressing illness and excessive illness burden might not exhibit the identical efficacy or scientific profit for sufferers, underscoring a necessity to contemplate how and when they’re used, in addition to who will most profit from their use.

In conclusion, Atrash expressed a necessity within the subject to determine why roughly 30% of sufferers don’t reply to therapy with bispecific T-cell engagers, suggesting that it could must do with the host immune system, health, and most cancers cell soluble BCMA ranges.

Transcript:

Using these bispecific [T-cell] engagers in the best setting is vital. For instance, using talquetamab, a GPRC5D bispecific antibody, as a pre-CAR T drug to regulate myeloma previous to administering CAR T has helped us with lowering CRS and ICANS. [Additionally, regarding] my expertise with teclistamab, if it’s utilized in sufferers who’re quickly progressing with massive illness burden, then it won’t present as a lot efficacy because it does for different sufferers. I really feel the long run instructions shall be relating to how one can use it, when to make use of it, [and] which inhabitants is fitter for these remedies.

Also, we’ve observed that while you begin the therapy within the first month or 2, you get a drop of about 30% within the survival curves, indicating that these sufferers didn’t reply to therapy. Predicting who [make up that] 30% is vital, and this has to do with the host immune system, health, in addition to the most cancers cell soluble BCMA ranges. Those are the vital takeaways.

Reference

Atrash S. Emerging T-cell engagers & novel immunotargets in a number of myeloma. Presented on the 2025 National Immune Cell Effector Therapy (ICE-T) Conference; July 26, 2025; Orlando, FL.