Key Clinical Summary:

• Design/Population: A retrospective real-world analysis using US Oncology Network electronic health records evaluated 751 patients with advanced multiple myeloma treated in community practices from late 2022 through July 2025, comparing those who received bispecific antibodies (n = 405) versus alternative non-bispecific therapies (n = 346) in the fifth line or later setting.
• Key Outcomes: Bispecific antibody utilization increased steadily over time, from ~5% initially to > 70% of eligible late-line patients in the most recent period, demonstrating rapid community adoption. The median age of bispecific-treated patients was 72 years, older and likely frailer than clinical trial populations. Median overall survival was ~ 22 months, comparable to outcomes reported in pivotal trials (eg, MajesTEC-1), despite real-world differences in age and comorbidity.
• Clinical Relevance: These findings suggest that bispecific antibodies can be effectively implemented in selected community oncology settings, with encouraging survival outcomes even in older, real-world patients. However, broader adoption will require significant infrastructure, multidisciplinary expertise, and hospital partnerships to manage step-up dosing and immune toxicities, underscoring the need to expand capable sites of care to improve patient access.

Ira Zackon, MD, Ontada, Albany, New York, presented real-world data from a large US community oncology network which found rapid adoption of bispecific antibodies for heavily pretreated multiple myeloma (MM) at the 2025 ASH Annual Meeting & Exposition.

The study found bispecific antibodies use increased from 5% in the first year after approval to over 70% of eligible patients most recently.  Among 751 patients treated in the fifth line or later, those receiving bispecific antibodies had a median overall survival of 22 months, comparable to pivotal clinical trial outcomes.

Dr Zackon concluced, “That's an encouraging signal that these therapies can be delivered with some equivalency, hopefully, of outcomes at the overall survival level. “

Transcript:

I'm Dr. Ira Zackon, senior medical director with Ontada, where I conduct real-world research, retrospective research. I have also been a practicing hematologist for a little over 30 years, and I'm here at ASH. It’s a pleasure to be with you.

I want to talk to you today about a study that we conducted in multiple myeloma patients. As you all know, bispecific antibodies have become an important effective therapy in patients currently delivered in late lines of therapy with the fifth or higher line of therapy. It's imperative that these therapies be delivered at the community setting. We wanted to look at that.

Our database is sourced in an electronic health record of a large network, the US oncology network in community practice. We looked for myeloma patients from the late 2022, the time of the first bispecific approval until most recently up through July of this year.

We identified patients with multiple myeloma who received a bispecific antibody or did not receive a bispecific antibody but received an alternative treatment for the fifth or greater line of therapy. They were on treatment, they're eligible potentially for bispecific, and we wanted to look at these 2 groups. What we saw was first of all, overall, we had 751 patients identified and 405 received bispecific antibodies and 346 received alternative therapies.

What we saw year-over-year importantly in terms of the utilization was a very steady year-over-year increase. If you took these 2 cohorts together eligible for treatment of those advanced lines, not surprisingly in the first year, 2020, it was only 5%, but then it went up to 39% and then it was over 60% and most recently over 70% of patients receiving a bispecific antibody proportionally in this population.

That was very encouraging to see that at the community level that these therapies can be adopted and accelerated. At the same time, I'd say this network may have more enriched in some larger practices, also resources to help stand up the delivery of bispecific antibody therapy. It's not completely generalizable to the community at large because you really do have to invest in a team, some select physicians to really become experts at delivering these therapies and cytokine release syndrome and neurotoxicity events and how to manage through that. Currently, they still require step-up dosing, as you know, which requires a hospital partner and a hospital team that you need to educate and certify. There's complexity to it and it's resource intensive. It's not for all practices yet. At the same time, in order to deliver this therapy to the broader population of myeloma patients, it's imperative that the expanded sites of service.

I will say we looked at the overall survival outcomes. Again, these are myeloma patients [who are] well-advanced. First of all, the median age in our patient population was 72 receiving bispecifics and 74 receiving non-bispecific antibody therapy and a little bit more frail patients or lower performance status in the non-bispecifics. Still even at the community level, some selection of patients perhaps. 

But when you look at that median age of 72, if we look at the median age of the clinical trial, for example, MajesTEC-1, which was the teclistamab trial that has the most mature follow-up, teclistamab was the first-in-class approved. The median age was about 64, I believe. We really are looking at a real-world population of older patients. They may tend to have more frailty, more comorbid health issues, and we might anticipate less favorable outcomes, but encouragingly, the median over survival was 22 months in our data, and that was 22 months in the MajesTEC-1 trial.

That's an encouraging signal that these therapies can be delivered with some equivalency, hopefully, of outcomes at the overall survival level. This analysis was limited to what we call structured data in the electronic health records. We cannot see the adverse effect profile, the safety issues that requires opening charts and getting into unstructured data. That would be kind of the next phase of really getting a more deeper dive on these patients, what was their depth of response, the duration of response, the adverse effect and safety profiles, but at least an encouraging reflection of adoption, most importantly, and at least equivalent overall survival outcomes, you can't compare directly, but encouraging in an older patient population.

Source:

Whitesell M, Su Z, Herms L, et al. Evolving real-world uptake and patient characteristics of bispecic antibodies in Relapsed/Refractory multiple myeloma: Insights from a US community oncology network. Dec 6-9, 2025; Orlando, FL. Abstract: 5857.

Moreau P, Garfall AL, van de Donk NWCJ, et al. Teclistamab in Relapsed or Refractory Multiple Myeloma. New England Journal of Medicine. Published online June 5, 2022. doi:10.1056/nejmoa2203478