Navigating Three BCMA-Targeted Modalities and Their Optimal Sequencing in Myeloma

This narrative review synthesizes efficacy, toxicity, and sequencing data across CAR-T, bispecific antibody, and antibody-drug conjugate platforms directed at B-cell maturation antigen (BCMA), giving pharmacists a framework for regimen selection in relapsed/refractory multiple myeloma.

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Background Information

BCMA-targeted therapies revolutionize multiple myeloma care, balancing efficacy with unique toxicities.

BCMA-targeted therapies have transformed multiple myeloma treatment due to their specific targeting and improved patient outcomes. Cil-cel shows promising long-term remission, while BsAb therapies offer flexible options but risk T-cell exhaustion and ADCs face ocular toxicity challenges. Understanding therapy characteristics and sequencing is crucial to optimize patient outcomes and manage unique adverse effects effectively. BCMA-targeted therapies require strategic sequencing to maximize efficacy and manage distinct side effects.

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Authors: Mihara K, Miyama T

Citation: Mihara K, Miyama T Characteristics and utilization of the three BCMA-targeted therapies in multiple myeloma. International journal of hematology. 2026;124(1):31-37. doi:10.1007/s12185-025-04128-4

Article Links: PubMed · Journal / DOI

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

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