Bridging the Gap: Community-Based Administration and Access Barriers for BCMA-Targeted Therapies in Multiple Myeloma

In this episode, 'Bridging the Gap: Community-Based Administration and Access Barriers for BCMA-Targeted Therapies in Multiple Myeloma,' the expert oncologists and oncology pharmacists explored the following questions:

What patient populations are best suited for community-based administration of B-cell maturation antigen (BCMA)-targeted therapies?

Do you see community administration of BCMA-targeted therapies increasing in the future?

Why is immediate access to BCMA-targeted therapies so essential for these patients?

Are you experiencing any pain points with any of the Food and Drug Administration (FDA)-approved therapies for relapsed/refractory multiple myeloma (RRMM)?

Zahra Mahmoudjafari noted that while patients with high disease burden, a history of severe cytokine release syndrome (CRS) or neurotoxicity, poor performance status, or limited caregiver support were historically considered less suitable for community-based administration, significant progress has been made as community centers develop strong patient selection criteria, outpatient roadmaps, and escalation strategies, often in partnership with academic centers for initial step-up dosing. She expressed strong confidence that community administration of BCMA-targeted therapies will continue to expand, emphasizing that academic centers have a responsibility to share real-world reports and protocols and to demystify manageable toxicities such as CRS and keratopathy for community colleagues. Al-Ola Abdallah underscored that immediate access to BCMA-directed therapy is critical given that real-world access limitations can dramatically reduce the proportion of patients who ultimately receive treatment, noting that having multiple therapeutic options including CAR T-Cell therapy, bispecific antibodies, and antibody-drug conjugates (ADCs) helps ensure more patients can access a BCMA-directed approach regardless of institutional infrastructure, and acknowledged that remaining pain points include infection risk, late neurological toxicities associated with CAR T-Cell therapy, and patient preference against certain modalities due to their toxicity profiles.

Throughout the conversation, the experts provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, 'REMS Programs for BCMA-Directed Therapies: Background, Best Practices, and Institutional Protocols,' panelists continue their discussion on relapsed/refractory multiple myeloma and highlight the background and purpose of Risk Evaluation and Mitigation Strategy (REMS) programs for BCMA-directed therapies, best practices for working with therapies that carry a REMS requirement, and the institutional protocols that support safe and consistent implementation.