Issues

Among the recent FDA-approved anticancer therapies, nearly one third are for blood cancer indications (Sengupta et al., p. 423), a testament to remarkable advances in clinical research on hematologic malignancies. Among the new therapies, bispecific antibodies are making a dramatic entrance, with three new FDA approvals for myeloma and another three for lymphoma. Usmani et al (p. 433) focuses on the current clinical evidence that led to the approvals for myeloma. The clinical potential of bispecifics targeting antibody-making B cells could be even greater with new approaches to increase their safety. Lancman et al. (pp. 440) report that while hypogammooglobulinemia is universal among responders to anti-BCMA bispecifics, the risk of infection is ten-fold lower when patients receive immunoglobulin replacement (IVIg) prophylaxis. As summarized by Stadtmauer and Garfall (p. 427), these findings lend real-world support for IVIg use as an effective strategy for mitigating infection risks while posing new questions of optimal dosage and duration of bispecific therapies as they become an integral part of long-term strategies in myeloma care.