Editor's Note: The treatment landscape for multiple myeloma continues to evolve with successive advances in immune-targeted therapies. As a novel class of immunotherapeutic agents, bispecific antibodies have helped address major treatment challenges in patients with relapsed or refractory disease and have become a key focus of research in multiple myeloma. The 2026 Cross-Strait Hematology Academic Conference was held in Zhuhai, Guangdong, on August 21–22. During the meeting, Oncology Frontier – Hematology Frontier invited Professor Wenming Chen of Beijing Chao-Yang Hospital, Capital Medical University, to discuss the evolving role of bispecific antibodies in multiple myeloma, strategies for combination and sequential treatment, and the latest evidence presented at the 2026 European Hematology Association (EHA) Congress in the context of current clinical research in China. His insights offer practical guidance for the standardized, effective, and individualized use of bispecific antibodies to maximize treatment efficacy and safety for patients.Oncology Frontier – Hematology Frontier: Data presented at EHA 2026 showed encouraging results for bispecific antibodies targeting different antigens, including BCMA and GPRC5D, as well as combination regimens incorporating bispecific antibodies with anti-CD38 monoclonal antibodies and immunomodulatory agents. How do you assess this new evidence? Could the role of bispecific antibodies move further into earlier lines of treatment, and how should their combination and sequencing with existing therapies be approached?
Professor Wenming Chen: Drug development in multiple myeloma is advancing rapidly, and how to translate these new therapies into clinical practice to maximize patient benefit remains a major concern. In the first-line setting, the standard approach continues to be a classic quadruplet regimen built around a proteasome inhibitor, an immunomodulatory drug, and an anti-CD38 monoclonal antibody. Regardless of transplant eligibility, patients who can tolerate treatment may receive this four-drug combination to maximize response rates.
At the same time, moving bispecific antibodies into first-line treatment has become a major research focus. Although currently approved bispecific antibodies are primarily used in patients with relapsed or refractory disease who have received four or more prior lines of therapy, investigations into earlier-line use are progressing rapidly. Internationally, several bispecific antibody products developed by companies such as Janssen, Pfizer, and Regeneron have entered clinical studies in the first-line setting, and relevant early-line data for a Janssen-developed agent have already received regulatory approval. In China, numerous clinical trials investigating earlier-line use of bispecific antibodies have also been initiated.
Particular interest surrounds older patients who are ineligible for transplantation. Researchers are exploring whether adding a bispecific antibody to an existing anti-CD38 monoclonal antibody-based regimen can further improve treatment efficacy. Although these combinations may deliver substantial short-term benefits, their impact on long-term survival remains to be established through extended follow-up.
Looking ahead, quadruplet regimens are likely to remain the mainstay of first-line treatment, with the aim of achieving deep responses. After relapse, combination therapies incorporating bispecific antibodies may become a new treatment trend. For older, transplant-ineligible patients, whether bispecific antibodies can replace existing quadruplet regimens and achieve deeper responses remains an open question that requires further evidence from long-term clinical trials.
Oncology Frontier – Hematology Frontier: As the use of bispecific antibodies expands, increasing attention is being paid to balancing their therapeutic benefits against immune-related adverse events, including infections and cytokine release syndrome (CRS), as well as their long-term effects on immune function. What key challenges must be addressed to optimize the clinical use of bispecific antibodies in multiple myeloma? What recommendations and expectations do you have for clinical practice in China?
Professor Wenming Chen: Bispecific antibodies have demonstrated excellent efficacy in clinical practice, but their use also presents challenges in adverse event management. Acute adverse events, including CRS, tend to occur during the initial treatment period. With accumulating clinical experience and improved management strategies, these events can now be effectively controlled and are no longer the principal safety concern.
In contrast, the risk of infection associated with prolonged treatment has become the most important safety issue. Continuous exposure to bispecific antibodies can lead to both cellular and humoral immune deficiencies, with the risk of infection increasing substantially, particularly during the first six months of treatment. In addition, treatment-associated hypogammaglobulinemia can further increase susceptibility to infection. Infection has therefore become the major adverse event limiting the long-term use of bispecific antibodies.
To address this challenge, researchers internationally are actively investigating fixed-duration treatment strategies as an alternative to conventional continuous therapy. Although continuous treatment may provide better efficacy, prolonged drug exposure inevitably increases the cumulative burden of adverse events. Over the past one to two years, interest in fixed-duration treatment has grown considerably. The main objective is to shorten patients’ exposure to these agents, thereby reducing infection risk, while determining whether treatment efficacy comparable to that of continuous therapy can be maintained. This has become a major shared priority across the field.
Although China entered the bispecific antibody field relatively later, its development has been rapid. Unlike CAR T-cell therapy, where China has established a leading position globally, bispecific antibody development is an area in which Chinese researchers and companies are making rapid progress and seeking to catch up with international leaders. Numerous domestic companies are conducting clinical studies, with development pipelines spanning multiple treatment settings, from heavily pretreated patients and second-line treatment to newly diagnosed disease. Over the next several years, as substantial amounts of domestic clinical data become available, China is poised not only to demonstrate strong clinical outcomes with bispecific antibody therapy but also to make an increasingly influential contribution to international research and clinical practice.
In my view, future research on bispecific antibodies should focus on combination strategies—specifically, how these agents can be integrated effectively with existing treatments to maximize patient benefit. As the range of available therapies continues to expand, identifying the most appropriate agents and combinations has become a shared challenge across the field. The central objective is to maximize clinical benefit while effectively reducing adverse events, easing patients’ financial burden, and meaningfully improving their quality of life.
Expert Profile
Professor Wenming Chen
Beijing Chao-Yang Hospital, Capital Medical University
Professor, Chief Physician, and Doctoral Supervisor at Beijing Chao-Yang Hospital, Capital Medical University.
- Member, International Myeloma Working Group (IMWG)
- Standing Committee Member, Asian Myeloma Network (AMN)
- Chair, Hematology Committee, China Association for Medical Education
- Vice President, Beijing Public Health Science Popularization Promotion Association
- Vice Chair, Myeloma Committee, Chinese Society of Clinical Oncology (CSCO)
- Vice Chair, Myeloma Committee, Hematology Branch, Chinese Medical Doctor Association
- Deputy Leader, China Autologous Stem Cell Transplantation Working Group
- Standing Committee Member, Hematology and Immunology Branch, Chinese Society for Immunology
- Standing Committee Member, Hematologic Oncology Committee, China Anti-Cancer Association
- Standing Committee Member, Hematology Branch, Chinese Association of Gerontology and Geriatrics
- Member, Hematopoietic Stem Cell Transplantation Group, Hematology Branch, Chinese Medical Association
- Standing Committee Member, Hematology Institutions Branch, China Hospital Association
