(PA-476) What Matters to Patients on Bispecific Antibodies for Relapsed/Refractory Myeloma: Priorities, Symptom Burden, and Delivery Preferences

Despite expanding therapeutic options for relapsed/refractory multiple myeloma (RRMM), limited data exist on patient experiences and quality-of-life (QoL) in those starting treated with bispecific antibodies (bsAbs). These agents offer off-the-shelf, T-cell-redirecting alternatives to CAR T-cell therapy, yet their sustained impact from the patient perspective, including treatment burden, side effect tolerability, and care preferences, remains under-characterized. Understanding these factors is critical as bsAbs move earlier in treatment algorithms and transition to community-based delivery.

Methods:

This retrospective observational study analyzed patient-reported outcomes collected through HealthTree Cure Hub platform between June 2024 and May 2025. A total of 88 RRMM patients who had received bsAbs were surveyed, with subsets (n=49) completing additional follow-up surveys ≥4 months after treatment initiation. Surveys captured treatment decision drivers, adverse events, QoL (pre/post initiation), and care delivery logistics. Paired t-tests and descriptive statistics were used to analyze changes in patient-reported outcomes. All data collection followed IRB-exempt protocols with informed consent.

Results:

Among 88 respondents, 26% ranked extended overall survival as the primary reason for selecting bsAbs, followed by delayed progression (25%) and tolerable side effects (24%). Of 77 patients who assessed clinical influence, 64% rated physician recommendation as “extremely influential.” At the time of relapse prior to bsAbs (n = 75), 43% reported severe fatigue, 27% rated their quality of life as poor or fair, and 25% reported frequent emotional distress.

Initial treatment was most often administered weekly (71% of 49), with later transitions to every-other-week (24%) or monthly dosing (31%). Among the same group, 61% preferred subcutaneous over intravenous delivery. Of 27 patients reporting adverse effects, weakened immunity (67%), cytopenias (41%), and hypogammaglobulinemia (26%) were most frequently cited.

Conclusions:

According to our study patients treated with bsAbs for RRMM often began treatment with significant fatigue, emotional strain, and limited functional well-being. Their choices were driven less by convenience or novelty and more by the belief that these therapies could extend survival and delay further progression, decisions shaped largely by input from their physicians. These patients weigh the practical and physical demands of ongoing care, with a high preference for subcutaneous delivery and less frequent dosing suggests that. As bsAbs move into broader clinical use, clinical trials that integrate efficacy with delivery adaptability and patient-defined acceptability may enhance therapy adoption in the real-world setting.