Therapies targeting B-cell maturation antigen (BCMA) now account for approximately 10% of immuno-oncology drugs in Phase I-III development globally. With just two marketed agents available targeting BCMA, and impressive clinical data emerging from pipeline agents, the market for BCMA-targeting therapies is set to become increasingly competitive in the near future, says GlobalData a leading data and analytics company.

Jessica McCormack, PhD, Oncology and Hematology Analyst at GlobalData, comments: “The investigation of BCMA-targeting therapies is a very active area of development right now, particularly in the field of cell therapy. There are currently 54 cell therapies in clinical development globally. One of these, Johnson & Johnson’s ciltacabtagebel autoleucel, is expected to be approved in the US and EU soon, with applications currently being considered by both the FDA and European Medicines Agency.”

Although cell therapies have demonstrated extremely impressive results, they are not without issue, with the significant production time, potential for toxic cytokine release syndrome and high costs meaning that these are not suitable for all patients. Thus, it is likely that there is space in the market for multiple new entrants that can show good efficacy while minimising some of these issues.

McCormack continues: “Early trials of several bispecific antibodies have shown response rates of over 63%. These are also available off-the-shelf, meaning these could be highly lucrative products should they gain approval. Additionally, there is some evidence that patients who fail one BCMA-targeting therapy may still gain benefit from another; Pfizer’s elranatamab trial included three responding patients who had previously been treated with a BCMA-targeting therapy.”

However, bispecifics have also struggled with complicated side-effect profiles, including cytokine release syndrome and peripheral neuropathy. Both Pfizer and Amgen paused trials this year for their respective bispecifics, elranatamab and pavurutamab, due to toxicity concerns, highlighting the difficulties companies have faced in developing these molecules.

McCormack concludes: “The potential that multiple BCMA-targeting agents could soon be available creates a welcome problem for physicians; what is the most effective sequencing of treatments? Moreover, which patients will benefit most from each type of therapy? Multiple trials are currently ongoing which will try to address these questions. While there are no clear winners yet, the increase in therapeutic options with different mechanisms of action looks set to benefit multiple myeloma patients.”