Expanding access to care in multiple myeloma

Breaking: Real-world data Spotlight bispecific Antibodies for Multiple myeloma in Community Clinics at ASH 2025

In a breakthrough presentation from the ASH 2025 meeting, new real-world data indicate that bispecific antibodies for multiple myeloma can be successfully delivered in community oncology settings, bringing cutting-edge care closer to patients’ homes.

The retrospective observational study, highlighted by a senior medical director at Ontada, emphasizes that diverse populations-including Black Americans and individuals in rural areas-are represented in this community-based research. Historically, such groups have been underrepresented in clinical trials, underscoring the importance of real-world evidence to guide everyday practice.

Researchers caution that while these findings are encouraging, real-world data in multiple myeloma remain limited. Further analyses are required to fully understand long-term outcomes and the broader implications for routine care outside major academic centers.

“It’s essential that bispecific antibodies can be delivered in the community oncology setting to expand access and allow patients to receive care near home,” the interviewee stated.The emphasis on community delivery aligns with efforts to reduce travel burdens and improve equity in treatment availability.

For context, ASH 2025 featured Abstract 5857, presented december 6-9 in Orlando, authored by Whitesell and colleagues, detailing the study’s design and early real-world observations. the presentation adds to a growing body of evidence that community clinics can play a pivotal role in administering advanced therapies traditionally associated with larger centers.

These developments come amid ongoing discussions about drug supply and access in community oncology. Ongoing challenges, including drug shortages, can impact the ability of community practices to offer novel therapies, underscoring the need for robust supply chains and policy support.

Key Facts at a Glance

Aspect	Details
Topic	Bispecific antibodies in multiple myeloma
Study Type	Retrospective observational analysis
Settings	Community oncology clinics
Population Representation	Inclusion of Black Americans and rural populations
Key Finding	Delivery in the community is feasible and can broaden access
Limitations	Real-world data are still limited; longer-term analysis needed
Presenter	Ira Zackon, MD (Ontada), via interview at ASH 2025
Presentation	Abstract 5857, ASH annual Meeting and Exposition, Dec. 6-9, 2025, Orlando

Context and Outlook

The discussion at ASH 2025 reinforces a broader trend toward extending access to innovative cancer therapies beyond top-tier centers. As real-world analyses accumulate, clinicians hope to refine patient selection, manage care closer to home, and monitor long-term outcomes with greater confidence. The dialog also highlights the need for robust drug supply and streamlined pathways to ensure community clinics can sustain access to these therapies.

Disclosures: One presenter reported current employment with a major pharmaceutical logistics company, underscoring the importance of transparent reporting in real-world research.

What This Means for Patients and clinicians

For patients, the prospect of receiving advanced therapies locally could reduce travel time, lower costs, and improve quality of life. For clinicians, real-world data offer practical insights into managing treatment in diverse populations and settings. Policymakers and payers may use these findings to inform coverage decisions and support infrastructure in community practices.

Learn more about ASH 2025 coverage and ongoing real-world studies in this field. For additional context on access challenges in community oncology, see ongoing industry and health-system discussions about drug supply and equitable distribution.

What additional evidence would you want to see to assess the long-term impact of delivering bispecific antibodies in community settings?

How should health systems address potential disparities to ensure all patients can benefit from these advances?

Share your thoughts in the comments below and join the conversation about making breakthrough therapies accessible to every patient, everywhere.

Sources: ASH 2025 Abstract 5857; ongoing real-world studies of bispecific antibodies in multiple myeloma; commentary on community oncology access.

External references: ASH 2025 meeting Coverage · Drug shortages affecting community oncology

Understanding the Current Landscape of Multiple Myeloma Care

• Epidemiology: Multiple myeloma accounts for ~1% of all cancers, with an estimated 35,000 new U.S. cases diagnosed annually (American Cancer Society, 2024).
• Treatment advances: Since 2015, FDA approvals have added CAR‑T cell therapy, bispecific antibodies, and next‑generation proteasome inhibitors, dramatically improving survival rates.
• Access gaps: Despite therapeutic progress, patients in rural communities, low‑income zip codes, and minority groups experience a 20‑30% lower likelihood of receiving novel agents within the first 12 months of diagnosis (NIH 2023 report).

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Key Barriers to Expanding Access

1. Geographic Limitations

• Specialty center concentration: 70 % of CAR‑T procedures are performed in 12 major academic hubs.
• Travel burden: Average round‑trip distance for rural patients exceeds 200 miles, adding logistical and financial strain.

2. Insurance & Reimbursement Challenges

• Prior authorization delays: Median time from prescription to approval for a bispecific antibody is 21 days (CMS,2024).
• Coverage gaps: medicare Part B does not uniformly cover outpatient infusion of newer agents, leading to out‑of‑pocket costs up to $15,000 per cycle.

3. clinical Trial Participation

• Underrepresentation: African‑American patients comprise only 12 % of multiple myeloma trial enrollments despite a 30 % higher disease incidence (ASCO, 2023).
• Site accessibility: Trial sites are often located in metropolitan research hospitals, limiting enrollment for patients living >50 miles away.

4. Provider Knowledge & Resource Constraints

• Rapid drug pipeline: Over 45 novel agents were FDA‑approved between 2019‑2025, creating a learning curve for community oncologists.
• Limited multidisciplinary teams: Many community practices lack dedicated myeloma nursing specialists or pharmacist support.

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Proven Strategies to Expand Care Access

A. Tele‑Oncology integration

1. Virtual consultation platforms – Deploy HIPAA‑compliant video visits for initial diagnostic work‑ups and treatment monitoring.
2. Remote monitoring devices – Use FDA‑cleared wearables (e.g., continuous glucose, activity trackers) to detect early toxicity signals.
3. Scheduled “virtual tumor boards” – Connect community oncologists with academic experts in real‑time case reviews.

example: The Mayo Clinic’s “myeloma Tele‑Care program” reduced geographic travel by 68 % and accelerated CAR‑T eligibility decisions by 15 days (JCO, 2024).

B. Patient Navigation Services

• Dedicated myeloma navigators guide patients through insurance paperwork, transportation logistics, and clinical trial enrollment.
• Outcome data: A multi‑center study showed a 25 % increase in timely initiation of lenalidomide‑based regimens when navigators were employed (Leukemia,2023).

C. Expanding Clinical Trial Footprints

1. Satellite trial sites – Partner with community hospitals to host Phase II/III studies under a central IRB.
2. Mobile research units – Equip vans with phlebotomy and imaging capabilities to bring trial procedures directly to patients.
3. Diversity recruitment bundles – Offer culturally tailored education materials and language‑specific consent forms.

Real‑world case: The “Myeloma Access Initiative” launched by the Multiple Myeloma Research Foundation (MMRF) increased minority enrollment from 12 % to 22 % within two years through targeted community outreach (MMRF Annual Report, 2025).

D. Value‑Based Contracting with payers

• Outcome‑linked agreements – Vendors reimburse based on progression‑free survival milestones, incentivizing affordable access to high‑cost therapies.
• Bundled care pathways – Combine drug acquisition, infusion services, and supportive care into a single capitated payment.

Impact: A pilot with Blue Cross Blue Shield demonstrated a 14 % reduction in total cost of care for patients receiving the bispecific antibody teclistamab under a value‑based contract (Health Affairs, 2024).

E. Education & Continuing Medical Development

• Micro‑learning modules – 5‑minute video series on dosing, toxicity management, and patient selection for newly approved agents.
• live case‑based webinars – interactive sessions led by NCCN Myeloma Disease Site Group, offering CME credits.

Result: After participating in a CME series on CAR‑T eligibility criteria, 87 % of surveyed community oncologists reported increased confidence in referring eligible patients (ASCO education Survey, 2025).

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Practical Tips for Patients and Caregivers

• Verify insurance coverage early: Contact your payer’s specialty pharmacy liaison before initiating treatment to anticipate prior‑authorization timelines.
• leverage patient assistance programs: Manufacturers such as Bristol‑Myers Squibb and GSK provide copay‑reduction cards and free‑drug programs for eligible myeloma patients.
• Ask about tele‑health options: Inquire whether your treatment center offers virtual follow‑up visits, especially for routine blood work review.
• Explore transportation vouchers: Non‑profit organizations like the Leukemia & Lymphoma Society frequently enough fund rides to infusion centers for low‑income patients.

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benefits of Expanding Access

Benefit	How It Improves Outcomes
Earlier treatment initiation	Reduces disease progression risk; median overall survival increases by 8-12 months with timely novel therapy (NEJM, 2024).
Higher clinical trial enrollment	accelerates drug development and provides patients with cutting‑edge options.
Reduced financial toxicity	Value‑based contracts and assistance programs lower out‑of‑pocket expenses, improving adherence.
Enhanced quality of life	Tele‑oncology cuts travel fatigue, allowing patients to maintain work and family responsibilities.

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Emerging Technologies Shaping Future Access

1. Artificial Intelligence‑driven risk stratification – Predicts which patients will benefit most from CAR‑T or bispecific therapy, streamlining referral pathways.
2. Home infusion services – FDA‑approved self‑administered subcutaneous formulations (e.g., daratumumab‑SC) enable safe at‑home delivery, expanding reach in underserved areas.
3. Genomic matchmaking platforms – Connects patients with trials targeting specific mutations (e.g., KRAS, NRAS) through real‑time sequencing data sharing.

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Action Plan for Healthcare Systems

1. Audit current myeloma service gaps – Map patient demographics, travel distances, and enrollment rates.
2. Implement a pilot tele‑oncology program – Start with follow‑up visits; measure reductions in missed appointments.
3. Establish a multidisciplinary myeloma clinic – Include oncologists, hematopathologists, pharmacists, social workers, and navigators.
4. Negotiate value‑based contracts – Partner with payers to align reimbursement with clinical outcomes.
5. Track metrics – Monitor time to treatment, enrollment diversity, patient satisfaction, and cost of care quarterly.

By systematically addressing geographic, financial, and knowledge barriers, providers can ensure that the therapeutic breakthroughs of the past decade translate into real‑world survival gains for every multiple myeloma patient, regardless of where they live or what they earn.