Table 2.

Concerns, opportunities and possible future directions regarding the use of selected anti-MM mAb classes for the treatment of NTE NDMM patients.

Drug Class	Concerns in Elderly Patients	Opportunities in Elderly Patients	Possible Future Directions
Anti-CD38 mAbs	IRRs, slight increase of infection risk	Synergy with other MM backbone treatments, easy to combine	Part of standard-of-care regimens for virtually all NTE NDMM patients?
Anti-SLAMF7 mAbs	Low efficacy	Very good safety, easy to combine	Exploration of their use in new combination therapies? With other immune therapies?
Checkpoint inhibitors	immune-mediated AEs, infections	Possible synergy with IMiD-based backbones	Suboptimal as compared with available alternatives.
ADCs	Corneal events	High efficacy as single agent, feasible combination with other MM backbone treatments	Exploration of their use in combination with other backbone MM treatments?
BiAbs	CRS, neurotoxicity, infections	Very high efficacy as single agent	Consolidation therapy in fit, MRD-positive, NTE NDMM patients?

Abbreviations: NTE, transplant-ineligible; MM, multiple myeloma; NDMM, newly diagnosed MM; mAbs, monoclonal antibodies; IRRs, infusion-related reactions; AEs, adverse events; IMiDs, immunomodulatory drugs; ADCs, antibody-drug conjugates; BiAbs, bispecific antibodies; CRS, cytokine release syndrome; MRD, minimal residual disease.