Addressing practical challenges with bispecific antibody therapy in multiple myeloma

Area of Science:

• Oncology
• Immunotherapy

Background:

• Bispecific antibodies (bsAbs) are effective in relapsed/refractory multiple myeloma.
• Investigational studies explore bsAbs in earlier myeloma stages, including newly diagnosed patients.

Purpose of the Study:

• To address key clinical questions regarding bsAb selection and administration.
• To discuss management strategies for bsAb-related toxicities and disease relapse.

Main Methods:

• Review of current clinical practices and expert opinions on bsAb therapy.
• Discussion of emerging data on toxicity management (e.g., tocilizumab, steroids) and infection risk mitigation.
• Exploration of strategies for managing disease relapse and sequencing bsAbs with CAR T-cell therapies.

Main Results:

• Tocilizumab and steroids are being investigated for cytokine release syndrome (CRS) and neurotoxicity.
• Infection remains a risk, necessitating strategies like modified dosing or finite therapy durations.
• Optimal management of relapse and sequencing with CAR T-cell therapies require further research.

Conclusions:

• Further investigation is needed for optimal bsAb selection, dosing, and toxicity management.
• Strategies for managing infections and disease relapse post-bsAb therapy are critical.
• Sequencing of bsAbs with chimeric antigen receptor (CAR) T-cell therapies needs clarification.