Adverse Effects Related to Bispecifics in Multiple Myeloma

EP: 1.The Evolving Landscape of Newly Diagnosed Multiple Myeloma

EP: 2.Highlights from ASH 2023 in Transplant-Eligible NDMM

EP: 3.Advances in the Treatment of High-Risk MM

EP: 4.Role of Transplant and MRD in Newly Diagnosed MM

EP: 5.The Evolving Treatment Paradigm for Transplant Ineligible MM

EP: 6.Treatment of Multiple Myeloma at Early Relapse

EP: 7.Potential Role for CAR T-Cell Therapy in MM at Early Relapse

EP: 8.Updates on BCMA-Targeting Bispecifics in MM

EP: 9.Real-World Evidence and Selecting Optimal Bispecifics in Multiple Myeloma

EP: 10.Step-Up Dosing Practices for Bispecifics in Multiple Myeloma

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EP: 11.Adverse Effects Related to Bispecifics in Multiple Myeloma

EP: 12.GPRC5D-Targeting Bispecifics in Multiple Myeloma

EP: 13.CAR T-Cell Therapy in Multiple Myeloma: Role in the Treatment Landscape

EP: 14.Treatment Considerations and Sequencing in Multiple Myeloma

This is a video synopsis/summary of a Peer Exchange featuring Krina K. Patel, MD, MSc; Amrita Krishnan, MD; Caitlin Costello, MD; Saad Z. Usmani, MD, MBA, FACP; and Rafat Abonour, MD.

The discussion focuses on adverse effects with B-cell maturation antigen (BCMA)–targeted bispecific antibodies. Cytokine release syndrome (CRS) from immune activation is common, manifesting as flu-like fever, tachycardia, hypotension, or hypoxemia, but high-grade CRS is rare. Neurotoxicity can also occur, usually low grade manifesting as headaches or sensory changes, but more severe immune effector cell–associated neurotoxicity syndrome is possible. Careful monitoring, especially early during step-up dosing, is imperative.

A major late effect is immunosuppression and infections. Intravenous immunoglobulin replacement is routinely used given profound B-cell aplasia. Prophylactic antibiotics or antivirals can be considered, but aggressively evaluating and treating suspected infections is critical. Myeloma patients are already immunocompromised at baseline from prior therapies, so infections require prompt evaluation and treatment in this population. Establishing relationships with infectious disease specialists is advised to help comanage infections with these novel immunotherapies.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.