Step-Up Dosing Practices for 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

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

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 real-world logistic considerations around administering B-cell maturation antigen (BCMA)–targeted bispecific antibodies. Initially, step-up dosing was done in an inpatient setting, but programs are transitioning to outpatient administration. However, inpatient administration remains standard for patients with high tumor burden who are at risk of cytokine release syndrome (CRS). Outpatient administration requires significant infrastructure and resources to monitor for CRS given substantial patient and caregiver burdens. Using bispecifics earlier when disease burden is lower may enable more outpatient treatment.

All panelists have both teclistamab and elranatamab available to allow flexibility for combinations or individual patient factors. The schedules are de-escalated quickly from weekly to monthly dosing based on response and tolerability to reduce infection risk and other toxicities. However, sporadic patients seem to maintain a response despite stopping treatment early due to toxicity, supporting further study of de-escalation strategies.

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