BsAbs and CAR T-cell therapies provide benefits such as increased progression-free survival or prolonged remission status. Given the novel mechanisms of action, unique side effect profiles of these therapeutic modalities, and potentially life-threatening toxicities, nursing, patient, and provider communication, education, and collaboration are critical to effectively coordinate, provide safe care, and ameliorate potential poor outcomes.
Significant advances in the multiple myeloma treatment landscape have occurred over the past several decades. New immunotherapies with novel mechanisms of action have been developed, such as bispecific antibodies (BsAbs), chimeric antigen receptor T-cell therapies (CAR-T), and antibody-drug conjugates, that have improved outcomes for heavily pretreated patients with RRMM. Clinicians should be aware of current treatment guidelines regarding optimal use of these immune therapies, how to choose the correct agent, and how they may be sequenced or combined with other therapies.
Here, we discuss common adverse events and management strategies for teclistamab, talquetamab, and elranatamab. Common adverse events shared by these therapies include cytokine release syndrome (CRS), immune effector cell associated neurotoxicity syndrome (ICANS), cytopenias, and infections.
This series of articles is intended to offer practical advice to advanced practitioners who may administer BsAbs or CAR-T to heavily pretreated patients with RRMM. It is hoped that they will serve to educate advanced practitioners on recent advances and best practices in the use of these novel immunotherapies for RRMM and thus improve treatment outcomes and enhance overall patient care.