Adverse Effect Management for Bispecific Antibodies in Multiple Myeloma

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ONCOLOGY® CompanionONCOLOGY® Companion, Volume 37, Supplement 8
Volume 37
Issue 8
Pages: 14

Saad. Z. Usmani, MD, leads a panel of experts in discussing toxicities associated with treatment for multiple myeloma.

During a recent CancerNetwork® Training Academy program, experts in multiple myeloma discussed adverse effect (AE) management in patients being treated with bispecific antibodies.

Meet the panel of experts.

Meet the panel of experts.

Common AEs

  • B-cell maturation antigen treatments can cause severe gastrointestinal (GI) AEs such as nausea, vomiting, dysgeusia, and anorexia.
    • Dysgeusia is more commonly associated with chemotherapy treatment vs a bispecific antibody.
  • Treatments targeting GPRC5D may cause skin and nail changes, which may lead to neuropathy and further affect patients who have preexisting low-grade neuropathy.
  • Cytomegalovirus and other gut infections may be common but are typically seen in patients who have had multiple lines of therapy and transplants.
    • An endoscopy should be performed to take a biopsy and stain for the virus in the GI tract.
  • Treatment with a FcRH5 bispecific antibody may induce neuropathy, specifically if patients are more predisposed by having received other agents in the past.
  • When an anti-CD38 antibody is incorporated into treatment, hypogammaglobulinemia may be observed, and intravenous immunoglobulin should be given prophylactically to mitigate the AE.

Key Takeaways

  • Patients should weigh themselves regularly and monitor their appetite to determine whether AEs are affecting their quality of life.
  • Clinicians should consider spacing out dosing to alleviate neurocognitive-sensitive neuropathy.
  • Longitudinal follow-up is needed to see how AEs are fully affecting a patient over time.
  • A multidisciplinary approach is suggested when neuropathies are being experienced to help improve the patient’s quality of life.
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