Making Outpatient Cellular Therapy Dosing the Default in Multiple Myeloma

In a conversation with CancerNetwork^® at the 23rd Annual International Myeloma Society (IMS) Meeting & Exposition, Jeffrey V. Matous, MD, discussed the feasibility of standardizing outpatient step-up dosing of agents like ramantamig (JNJ-5322) in community practices for the treatment of patients with multiple myeloma. He spoke in the context of findings he presented on the phase 1 TRIlogy-1(NCT05652335) study, which demonstrated robust efficacy and manageable safety of ramantamig among patients with relapsed/refractory multiple myeloma across all settings.¹

According to Matous, a member physician at the Colorado Blood Cancer Institute at Presbyterian St. Luke’s Medical Center, part of the Sarah Cannon Blood Cancer Network, and a clinical professor of Medicine at the University of Colorado Health Sciences Center, outpatient dosing with agents like ramantamig must become “the default” due to patients wanting to avoid staying in a hospital. However, certain populations, such as those with rapidly progressive disease or frailty, may require “more caution” and use of inpatient dosing.

Transcript:

CancerNetwork: What would need to happen for outpatient step-up dosing like this to become the default rather than the exception at community sites?

Matous: I think outpatient dosing needs to be the default because patients don’t want to be in the hospital, they don’t want to have severe CRS [cytokine release syndrome], and the ticket for that is CRS mitigation with tocilizumab [Actemra]. There are studies looking at, for example, dexamethasone prophylaxis for CRS mitigation that might end up being just as effective with T cell redirection. But that’s the big thing. Now, having said that, if I’m a community doctor, there might be a certain patient where I’m thinking, “I’d like to do outpatient, but maybe this patient should be treated inpatient.” Now, who would that patient be? Maybe it’s a patient who has very rapidly progressive disease or might be [frailer], for example. Maybe that’s the patient where you exhibit more caution. But I think, for the most part, virtually everybody can be treated. I would recommend that you not treat people on a Friday as an outpatient unless you’re set up to deal with the potential for CRS on a weekend. Just be smart about when you treat patients, so you hopefully don’t have to get bothered or have the patients be bothered over the weekend.

Reference

Matous JV, Varga C, Krishnan AY, et al. Updated safety and efficacy of ramantamig (JNJ-5322) at the recommended phase 2 dose demonstrating feasibility of outpatient dosing in relapsed/refractory multiple myeloma. Presented at: 23rd International Myeloma Society Annual Meeting; September 23-26, 2026; Glasgow, Scotland. Abstract OA-70.