Managing Safety and Infection Risk With Bispecific Antibodies in Relapsed/Refractory Multiple Myeloma

Dr. Binod Dhakal, Dr. Prerna Mewawalla, and Dr. Carol Ann Huff discuss practical strategies for managing the safety profile of BCMA-directed bispecific antibodies in relapsed/refractory multiple myeloma (RRMM).

The conversation focuses on key adverse events, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), infections, and cytopenias.

Dr. Mewawalla outlines her institution’s outpatient approach to step-up dosing, emphasizing the use of standardized workflows, caregiver support, patient education, and prophylactic interventions to reduce the incidence and severity of CRS.

Both faculty members highlight the critical importance of infection prevention, including immunoglobulin replacement, antiviral and Pneumocystis prophylaxis, and supportive care measures.

The panel also shares real-world experience demonstrating that with appropriate monitoring and multidisciplinary care pathways, bispecific antibodies can be administered safely in outpatient and community settings.

The discussion reinforces the importance of proactive toxicity management to optimize outcomes for patients with RRMM receiving BCMA-directed therapies.