Adverse Effects

Biomarkers

Brain Cancer

HER2-Positive Breast Cancer

Triple-Negative Breast Cancer

Breast Cancer

Colorectal Cancer

Esophageal Cancer

Gastric Cancer

Liver Cancer

Pancreatic Cancer

Gastrointestinal Cancer

Bladder Cancer

Kidney Cancer

Prostate Cancer

Genitourinary Cancers

Cervical Cancer

Endometrial Cancer

Ovarian Cancer

Gynecologic Cancers

Head & Neck Cancer

Multiple Myeloma

Myelodysplastic Syndromes

Myeloproliferative Neoplasms

Hematologic Oncology

Hormone-related Cancers

Immunotherapy

Vaccines

Infection

Leukemia

Non-Small Cell Lung Cancer (NSCLC)

Small Cell Lung Cancer (SCLC)

Lung Cancer

Lymphoma

Melanoma

Mesothelioma

Neuroendocrine Tumors

Oncology

Pediatric Cancers

Radiation Oncology

Sarcoma

Screening

Skin Cancer & Melanoma

Surgery

Thyroid Cancer

News

Clinical Topics

Global Bulletin

All News

Approval Alert

Media

2 Minute Drill

Around the Practice

Between the Lines

Breaking Barriers

Face Off

From All Angles

Meeting of the Minds

Morning Rounds

OncView

Podcasts

Readout 360

Training Academy

Treatment Algorithms with the Oncology Brothers

Conferences

Publications

All Journals

Editorial Board

For Authors

Year in Review

Events

Frontline Forum

Satellite Sessions

CME/CE

Resources

Contemporary Concepts

Awareness Month

Interactive Tools

Nurse Practitioners/Physician's Assistants

Partners

Career Center

Subscribe

Home to the journal Oncology, Cancer Network provides research and opinion on the screening, early detection, diagnosis, treatment, and prevention of cancers.

About

Advertise

CureToday.com

OncLive.com

OncNursingNews.com

TargetedOnc.com

Editorial

Contact

Terms and Conditions

Privacy

Do Not Sell My Personal Information

Cancer Network

Facebook

LinkedIn

Spotlight

Around the Practice 

Journal

Insights from Experts at Mayo Clinic on Translating Evidence to Clinical Practice

Optimizing Outcomes in Patients with HER2+ Metastatic Breast Cancer

Clinical

Acute Myeloid Leukemia

Genitourinary Cancer

Gynecologic Cancer

Hematology

Skin Cancer

1rem

View

Real World Insights: Bispecific Antibodies in R/R MM

Video Series

Relapsed/Refractory Multiple Myeloma

Panelists discuss how patient 3 is a 61-year-old man with R-ISS stage III IgG-L double-hit myeloma/plasma cell leukemia and extramedullary plasmacytoma diagnosed in 2023 s/p radiation, now with a CNS relapse on elranatamab. 

Meet our 61-Year-Old Patient With Late-Line R/R on a BCMA-Targeting Bispecific

Videos

Douglas Sborov, MD; Mary Steinbach, NP; and Kelley Julian, PharmD, BCOP, discuss 3 complex cases of patients with myeloma with late-line, heavily pretreated disease and why they opted to treat these patients with BCMA- and GPRC5D-directed bispecifics. They also focus on expected toxicities and supportive care strategies to maximize patient tolerability of R/R MM treatment drugs and drug sequencing in patients who are difficult to treat.

Panelists discuss how patient 1 is a 76-year-old female with unknown- stage R-ISS, oligosecretory IgG-K/KLC MM currently treated with talquetamab. One year following the talquetamab initiation, she is in VGPR/MRD- (likely CR or sCR as IFE positive is LLC and she has KLC). To spare toxicity physicians have decreased her dosing to monthly, starting with cycle 14 day 1.

Meet a 76-Year-Old Patient With Late-Line R/R MM, Unsuitable For CAR T Therapy

Panelists discuss how this patient was admitted after the day 1 dose of talquetamab for observation for CRS and ICANS. Patients such as this are given a 0.01-mg/kg dose on the first day, a 0.06-mg/kg dose on day 3, and a 0.04-mg/kg dose on day 5 if there are no issues. The patient is then monitored for 48 hours and is discharged before getting the 
0.08-mg/kg dose. 


Role of Step-Up Dosing

Panelists discuss how an early adverse event for this drug class no matter what the mechanism or target is, is cytokine release syndrome (CRS), and it tends to occur on a timescale that is predictable. When treating patients in the outpatient setting, they receive dexamethasone, given at the first fever, which is the first sign of cytokine release syndrome (CRS) and helps mitigate it.

Dosing Frequency, and Adverse Event Management With Bispecific Therapy

Panelists discuss how any patient receiving a bispecific antibody should be given IVIG for their hypogammaglobulinemia and patients should be treated with this monthly for the first 6 months of treatment. 

Strategies For Management of Infections

Panelists note how they always discuss the pro and cons of each treatment with their patients and the treatment efficiency’s, highlighting the most common and dangerous adverse effects. Panelists discuss the importance of closely monitoring patients and providing ongoing supportive care. 

Optimizing Treatment Goals and Supportive Care For Relapsed/Refractory Multiple Myeloma in Older Patients

Panelists discuss how patient 2 is a 55-year-old female with R/R MM including multiple EMD progressions now s/p Abecma. The patient is now s/p radiation for cutaneous lesions and continues talquetamab. 

Meet a 55-Year-Old Who Was Refractory to or Relapsed on BCMA CAR T Therapy

Panelists discuss how recent PET is reviewed with the patient, and there is evidence of near resolution of PET avid EMD lesions, though they will continue to monitor adenopathy – most suspicious for a reactive process. For patients treated with IVIG, the goal is to maintain a biological level of IgG at 400 mg/dL.

Patient Tolerability of Talquetamab and Use of IVIG

Panelists discuss how a patient who is neutropenic is given supportive care with GCSF, as do patients who have prolonged neutropenia, then that patient will be on antibiotic and antifungal prophylaxis. 

Strategizing Talquetamab Use In Relapsed/Refractory Multiple Myeloma: Balancing Efficacy, Infection Control, and Next-Line Therapy

Panelists note that while both teclistamab and elranatamab are weekly doses, elranatamab is a flat dose, and physicians have seen quick and positive responses to elranatamab treatment and physicians have seen…treatment and have been able to pull back patients from doses earlier to prevent an increase in adverse effects from infection. 

Dosing Strategies in Different Targets Bispecifics

Meet our 61-Year-Old Patient With Late-Line R/R on a BCMA-Targeting Bispecific

EP: 1.Meet a 76-Year-Old Patient With Late-Line R/R MM, Unsuitable For CAR T Therapy

EP: 2.Role of Step-Up Dosing

EP: 3.Dosing Frequency, and Adverse Event Management With Bispecific Therapy

EP: 4.Strategies For Management of Infections

EP: 5.Optimizing Treatment Goals and Supportive Care For Relapsed/Refractory Multiple Myeloma in Older Patients

EP: 6.Meet a 55-Year-Old Who Was Refractory to or Relapsed on BCMA CAR T Therapy

EP: 7.Patient Tolerability of Talquetamab and Use of IVIG

EP: 8.Strategizing Talquetamab Use In Relapsed/Refractory Multiple Myeloma: Balancing Efficacy, Infection Control, and Next-Line Therapy

EP: 9.Meet our 61-Year-Old Patient With Late-Line R/R on a BCMA-Targeting Bispecific

EP: 10.Dosing Strategies in Different Targets Bispecifics