From Tertiary Centers to Community Settings: Effective Implementation of Bispecific Antibody Therapies in Multiple Myeloma Care

Panelists discuss how bispecific T-cell–engaging therapies targeting BCMA, GPRC5D, and FcRH5 have emerged as novel immunotherapeutic approaches showing meaningful clinical activity for patients with heavily pretreated relapsed/refractory multiple

Panelists discuss how advances in bispecific antibodies and CAR T-cell therapies are transforming treatment approaches for relapsed/refractory multiple myeloma, while presenting complex operational challenges that require innovative institutional strategies.

Panelists discuss how specific recommended dosing schedules exist for step-up medication administration, and protocols should incorporate flexibility for individualized dose adjustments based on patient response, tolerability, and clinical factors while maintaining systematic documentation of any deviations from standard escalation timelines.

Panelists discuss how when selecting between weekly and biweekly dosing schedules for talquetamab and teclistamab in multiple myeloma treatment, health care institutions must carefully weigh factors like patient convenience, monitoring requirements, resource utilization, and total cost of care alongside clinical outcomes to determine optimal treatment pathways for both patient and health system benefits.

Panelists discuss how infrastructure including specialized staff training, updated protocols, enhanced monitoring systems, and comprehensive educational resources for health care providers is essential for institutions to successfully implement and optimize bispecific antibody therapies while ensuring patient safety and treatment efficacy.

Panelists discuss how bispecific antibody therapies in relapsed/refractory multiple myeloma commonly present with cytokine release syndrome (CRS), immune effector cell–associated neurotoxicity syndrome (ICANS), and increased infection risks, while talquetamab specifically exhibits distinctive adverse events including nail changes, skin reactions, and oral toxicities.

Panelists discuss understanding institutional protocols for managing cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS) prophylaxis in bispecific antibody therapy, along with criteria for safely selecting patients for outpatient step-up dosing.

Panelists discuss how clinical management of CAR T-cell therapy–associated toxicities focuses primarily on early recognition and prompt intervention with tocilizumab and/or corticosteroids for cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS), following established grading systems and treatment algorithms.

Panelists discuss insights on infection prevention protocols and electronic health record (EHR)–based toxicity management strategies for patients receiving bispecific antibody therapies in relapsed/refractory multiple myeloma (RRMM).

Panelists discuss the guidance on managing REMS program compliance for bispecific therapies and strategies for educating non-oncology health care providers about cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS) toxicities.