Opinion
Video
Key Considerations in Treatment Selection for Patients With Multiple Myeloma
Experts describe considerations for selecting appropriate patients for treatment with a bispecific antibody, including prior therapies for relapsed or refractory multiple myeloma. Strategies to quickly prepare patients for treatment with a bispecific antibody are also discussed.
This is a video synopsis/summary of a Practice Pearls involving Ryan Haumschild, PharmD, MS, MBA; Matthew Pianko, MD; and Anthony Perissinotti, PharmD, BCOP.
This video discusses considerations for selecting multiple myeloma patients for bispecific antibody treatment. Pianko explains that currently, bispecific antibodies are only available for patients who have had at least 4 prior therapy lines due to insurance coverage requirements. Main selection considerations are feasibility of managing cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome risks and ensuring sufficient resources to enable proper CRS mitigation protocols involving steroids and tocilizumab.
Pianko states step-up bispecific antibody dosing results in mostly mild CRS cases. He highlights bispecific antibodies’ more rapid, off-the-shelf initiation advantage. Regarding choosing among available bispecific antibodies, Pianko explains there are open questions about optimally sequencing the different immunotherapies in terms of distinct adverse effect profiles, potential impacts on subsequent chimeric antigen receptor (CAR) T-cell production, and lacking CAR T-cell maintenance therapy versus repeat bispecific antibody dosing potential. He states that while there are many sequencing factors to weigh, all the new options are currently viable choices, making this an exciting yet complex decision landscape needing more real-world evidence.
Video synopsis is AI-generated and reviewed by Pharmacy Times® editorial staff.
