Overview of the toxicities associated with bispecific agents in multiple myeloma

Monique Minnema, MD, PhD, University Medical Center Utrecht, Utrecht, Netherlands, presents an overview of the toxicities associated with bispecific agents in patients with multiple myeloma (MM). Cytokine release syndrome (CRS) can be managed with IL-6 blockade, such as tocilizumab. Other T-cell-directed toxicities include injection site rejection and tumor flares. Additionally, neurotoxicities such as immune effector cell-associated neurotoxicity syndrome (ICANS) are reported in up to 10% of patients and need to be immediately treated with steroids such as dexamethasone. Infections are also common side effects, particularly with BCMA-targeting bispecifics, and can be managed with vaccinations and IgG administrations. Talquetamab has skin, tongue, nails, and salivary glands side effects, due to it being GPRC5D-directed, which are often hard to manage. This interview took place during the 2024 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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