Toxicity Profile of Chimeric Antigen Receptor T-Cell and Bispecific Antibody Therapies in Multiple Myeloma: Pathogenesis, Prevention and Management
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Published:2023-07-01
Issue:7
Volume:30
Page:6330-6352
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ISSN:1718-7729
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Container-title:Current Oncology
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language:en
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Short-container-title:Current Oncology
Author:
Markouli Mariam1ORCID, Ullah Fauzia2ORCID, Unlu Serhan2ORCID, Omar Najiullah2, Lopetegui-Lia Nerea3ORCID, Duco Marissa4, Anwer Faiz3, Raza Shahzad3ORCID, Dima Danai23ORCID
Affiliation:
1. Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA 2. Department of Translational Hematology and Oncology Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA 3. Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, OH 44195, USA 4. Department of Pharmacy, Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, OH 44195, USA
Abstract
Multiple myeloma is the second-most common hematologic malignancy in adults worldwide. Despite ongoing advancement in therapeutic modalities, it remains an incurable disease with a 5-year survival rate of approximately 50%. The recent development and introduction of anti-BCMA immunotherapies into clinical practice, including chimeric antigen receptor T-cell (CAR-T) therapies and bispecific antibodies, has radically shifted the treatment paradigm. However, despite the promising potential of these therapies for broader application, frequent and significant adverse effects have been reported, both in short- and in long-term settings, requiring increasing awareness and vigilance in the treating team, close monitoring, and prompt interventions with a multidisciplinary approach. In this review, we will discuss the toxicities associated with CAR-T cell and bispecific antibody therapies, focusing on results from major clinical studies and real-world observations. In addition, we will emphasize on effective strategies for prevention, monitoring and management, and provide expert recommendations.
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