In an interview with Pharmacy Times, Paula Rodríguez-Otero, MD, PhD, discusses less frequent linvoseltamab dosing, CRS monitoring, and how community practices could prepare for its potential use in high-risk smoldering multiple myeloma.
In an interview with Pharmacy Times, Paula Rodríguez-Otero, MD, PhD, a hematologist at the University of Navarra Clinic in Pamplona, Spain, discusses linvoseltamab dosing and safety monitoring in high-risk smoldering multiple myeloma. She also considers how community practices could prepare if ongoing research establishes a role for the therapy in this population.
Rodríguez-Otero explains the rationale for more intensive dosing early in treatment, when disease burden is higher, followed by progressively longer intervals between administrations. She describes this approach as consistent with broader bispecific antibody practice and notes that less frequent dosing can help reduce severe infection rates.
The discussion distinguishes initial step-up dosing from subsequent reductions in treatment frequency. According to Rodríguez-Otero, cytokine release syndrome (CRS) in the study occurred predominantly during the step-up phase, particularly after the first step-up dose. She reports that CRS affected approximately 45% of patients, with all events classified as grade 1 and few patients requiring tocilizumab. No immune effector cell–associated neurotoxicity syndrome was reported.
Although these findings suggest manageable acute toxicity, Rodríguez-Otero does not characterize CRS management as effortless. She explains that the overall approach resembles management of linvoseltamab in relapsed or refractory multiple myeloma, where clinicians already have experience recognizing and treating these events.
Looking ahead, Rodríguez-Otero anticipates substantial overlap between existing linvoseltamab workflows and those needed for potential treatment of high-risk smoldering disease. She expects follow-up and prophylactic measures to remain broadly similar, allowing practices to draw on their familiarity with the drug.
For pharmacy teams, the interview highlights the distinction between early CRS surveillance and ongoing infection prevention as dosing becomes less frequent. Existing bispecific therapy experience could support future implementation, but any expansion into smoldering myeloma will depend on confirmatory evidence. The interview frames community readiness as preparation for a potential indication rather than an established change in routine care.
