Opinion|Videos|December 16, 2024
Preventing CRS and ICANS Across Sites of Care
Key Takeaways
- Weekly dosing may provide consistent therapeutic levels, while biweekly dosing reduces hospital visits, affecting patient convenience and healthcare resource allocation.
- Formulary decisions should evaluate efficacy, safety profiles, cost-effectiveness, and integration potential into existing treatment regimens.
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.
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Episodes in this series
Video content above is prompted by the following
- What supportive care measures are utilized prophylactically at your institution for patients receiving bispecific antibodies to prevent CRS and ICANS?
- What criteria would be important to consider when determining patient eligibility for outpatient administration of step-up dosing for bispecific antibodies, considering the higher risk of toxicities during this phase?
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Related to this article
September’s hematology coverage examined a new definition of myeloma cure, patient preferences for treatment delivery, and emerging strategies for deepening responses.
A detailed LINKER-MM1 analysis found that cytokine release syndrome (CRS) with linvoseltamab occurred early, was predominantly low grade, and became less frequent with successive step-up and full doses.
An MRD-guided strategy incorporating teclistamab-daratumumab intensification produced deep responses in newly diagnosed high-risk multiple myeloma, although infections affected more than three-fourths of treated patients.
Phase 2 MILESTONE results suggest that postinduction minimal residual disease (MRD) negativity can identify a small subset of transplant-eligible patients with newly diagnosed multiple myeloma who may defer autologous stem cell transplantation.
A phase 3 trial shows etentamig boosts response and delays progression in triple-class exposed RRMM.
Fixed-duration KRd slowed progression in high-risk smoldering myeloma, but high rates of severe toxicity temper enthusiasm.
IRAKLIA data show that isatuximab OBI boosts comfort and satisfaction vs IV in multiple myeloma, enabling fast at-home dosing with strong completion rates.
Gut microbiome disruption from antianaerobic antibiotics weakens CAR T-cell therapy, raising relapse and CRS/ICANS risk; stewardship and microbiome repair may improve cancer outcomes.
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