Management of Toxicities Associated with BCMA, GPRC5D, and FcRH5-Targeting Bispecific Antibodies in Multiple Myeloma

Curr Hematol Malig Rep. 2024 Dec;19(6):237-245. doi: 10.1007/s11899-024-00740-z. Epub 2024 Aug 15.

Abstract

Purpose of review: The introduction of bispecific antibodies is one of the most significant recent advances in the treatment of relapsed/refractory multiple myeloma. This review will summarize the management of the toxicities associated with newly approved T cell-engaging bispecific antibodies and those which may be approved in the near future.

Recent findings: Numerous trials have shown that bispecific antibodies can be both effective and tolerable when adverse events are properly managed. Cytokine release syndrome and increased infections are observed across all bispecific antibodies. Additional adverse events are target-specific, such as the more severe hypogammaglobulinemia and infections of BCMA bispecific antibodies and the dysgeusia, nail dystrophy, and skin changes of GPRC5D bispecific antibodies. Bispecific antibodies will surely become a mainstay of multiple myeloma therapy given their efficacy and accessibility. Their unique toxicities must be carefully considered and managed to ensure they are utilized safely.

Keywords: Cevostamab; Cytokine Release Syndrome; ICANS; Talquetamab; Teclistamab.

Publication types

  • Review

MeSH terms

  • Antibodies, Bispecific* / adverse effects
  • Antibodies, Bispecific* / therapeutic use
  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use
  • B-Cell Maturation Antigen* / antagonists & inhibitors
  • B-Cell Maturation Antigen* / immunology
  • Humans
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / immunology
  • Multiple Myeloma* / therapy
  • Receptors, Fc*
  • Receptors, G-Protein-Coupled* / immunology

Substances

  • Antibodies, Bispecific
  • B-Cell Maturation Antigen
  • Receptors, Fc
  • Receptors, G-Protein-Coupled
  • GPRC5D protein, human
  • FCRL5 protein, human
  • TNFRSF17 protein, human
  • Antineoplastic Agents, Immunological