Dr. Sborov on Managing Bispecific Antibody–Related Adverse Effects in Multiple Myeloma

Douglas W. Sborov, MD, MS, assistant professor, Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah School of Medicine; director, Multiple Myeloma Program and Division of Hematology Biorepository; member, Huntsman Cancer Institute (HCI) Experimental Therapeutics Program; physician leader, Multiple Myeloma/Bone Marrow Transplant arm, HCI Clinical Trials Office; and member, HCI Protocol Review and Monitoring Committee, Huntsman Translational Scholar, University of Utah Health, discusses management strategies for bispecific antibody–related adverse effects in multiple myeloma.

Low-grade cytokine release syndrome (CRS) is one of the main toxicities associated with bispecific antibodies, Sborov says. Early intervention with tocilizumab (Actemra) was met with hesitation initially because it was unknown whether it would negatively affect the efficacy of bispecific antibodies. However, the field now intervenes with tocilizumab even at the onset of grade 1 CRS, which improves the tolerability of the bispecific agent and does not decrease efficacy, Sborov explains.

However, given the COVID-19 pandemic, many institutions are experiencing a shortage with tocilizumab, which is pushing the field to evaluate other CRS management strategies, such as siltuximab (Sylvant) and anakinra (Kineret), Sborov says.