Department of Medical Oncology, Dana-Farber Cancer Institute, Jerome Lipper Center for Multiple Myeloma Research, Harvard Medical School, Boston, MA, USA.
Division of Hematology, Brigham and Women's Hospital, Boston, MA, USA.
Expert Opin Drug Saf. 2023 Jul-Dec;22(11):1049-1071. doi: 10.1080/14740338.2023.2274420. Epub 2023 Nov 28.
Multiple new drugs have been approved over the past 5 years for the treatment of relapsed/refractory multiple myeloma (RRMM), and these are being increasingly widely used. Clinicians need to familiarize themselves with common toxicities associated with these drugs and with novel toxicities requiring specific management and supportive care.
We review common toxicities associated with agents approved for RRMM in the past 5 years, including the anti-CD38 monoclonal antibody isatuximab, the antibody-drug conjugate belantamab mafodotin, the bispecific antibody teclistamab, the chimeric antigen receptor (CAR) T cell products idecabtagene vicleucel and ciltacabtagene autoleucel, the selective inhibitor of nuclear export compound selinexor, and the drug-peptide conjugate melflufen, as well as toxicities associated with emerging agents for RRMM including additional bispecific antibodies, the BCL-2 inhibitor venetoclax, and the cereblon E3 ligase modulators iberdomide and mezigdomide. We searched the published literature using PubMed, plus congress abstracts, for the above list of drug names or classes and 'myeloma.'
Optimal management of toxicities associated with these recently approved and emerging therapies will be critical in maximizing clinical benefit and aiding widespread adoption in routine clinical practice. We summarize current recommendations and guidelines and provide expert insights into supportive care requirements.
过去 5 年来,已有多种新药物获批用于治疗复发/难治性多发性骨髓瘤(RRMM),且这些药物的应用日益广泛。临床医生需要熟悉这些药物常见的毒性作用,以及需要特定管理和支持性治疗的新型毒性作用。
我们回顾了过去 5 年中获批用于 RRMM 的药物相关的常见毒性作用,包括抗 CD38 单克隆抗体伊沙妥昔单抗、抗体药物偶联物贝兰他单抗mafodotin、双特异性抗体替西木单抗、嵌合抗原受体(CAR)T 细胞产品 idecabtagene vicleucel 和 cilta-cabtagene autoleucel、核输出抑制剂 selinexor、药物-肽偶联物 melphalan,以及 RRMM 新兴药物相关的毒性作用,包括其他双特异性抗体、BCL-2 抑制剂 venetoclax 以及 cereblon E3 连接酶调节剂 iberdomide 和 mezigdomide。我们使用 PubMed 搜索了已发表的文献,以及上述药物名称或类别和“骨髓瘤”的会议摘要。
最佳管理与这些最近批准和新兴疗法相关的毒性作用,对于最大限度地提高临床获益和促进其在常规临床实践中的广泛应用至关重要。我们总结了当前的推荐和指南,并提供了支持性治疗需求的专家见解。