Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.
Curr Hematol Malig Rep. 2024 Dec;19(6):237-245. doi: 10.1007/s11899-024-00740-z. Epub 2024 Aug 15.
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.
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.
双特异性抗体的出现是复发性/难治性多发性骨髓瘤治疗领域最近取得的重大进展之一。本综述将总结新批准的 T 细胞结合双特异性抗体以及近期可能获得批准的双特异性抗体相关毒性的处理方法。
大量试验表明，只要正确管理不良反应，双特异性抗体在疗效和耐受性方面均具有优势。所有双特异性抗体均会发生细胞因子释放综合征和感染增加。其他不良反应具有靶向特异性，如 BCMA 双特异性抗体更严重的低丙种球蛋白血症和感染，以及 GPRC5D 双特异性抗体的味觉障碍、指甲营养不良和皮肤改变。鉴于其疗效和可及性，双特异性抗体肯定将成为多发性骨髓瘤治疗的主要方法。必须仔细考虑和管理其独特的毒性，以确保安全使用。
