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多发性骨髓瘤中针对 BCMA、GPRC5D 和 FcRH5 的双特异性抗体相关毒性的管理。

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

机构信息

Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA.

出版信息

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


DOI:10.1007/s11899-024-00740-z
PMID:39145912
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.

摘要

目的综述: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。

最近的发现: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。

相似文献

[1]
Management of Toxicities Associated with BCMA, GPRC5D, and FcRH5-Targeting Bispecific Antibodies in Multiple Myeloma.

Curr Hematol Malig Rep. 2024-12

[2]
Bispecific antibodies targeting BCMA, GPRC5D, and FcRH5 for multiple myeloma therapy: latest updates from ASCO 2023 Annual Meeting.

J Hematol Oncol. 2023-8-3

[3]
Clinical Management of Patients With Relapsed/Refractory Multiple Myeloma Treated With Talquetamab.

Clin Lymphoma Myeloma Leuk. 2024-10

[4]
Anti-BCMA/GPRC5D bispecific CAR T cells in patients with relapsed or refractory multiple myeloma: a single-arm, single-centre, phase 1 trial.

Lancet Haematol. 2024-10

[5]
Newly approved and forthcoming T-cell-redirecting bispecific antibodies for the treatment of relapsed/refractory multiple myeloma.

J Oncol Pharm Pract. 2023-4

[6]
Talquetamab, a T-Cell-Redirecting GPRC5D Bispecific Antibody for Multiple Myeloma.

N Engl J Med. 2022-12-15

[7]
Antibody treatment in multiple myeloma.

Clin Adv Hematol Oncol. 2021-3

[8]
[Development and prospects of bispecific antibodies for multiple myeloma].

Rinsho Ketsueki. 2024

[9]
Teclistamab, a B-cell maturation antigen × CD3 bispecific antibody, in patients with relapsed or refractory multiple myeloma (MajesTEC-1): a multicentre, open-label, single-arm, phase 1 study.

Lancet. 2021-8-21

[10]
Focus on monoclonal antibodies targeting B-cell maturation antigen (BCMA) in multiple myeloma: update 2021.

Br J Haematol. 2021-5

引用本文的文献

[1]
The silent signals: emerging safety concerns in bispecific antibody therapy for multiple myeloma.

Front Med (Lausanne). 2025-8-13

[2]
A roadmap to implementing outpatient administration of bispecific antibodies in multiple myeloma.

Front Oncol. 2025-7-30

[3]
Comprehensive assessment of adverse event profiles associated with bispecific antibodies in multiple myeloma.

Blood Cancer J. 2025-8-1

[4]
Pathogenesis, Diagnosis, and Management of Cytokine Release Syndrome in Patients with Cancer: Focus on Infectious Disease Considerations.

Curr Oncol. 2025-3-28

[5]
T-Cell Engagers In Multiple Myeloma: A Clinical Review.

Blood Lymphat Cancer. 2025-3-24

本文引用的文献

[1]
Pityriasis lichenoides et varioliformis acuta in a patient treated with cevostamab.

JAAD Case Rep. 2024-3-5

[2]
Talquetamab in multiple myeloma.

Haematologica. 2024-3-1

[3]
IVIg Use Associated with Ten-Fold Reduction of Serious Infections in Multiple Myeloma Patients Treated with Anti-BCMA Bispecific Antibodies.

Blood Cancer Discov. 2023-11-1

[4]
The changing spectrum of infection with BCMA and GPRC5D targeting bispecific antibody (bsAb) therapy in patients with relapsed refractory multiple myeloma.

Haematologica. 2024-3-1

[5]
Elranatamab in relapsed or refractory multiple myeloma: phase 2 MagnetisMM-3 trial results.

Nat Med. 2023-9

[6]
Monitoring, prophylaxis, and treatment of infections in patients with MM receiving bispecific antibody therapy: consensus recommendations from an expert panel.

Blood Cancer J. 2023-8-1

[7]
Infections following bispecific antibodies in myeloma: a systematic review and meta-analysis.

Blood Adv. 2023-10-10

[8]
Prevention and management of adverse events during treatment with bispecific antibodies and CAR T cells in multiple myeloma: a consensus report of the European Myeloma Network.

Lancet Oncol. 2023-6

[9]
Talquetamab, a T-Cell-Redirecting GPRC5D Bispecific Antibody for Multiple Myeloma.

N Engl J Med. 2022-12-15

[10]
Onychomadesis and palmoplantar keratoderma associated with talquetamab therapy for relapsed and refractory multiple myeloma.

JAAD Case Rep. 2022-11-17

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