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与复发或难治性多发性骨髓瘤患者接受塔卢卡单抗治疗相关不良事件的临床管理中的护理注意事项。

Nursing Considerations for the Clinical Management of Adverse Events Associated with Talquetamab in Patients with Relapsed or Refractory Multiple Myeloma.

机构信息

Mount Sinai Health System, New York, New York.

City of Hope Comprehensive Cancer Center, Duarte, California.

出版信息

Semin Oncol Nurs. 2024 Oct;40(5):151712. doi: 10.1016/j.soncn.2024.151712. Epub 2024 Aug 17.

Abstract

OBJECTIVES

Talquetamab is a newly approved bispecific antibody targeting the CD3 receptor on T cells and a receptor, G protein-coupled receptor family C group 5 member D (GPRC5D), highly expressed on multiple myeloma (MM) cells. In addition to immune therapy-related adverse events (AEs) associated with bispecific antibody therapies, talquetamab is associated with unique skin/nail and oral GPRC5D-related side effects that require additional supportive care. This review provides clinical management strategies for talquetamab based on oncology nurses' experience during the MonumenTAL-1 (NCT03399799/NCT04634552) clinical trial. The objective of this review is to raise awareness among nurses and patients to better understand and manage the side effects associated with talquetamab treatment in order to optimize patient outcomes.

DATA SOURCES

MonumenTAL-1 is a phase 1/2 clinical trial of talquetamab in patients with relapsed/refractory MM who are triple-class exposed. Details on overall response, safety, and AE incidence and occurrence were previously published. Management strategies for the T-cell-related and unique GPRC5D-related AEs were collected from oncology nurses from different study sites.

CONCLUSION

Talquetamab has shown overall response rates of >71% in patients with relapsed/refractory MM in the MonumenTAL-1 study. AEs were low grade and predictable; few led to study discontinuation.

IMPLICATIONS FOR NURSING PRACTICE

Oncology nurses have specialized knowledge of treatment administration monitoring based on their participation in the MonumenTAL-1 trial. This review provides information for nurses in both the academic and community settings on how to monitor, counsel, and support patients, which will in turn improve patients' quality of life and overall survival.

摘要

目的

Talquetamab 是一种新批准的双特异性抗体,靶向 T 细胞上的 CD3 受体和多发性骨髓瘤(MM)细胞上高度表达的 G 蛋白偶联受体家族 C 组 5 成员 D(GPRC5D)受体。除了与双特异性抗体治疗相关的免疫治疗相关不良事件(AE)外,talquetamab 还与独特的皮肤/指甲和口腔 GPRC5D 相关副作用相关,需要额外的支持性护理。本综述根据肿瘤护士在 MonumenTAL-1(NCT03399799/NCT04634552)临床试验期间的经验,提供了 talquetamab 的临床管理策略。本综述的目的是提高护士和患者的认识,以更好地理解和管理与 talquetamab 治疗相关的副作用,从而优化患者的治疗效果。

数据来源

MonumenTAL-1 是一项 talquetamab 治疗三药暴露复发/难治性 MM 患者的 1/2 期临床试验。总体缓解率、安全性以及 AE 发生率和发生情况的详细信息此前已发表。从不同研究地点的肿瘤护士收集了与 T 细胞相关和独特的 GPRC5D 相关 AE 的管理策略。

结论

在 MonumenTAL-1 研究中,talquetamab 在复发/难治性 MM 患者中的总体缓解率>71%。AE 为低级别且可预测;少数导致研究中止。

对护理实践的意义

肿瘤护士基于参与 MonumenTAL-1 试验,具有治疗管理监测的专业知识。本综述为学术和社区环境中的护士提供了如何监测、咨询和支持患者的信息,这将提高患者的生活质量和总体生存率。

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