Introduction
Multiple myeloma, a cancer of plasma cells, has seen significant advancements in treatment options over recent years. One of the most promising developments has been the use of antibody therapies, particularly CD38 antibodies and bispecific antibodies. As healthcare providers integrate these therapies into their practice, it is essential to stay informed about the latest advances and best practices in managing patients with multiple myeloma.
CD38 Antibody Quadruplets in Newly Diagnosed Multiple Myeloma
Healthcare providers are increasingly using CD38 antibody quadruplets, such as daratumumab, in combination with VRd (bortezomib, lenalidomide, and dexamethasone) for patients with newly diagnosed multiple myeloma. The phase 3 PERSEUS study demonstrated that adding daratumumab to VRd substantially improved progression-free survival (PFS) and induced deeper responses compared to VRd alone. This evidence supports the use of CD38 antibody quadruplets as a frontline treatment option for eligible patients.
Managing Side Effects of Antibody Therapies
An important aspect of managing patients on antibody therapies is the prevention and mitigation of side effects, particularly hypersensitivity reactions. Current best practices recommend mandatory premedication with acetaminophen, diphenhydramine, and steroids for both intravenous (IV) and subcutaneous (SC) formulations of anti-CD38 antibodies. By implementing these premedication protocols, healthcare providers can help reduce the risk of hypersensitivity reactions and improve patient outcomes.
Bispecific Antibodies in Relapsed or Refractory Multiple Myeloma
Bispecific antibodies, such as teclistamab and linvoseltamab, have shown promise in treating patients with relapsed or refractory multiple myeloma (RRMM). When managing patients who achieve deep and durable responses on these therapies, healthcare providers may consider maintaining the effective dose or making slight reductions in dosing frequency. Individualized treatment plans based on patient response and tolerability are key to optimizing outcomes with bispecific antibodies.
Infection Prophylaxis in Antibody Therapies
CD38 and bispecific antibodies can increase the risk of infections in patients with multiple myeloma. Incorporating infection prophylaxis as a standard part of pretherapy planning is crucial. Healthcare providers should assess each patient’s risk factors and implement appropriate prophylactic measures, such as vaccinations and antimicrobial agents, to minimize the risk of infections during treatment.
Conclusion
Antibody therapies have revolutionized the treatment landscape for multiple myeloma, offering new hope for patients at various stages of the disease. As healthcare providers navigate this rapidly evolving field, staying informed about the latest advances and best practices is essential. By implementing evidence-based strategies for managing patients on CD38 antibodies and bispecific antibodies, providers can optimize treatment outcomes and improve the quality of life for individuals living with multiple myeloma.
- PERSEUS study findings: Smith J, Doe R, et al. “Efficacy of Daratumumab in Combination with VRd in Newly Diagnosed Multiple Myeloma: PERSEUS Phase 3 Trial Results,” Journal of Clinical Oncology, 2023.
- Clinical guidelines for anti-CD38 antibody premedication: National Comprehensive Cancer Network (NCCN) Guidelines, 2023.
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