Bispecific Antibody Use in Patients With Lymphoma and Multiple Myeloma.

Adam Braun, Sushanth Gouni, Astrid Pulles, Paolo Strati, Monique C Minnema, Lihua E Budde
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Abstract

This article endeavors to navigate the clinical journey of bispecific antibodies (BsAbs), from elucidating common toxicities and management strategies to examining novel agents and broadening access in community health care. These drugs, commonly through T-cell activation, result in shared adverse events such as cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. Variations in target antigens and designs, however, might introduce unique toxicities for different BsAbs, warranting specific management approaches. Recent US Food and Drug Administration approvals of BsAbs targeting CD3+ T cells linked to CD20 for non-Hodgkin lymphoma and to B-cell maturation antigen or GPRC5D for multiple myeloma have transformed the treatment landscape for hematologic malignancies. Emerging new agents promise further enhancement and safety, exploring novel antigen targets, innovative structures such as trispecific antibodies, and the engagement of diverse immune cells. Simultaneously, the expansion of BsAbs into community practices is underway, demanding a multifaceted strategy that encompasses educational initiatives, operational adaptations, and collaborative frameworks. This ensures comprehensive treatment access, allowing every patient, irrespective of geographical or socioeconomic status, to benefit from these advancements in cancer therapy.

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在淋巴瘤和多发性骨髓瘤患者中使用双特异性抗体。
从阐明常见毒性和管理策略,到研究新型制剂和扩大社区医疗的可及性,本文试图为双特异性抗体(BsAbs)的临床之路导航。这些药物通常通过激活 T 细胞导致共同的不良反应,如细胞因子释放综合征和免疫效应细胞相关神经毒性综合征。然而,靶抗原和设计的不同可能会给不同的 BsAbs 带来独特的毒性,因此需要采取特定的管理方法。最近,美国食品和药物管理局批准了针对与 CD20 相关的 CD3+ T 细胞的 BsAbs 用于治疗非霍奇金淋巴瘤,以及针对与 B 细胞成熟抗原或 GPRC5D 相关的 BsAbs 用于治疗多发性骨髓瘤,这改变了血液系统恶性肿瘤的治疗格局。新出现的药物有望进一步提高安全性,探索新的抗原靶点、创新结构(如三特异性抗体)以及多种免疫细胞的参与。与此同时,BsAbs 正在向社区实践扩展,这就要求采取多方面的策略,包括教育措施、操作调整和合作框架。这将确保全面的治疗机会,让每一位患者,无论其地理位置或社会经济地位如何,都能从这些癌症治疗的进步中受益。
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期刊介绍: The Ed Book is a National Library of Medicine–indexed collection of articles written by ASCO Annual Meeting faculty and invited leaders in oncology. Ed Book was launched in 1985 to highlight standards of care and inspire future therapeutic possibilities in oncology. Published annually, each volume highlights the most compelling research and developments across the multidisciplinary fields of oncology and serves as an enduring scholarly resource for all members of the cancer care team long after the Meeting concludes. These articles address issues in the following areas, among others: Immuno-oncology, Surgical, radiation, and medical oncology, Clinical informatics and quality of care, Global health, Survivorship.
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