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TL;DR
This narrative review summarizes the management of adverse reactions, such as cytokine release syndrome and cytopenias, associated with four FDA-approved BCMA-directed therapies for adult patients with relapsed refractory multiple myeloma.
Journal of Clinical Medicine · 12 authors, 10 centres
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This narrative review summarizes the management of adverse reactions, such as cytokine release syndrome and cytopenias, associated with four FDA-approved BCMA-directed therapies for adult patients with relapsed refractory multiple myeloma.
This focused narrative review synthesizes evidence from four original phase I/II clinical trials and FDA access data packages for the FDA-approved BCMA-directed agents idecabtagene vicleucel, ciltacabtagene autoleucel, teclistamab, and belantamab mafodotin in adult relapsed refractory multiple myeloma. The review details the risk factors, pathogenesis, clinical features, and stepwise prevention and treatment management for major complications including cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, cytopenias, infections, hemophagocytic lymphohistiocytosis, and organ toxicity. The central finding is that constant monitoring, early identification of symptoms, and prompt intervention are critical to mitigate these potentially severe adverse effects. A key limitation noted is that the review is based on a small number of completed trials, and further phase III trials with longer follow-up are needed to establish the safety of these agents.