Policy ReviewPrevention and management of adverse events duringtreatment with bispecific antibodies and CART cells inmultiple myeloma:a consensus report of the EuropeanMyeloma NetworkHeinzLudwig.Evngelos Terpos,Niels van de Donk Maria-Victoria Mateos,PhilippeMoreau Melitios-Athanasios Dimopoulos,Michel Delforge,Paula Rodriguez-Otero,Jesus San-Miguel Kwee Yong,Francesca Gay,Hermann Einsele,Roberto Mina Jo Coers,Christoph DriessenPellegrino Musto,Sonja Zweegman,Monika Engelhardt,Gordon Cook,Katja Weisel,Annemiek Broijl Meral Beksac,Jelena Bila,Fredrik Schjesvold.Michele Cavo,Roman Hajek,Cyrille Touzeau,Mario Boccadoro,Pieter SonneveldT-cell redirecting bispecific antibodies(BsAbs)and chimeric antigen receptor Tcells(CAR Tcells)have revolutionisedLancetOncol 2023:24:e255-69multiple myeloma therapy,but adverse events such as cytokine release syndrome immune effector cell-associated pmentincinineurotoxicity syndrome (ICANS),cytopenias,hypogammaglobulinaemia,and infections are common.This PolicyOttakring,Wilhel minen CancerReview presents a consensus from the European Myeloma Network on the prevention and management of theseResearchInstitute,Vienna.Austria (ProfH Ludwig MD):adverse events.Recommended measures include premedication,frequent assessing for symptoms and severity ofDepartment ofClinicalcytokine release syndrome,step-up dosing for several BsAbs and some CAR T-cell therapies;corticosteroids;andTherapeutis,School oftocilizumab in the case of cytokine release syndrome.Other anti-IL-6 drugs,high-dose corticosteroids,and anakinraMedicine National andmight be considered in refractory cases.ICANS often arises concomitantly with cytokine release syndrome.Kapodistrian University ofAthens,Athens,GreeceGlucocorticosteroids in increasingdoses are recommended ifneeded,as well as anakinra ifthe response is inadequate,(E Terpos MD,and anticonvulsants if convulsions occur.Preventive measures against infections indude antiviral and antibacterialProf M-A Dimopouls MD):drugs and administration of immunoglobulins.Treatment of infections and other complications is also addressed.Department of HematologyAmste re由m UMC VUIntroductioncontain a modified fragment crystallisable(Fc)domain,University,Amsterdam,Netherland由Treatment of patients with multiple myeloma has beenwhich results in a longer half-life than with non-IgG.(Prof Nvande Dorik MD.revolutionised through the use of targeted immunelike formats without an Fc domain (eg,bispecific TcellProf S Zweegman MD):Hospitaltherapies and in particular Tcell redirecting bispecificengagers and dual-affinity retargeting proteins).Universitariode Salamanca,Instituto de Investigaconantibodies(BsAbs)and chimeric antigen receptor T cellsTeclistamab is approved for clinical use in relapsed orBiomedica deSalamanca,(CAR T cells).The remarkable efficacy of BsAbs and CARrefractory multiple myeloma,and requests for approvalCentrode Investigacon delT cells in patients with relapsed or refractory multiple have been filed for talquet
