Sagar Lonial, MD, FACP, FASCP

Panelists discuss how they collaborate with community oncology partners to expand bispecific antibody delivery, emphasizing that acute toxicities occur early at academic centers while maintenance dosing can be safely managed locally.

Panelists discuss how they manage talquetamab-specific toxicities including dysgeusia and nail/skin changes through patient preparation, dietary modifications with umami-rich foods, emollients, and extended dosing intervals.

Panelists discuss how they modify bispecific dosing intervals based on treatment response rather than dose intensity, extending administration frequency to every two or four weeks once patients achieve deeper responses.

Panelists discuss how they manage adverse events with bispecifics through universal IVIg administration from treatment initiation, comprehensive infection prophylaxis, and growth factor support for cytopenias.

Panelists discuss how real-world outcomes with bispecific antibodies align closely with clinical trial data in terms of response rates, though with lower infection rates due to improved prophylaxis strategies.

Panelists discuss how they implement step-up dosing for bispecific antibodies, transitioning from inpatient to outpatient approaches using prophylactic tocilizumab and existing infrastructure from CAR-T and transplant programs.

Panelists discuss how they sequence bispecific antibodies with CAR-T therapy in relapsed/refractory multiple myeloma, preferring CAR-T before BCMa bispecifics and considering GPR-C5 targeting as bridging therapy.

Panelists discuss how they approach frontline therapy for transplant-ineligible or deferred patients, emphasizing reduced-intensity quadruplets for frail patients while considering transplant eligibility more broadly for fit older adults.

Panelists discuss how they utilize minimal residual disease testing at various timepoints post-transplant to guide maintenance decisions and assess the potential for treatment discontinuation in sustained MRD-negative patients.

Panelists discuss how they approach maintenance therapy after transplant, tailoring treatment intensity based on risk stratification and considering clinical trials versus standard lenalidomide or doublet regimens.

Panelists discuss how they manage adverse events in patients receiving quadruplet induction, particularly focusing on neuropathy prevention, dexamethasone dose reduction, infection prophylaxis, and IgG monitoring strategies.

Panelists discuss how data from the Perseus and Ischaemia trials inform their selection of quadruplet induction regimens and use of MRD negativity as a treatment endpoint before transplant.