Dr. Sperling on Managing CAR T-Cell Therapy–Related Toxicities in Multiple Myeloma

Adam Sperling, MD, PhD, a physician at the Dana-Farber Cancer Institute, and an instructor in medicine at Harvard Medical School, discusses managing CAR T-cell therapy–related toxicities in multiple myeloma.

Managing cytokine release syndrome (CRS) and neurotoxicity is a challenge in multiple myeloma, says Sperling. However, the experience with CAR T-cell therapy in lymphoma and leukemia has yielded insight into how to best manage these toxicities, Sperling explains. Moreover, physician comfort in intervening early for toxicity management will increase with additional experience in utilizing these products, Sperling says.

Academic centers that have experience with CAR T-cell therapy from participating in clinical trials will most likely be comfortable using these products in the commercial setting, says Sperling. The protocols for managing CAR T-cell therapy–related toxicities that are being built closely resemble the protocols employed on the clinical trials that evaluated the therapies, Sperling adds.

Notably, the CRS and neurotoxicity observed with idecabtagene vicleucel (ide-cel; Abecma) appear to be less significant compared with those observed with CD19-directed CAR T-cell therapies in lymphoma and leukemia, so toxicities may be easier to manage in multiple myeloma, concludes Sperling.