Recommendations for the effective use of T-cell–redirecting therapies: a Canadian consensus statement

BackgroundT-cell–redirecting therapies, such as bispecific antibodies and chimeric antigen receptor T-cells, exploit the cytotoxic capabilities of the immune system to destroy cells expressing specific surface antigens, including malignant cells. These therapies have demonstrated unprecedented rates...

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Main Authors: Guido Lancman, Kevin Song, Darrell White, Tina Crosbie, Ismail Sharif, Marianne Emond, Muhammad Saleem Raza, Martine Elias, Rayan Kaedbey, Michael P. Chu
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2024.1446995/full
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author Guido Lancman
Kevin Song
Darrell White
Tina Crosbie
Ismail Sharif
Marianne Emond
Muhammad Saleem Raza
Martine Elias
Rayan Kaedbey
Michael P. Chu
author_facet Guido Lancman
Kevin Song
Darrell White
Tina Crosbie
Ismail Sharif
Marianne Emond
Muhammad Saleem Raza
Martine Elias
Rayan Kaedbey
Michael P. Chu
author_sort Guido Lancman
collection DOAJ
description BackgroundT-cell–redirecting therapies, such as bispecific antibodies and chimeric antigen receptor T-cells, exploit the cytotoxic capabilities of the immune system to destroy cells expressing specific surface antigens, including malignant cells. These therapies have demonstrated unprecedented rates, depth, and duration of responses in relapsed and refractory multiple myeloma. However, there are significant challenges in implementing these therapies into practice, which require multidisciplinary and multicenter coordination and significant healthcare resources to effectively manage these patients. So far, there are no Canadian guidelines for the effective implementation and use of T-cell–redirecting therapies.MethodsThis consensus statement was developed based on three advisory meetings held in March, July, and November 2023. During these meetings, a panel of Canadian subject matter experts and representation from Myeloma Canada gathered to discuss the optimal procedures for the use of T-cell–redirecting therapies in the treatment of multiple myeloma. Members of the panel performed a thorough review of randomized clinical trials, real-world data, and other current literature, and provided their up-to-date clinical experience with T-cell–redirecting therapies in Canadian practice settings. Subsequently, asynchronous working groups were appointed to develop unified criteria for patient selection, appraise referral pathways, and devise strategies for management of short-term and long-term adverse events arising from the use of T-cell–redirecting therapies in multiple myeloma.ResultsHere, we present recommendations for optimizing patient selection, referral pathways, and adverse event management in the Canadian practice setting. These recommendations are relevant for hematologists/oncologists, oncology nurses, pharmacists, nurse practitioners, physician assistants, and other providers who treat patients with multiple myeloma, as well as individuals with multiple myeloma and their care partners. These recommendations will be of interest to clinicians who treat patients with MM at community clinics and hospitals and who may be interested in referring patients for T-cell–redirecting therapy.
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spelling doaj-art-bfa03ffc22104a2dab49975fc413150f2025-08-20T02:28:16ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-11-011410.3389/fonc.2024.14469951446995Recommendations for the effective use of T-cell–redirecting therapies: a Canadian consensus statementGuido Lancman0Kevin Song1Darrell White2Tina Crosbie3Ismail Sharif4Marianne Emond5Muhammad Saleem Raza6Martine Elias7Rayan Kaedbey8Michael P. Chu9Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, CanadaThe Leukemia/Bone Marrow Transplant Program of BC, BC Cancer Agency, Vancouver General Hospital, Vancouver, BC, CanadaQueen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, NS, CanadaPharmacy Department, The Ottawa Hospital, Ottawa, ON, CanadaDurham Region Cancer Centre, Oshawa, ON, CanadaPharmacy Department, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec City, QC, CanadaDr. Everett Chalmers Regional Hospital, Fredericton, NB, CanadaMyeloma Canada, Dorval, QC, CanadaSegal Cancer Centre, Jewish General Hospital, McGill University, Montréal, QC, Canada0Cross Cancer Institute, Edmonton, AB, CanadaBackgroundT-cell–redirecting therapies, such as bispecific antibodies and chimeric antigen receptor T-cells, exploit the cytotoxic capabilities of the immune system to destroy cells expressing specific surface antigens, including malignant cells. These therapies have demonstrated unprecedented rates, depth, and duration of responses in relapsed and refractory multiple myeloma. However, there are significant challenges in implementing these therapies into practice, which require multidisciplinary and multicenter coordination and significant healthcare resources to effectively manage these patients. So far, there are no Canadian guidelines for the effective implementation and use of T-cell–redirecting therapies.MethodsThis consensus statement was developed based on three advisory meetings held in March, July, and November 2023. During these meetings, a panel of Canadian subject matter experts and representation from Myeloma Canada gathered to discuss the optimal procedures for the use of T-cell–redirecting therapies in the treatment of multiple myeloma. Members of the panel performed a thorough review of randomized clinical trials, real-world data, and other current literature, and provided their up-to-date clinical experience with T-cell–redirecting therapies in Canadian practice settings. Subsequently, asynchronous working groups were appointed to develop unified criteria for patient selection, appraise referral pathways, and devise strategies for management of short-term and long-term adverse events arising from the use of T-cell–redirecting therapies in multiple myeloma.ResultsHere, we present recommendations for optimizing patient selection, referral pathways, and adverse event management in the Canadian practice setting. These recommendations are relevant for hematologists/oncologists, oncology nurses, pharmacists, nurse practitioners, physician assistants, and other providers who treat patients with multiple myeloma, as well as individuals with multiple myeloma and their care partners. These recommendations will be of interest to clinicians who treat patients with MM at community clinics and hospitals and who may be interested in referring patients for T-cell–redirecting therapy.https://www.frontiersin.org/articles/10.3389/fonc.2024.1446995/fullmultiple myelomaT-cell–redirecting therapybispecific antibodiesCAR T-cellsconsensus statementreferral
spellingShingle Guido Lancman
Kevin Song
Darrell White
Tina Crosbie
Ismail Sharif
Marianne Emond
Muhammad Saleem Raza
Martine Elias
Rayan Kaedbey
Michael P. Chu
Recommendations for the effective use of T-cell–redirecting therapies: a Canadian consensus statement
Frontiers in Oncology
multiple myeloma
T-cell–redirecting therapy
bispecific antibodies
CAR T-cells
consensus statement
referral
title Recommendations for the effective use of T-cell–redirecting therapies: a Canadian consensus statement
title_full Recommendations for the effective use of T-cell–redirecting therapies: a Canadian consensus statement
title_fullStr Recommendations for the effective use of T-cell–redirecting therapies: a Canadian consensus statement
title_full_unstemmed Recommendations for the effective use of T-cell–redirecting therapies: a Canadian consensus statement
title_short Recommendations for the effective use of T-cell–redirecting therapies: a Canadian consensus statement
title_sort recommendations for the effective use of t cell redirecting therapies a canadian consensus statement
topic multiple myeloma
T-cell–redirecting therapy
bispecific antibodies
CAR T-cells
consensus statement
referral
url https://www.frontiersin.org/articles/10.3389/fonc.2024.1446995/full
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