For a patient with triple-class-refractory myeloma and cytopenias who has been collected for CAR-T, would you choose aggressive chemotherapy or a bispecific antibody for bridging?
This question seems quite specific but happens quite often. Multi-drug chemotherapy runs the risk of profound cytopenias and infections, while bispecifics (either BCMA or GPRC5D) have theoretical risks and unknown efficacy.
2 Answers
Mednet MemberInvited Expert
Medical Oncology · University of Chicago
Answered on · Updated on
The median time to response for bispecific antibodies targeting BCMA and GPRC5d is over a month. Usually, when we employ bridging therapy we want a much quicker response. Resistance likely doesn’t play a role here because of the short time that they are being used.
I prefer to avoid VD-pace-like reg...
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Mednet MemberInvited Expert
Medical Oncology · University of Kansas Medical Center
Answered on
It is a common question and also remains a challenging situation in the real world! Many key points need to be addressed here regarding the disease (assuming pt is fit since he is undergoing CAR-T):
- If the disease is aggressive with a high burden (I will be aggressive with using VDPACE or VDPACE-l...
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