Comparison of novel immunotherapy approaches in multiple myeloma
. | Antibody drug conjugates . | Bispecific T-cell engagers . | CAR T-cell therapy . |
---|---|---|---|
Advantages | Off-the-shelf therapy | Off-the-shelf therapy | - |
Immune and nonimmune mechanisms of action | - | - | |
Infrequent dosing (every 3 wk-12 wk) | - | One-time therapy | |
Encouraging response rates | Deep responses | Deep responses | |
No CRS/ICANS | Mostly grade 1-2 CRS/ICANS | - | |
Outpatient administration | Only initial dosing as inpatient | Vacation from continuous therapy | |
Disadvantages | Continuous therapy until progression | Continuous therapy until progression | - |
Frequent dose interruptions | Weekly or biweekly dosing | Administration delays due to manufacturing time | |
Ocular toxicity | Significant immunosuppression | Potential for severe CRS/ICANS; prolonged cytopenias | |
Ophthalmic exams prior to dosing | Specialized centers required | Complex infrastructure required | |
Cost ($$) | Cost ($$) | Cost ($$$) |
. | Antibody drug conjugates . | Bispecific T-cell engagers . | CAR T-cell therapy . |
---|---|---|---|
Advantages | Off-the-shelf therapy | Off-the-shelf therapy | - |
Immune and nonimmune mechanisms of action | - | - | |
Infrequent dosing (every 3 wk-12 wk) | - | One-time therapy | |
Encouraging response rates | Deep responses | Deep responses | |
No CRS/ICANS | Mostly grade 1-2 CRS/ICANS | - | |
Outpatient administration | Only initial dosing as inpatient | Vacation from continuous therapy | |
Disadvantages | Continuous therapy until progression | Continuous therapy until progression | - |
Frequent dose interruptions | Weekly or biweekly dosing | Administration delays due to manufacturing time | |
Ocular toxicity | Significant immunosuppression | Potential for severe CRS/ICANS; prolonged cytopenias | |
Ophthalmic exams prior to dosing | Specialized centers required | Complex infrastructure required | |
Cost ($$) | Cost ($$) | Cost ($$$) |
ICANS, immune effector cell-associated neurotoxicity syndrome; wk, week.