Tyler Sandahl, PharmD, Clinical Pharmacist at the Mayo Clinic, discusses the use of tocilizumab in multiple myeloma patients.
Multiple myeloma is a cancer that occurs due to abnormal, uncontrolled growth of plasma cells in the bone marrow. The most common symptom is anemia, which can be associated with fatigue and shortness of breath. Other features of the condition may include:
- multiple infections
- abnormal bleeding
- bone pain
- weak and/or easily broken bones
- numbness and/or weakness of the arms and legs
The exact underlying cause of Multiple myeloma is currently unknown. Factors that are associated with an increased risk of developing Multiple myeloma include increasing age, male sex, African American race, radiation exposure, a family history of the condition, obesity, and/or a personal history of monoclonal gammopathy of undetermined significance (MGUS).
Tocilizumab is an anti-BCMA used in relapsed refractory multiple myeloma after at least four prior lines of therapy. The study included 45 patients who had received at least one dose of tocilizumab and completed step-up dosing. The objective was to evaluate the safety outcomes and healthcare resource utilization in the real-world.
As discussed by Dr. Sandahl, some patients experienced cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), requiring hospital admission for treatment and observation. Acetaminophen and dexamethasone were the main treatments for CRS, with tocilizumab given in some cases. Despite these adverse events, outpatient administration was deemed safe and feasible, with most doses requiring 30 minutes to an hour of clinic time for monitoring. The findings suggest that with appropriate monitoring and rapid escalation of care, outpatient administration of tocilizumab can be implemented effectively, potentially expanding its use in the community setting beyond the step-up dosing period.
For more information about multiple myeloma and other rare cancers, visit https://checkrare.com/diseases/cancers/
