Faculty Collaboration Database

Pharmacist perspectives on emerging T cell-engaging bispecific therapies in cancer therapeutics. Am J Health Syst Pharm 2024 Jul 08;81(14):574-582

Date

02/23/2024

Pubmed ID

38394329

DOI

10.1093/ajhp/zxae050

Scopus ID

2-s2.0-85194354207 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

PURPOSE: To summarize the pharmacology, efficacy, safety, dosing, administration, and pharmacist perspectives related to operationalization of new and emerging bispecific therapies indicated for the treatment of various cancers.

SUMMARY: In recent years, there have been significant advancements in the expansion of immunotherapeutics in the treatment of various malignancies. Bispecific T cell-engaging therapies represent an emerging therapeutic drug class for the treatment of cancer. These therapies are unique antibody constructs that bind simultaneously to 2 targets, a tumor-specific antigen and CD3 on T cells, to elicit an immune response. Recently, several bispecific therapies have been approved, including epcoritamab, glofitamab, mosunetuzumab, tebentafusp, and teclistamab. Epcoritamab and glofitamab have been approved for diffuse large B cell lymphoma, while mosunetuzumab, tebentafusp, and teclistamab have been approved for follicular lymphoma, uveal melanoma, and multiple myeloma, respectively. As a result of their mechanism of action, the approved bispecific therapies have the potential to cause cytokine release syndrome, and, along with this, they all have unique and specific monitoring parameters and operational considerations that require clinician awareness when administering these therapies. Such operational challenges include within-patient dose escalations at therapy initiation, hospitalization for monitoring, and various pharmacological strategies for prophylaxis of cytokine release syndrome.

CONCLUSION: Bispecific therapies have continued to evolve the therapeutic landscape of cancer, primarily in hematological malignancies. Health-system pharmacists have the opportunity to play a key role in the operationalization and management of this new and emerging drug class.

Author List

Moore DC, Digiantonio N, Oxencis CJ, Taucher KD

Author

Carolyn J. Oxencis PharmD Adjunct Associate Professor in the School of Pharmacy Operations department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Antibodies, Bispecific
Antineoplastic Agents
Humans
Immunotherapy
Neoplasms
Pharmacists
Professional Role
T-Lymphocytes