Managing Cranial Nerve Impairment in Multiple Myeloma Following Cilta-cel

EP: 1.Reviewing the Approval Process of Teclistamab in Multiple Myeloma

EP: 2.Multiple Myeloma and ALL Experts Face Off in Data Analyzing Cilta-Cel and Ponatinib Hydrochloride

EP: 3.ASH 2023: The Most Relevant Multiple Myeloma Data Presented

EP: 4.ODAC Casts 11 to 0 Vote in Favor of Cilta-Cel in R/R Multiple Myeloma

EP: 5.Ide-Cel Receives Favorable ODAC Vote for R/R Multiple Myeloma

EP: 6.FDA Approves Ide-Cel in Previously Treated Multiple Myeloma

EP: 7.FDA Approves Cilta-Cel for Relapsed/Refractory Myeloma After 1 Therapy

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EP: 8.Managing Cranial Nerve Impairment in Multiple Myeloma Following Cilta-cel

EP: 9.APPs Focus on Education of Talquetamab Use and Administration in Multiple Myeloma

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EP: 11.Daratumumab Retreatment Yields Sustained Response in R/R Multiple Myeloma

EP: 12.Step-Up Teclistamab Dosing Produces Responses in R/R Multiple Myeloma

EP: 13.Building On Outcomes With Isatuximab in Newly Diagnosed Myeloma

EP: 14.Continued Success of Venetoclax in t(11;14) Multiple Myeloma Despite Negative Trials

EP: 15.Leveraging CAR T-Cell Therapy Advancements in R/R Multiple Myeloma

EP: 16.FDA Approves Subcutaneous Daratumumab Regimen in Newly Diagnosed Multiple Myeloma

EP: 17.Bispecific Antibodies Are Taking the Multiple Myeloma World by Storm

EP: 18.MRD May Predict Improved Outcomes in Multiple Myeloma

EP: 19.Evaluating the Use of CAR T-Cell Therapy for Multiple Myeloma in Academic and Community Settings

EP: 20.Linvoseltamab Still Efficacious Despite CRL in Multiple Myeloma

EP: 21.Exploring GPRC5D as an Important Target for Multiple Myeloma

EP: 22.Long-Term Data Affirm Enduring Responses With Teclistamab in R/R Multiple Myeloma

EP: 23.Determining Administration of BCMA, T-Cell Engagers in R/R Multiple Myeloma

EP: 24.Optimizing AE Management Post CAR T-Cell Therapy in Multiple Myeloma

EP: 25.Assessing NP Roles in Talquetamab Treatment for Multiple Myeloma

EP: 26.Daratumumab Combo Yields MRD-Negative Status in Transplant-Ineligible NDMM

EP: 27.Mitigating Adverse Effects Following GPRC5DTargeted Therapy in Multiple Myeloma

EP: 28.Managing Toxicities Following BCMA-Directed Immunotherapy for Myeloma

EP: 29.Using Real-World Data to Form GPRC5D Therapy Strategies in R/R Multiple Myeloma

EP: 30.Optimal Sequencing Between CAR T and Bispecifics in Multiple Myeloma

EP: 31.Multiple Myeloma Experts Face Off on Sequencing Therapy Options

EP: 32.D-VRd Regimen Sustains MRD Response In Newly Diagnosed Multiple Myeloma Subgroup

EP: 33.Maintenance Teclistamab Yields Preliminary Activity in NDMM

EP: 34.General Lifestyle Recommendations for Receiving Talquetamab in Multiple Myeloma

EP: 35.Belantamab Mafodotin Regimen Improves OS in R/R Multiple Myeloma

EP: 36.Overall MRD Negativity Rates Improved with Cilta-cel vs SOC in MM

EP: 37.Fostering Academic, Community Practice Collaboration for Bispecific Therapy in Multiple Myeloma

EP: 38.Experts Discuss Choosing Bispecifics and Sequencing Options in Multiple Myeloma

EP: 39.CAR T-Cell Therapy Is a Desirable Option in Second-Line Multiple Myeloma

EP: 40.Appropriately De-Escalating Talquetamab to Monthly Dosing in Multiple Myeloma

It is critical to quickly conduct neurological workups to verify cases of cranial nerve palsy (CNP) in patients with multiple myeloma who receive treatment with ciltacabtagene autoleucel (cilta-cel; Carvykti), according to Leslie Bennett, MSN, RN.

Bennett, a nurse coordinator at Stanford Healthcare, spoke with CancerNetwork^® during the 2024 Oncology Nursing Society Conference about the importance of clinicians and nurse providers preparing for CNP in patients who undergo treatment with cilta-cel for multiple myeloma. She stated that nurses, in particular, should be educated on this toxicity so that they can identify and subsequently mitigate symptoms in patients who may experience CNP before, during, or after CAR T-cell infusion.

In a poster presentation given at the conference, Bennett highlighted findings on CNP outcomes from the phase 1/2 CARTITUDE-1 trial (NCT03548207), phase 2 CARTITUDE-2 trial (NCT04133636), and phase 3 CARTITUDE-4 trial (NCT04181827), which assessed the use of cilta-cel in various populations with multiple myeloma. Across these trials, patients had CNP onset at a median of approximately 3 weeks following treatment with cilta-cel. Additionally, most cases of CNP affected male patients and were typically low-grade.

Transcript:

[Cranial nerve impairments are] something that we do discuss in the new patient visit, when the patients are being consented, and when we’re talking about all the neurological toxicities, including the fact that they could have the cranial nerve VII impairment causing the palsy typically during delayed onset.

It’s good for nurses, specifically, to be educated on this so that they can prepare their patients and the caregivers before, during, and after their CAR T infusions so that they can find the signs and symptoms and adequately get them addressed. It’s important to have a rapid neurological workup to ensure that what indeed is happening is a nerve palsy and not another neurological [adverse] effect from the CAR T therapy.

Reference

Bennett L, Kruyswijk S, Sidana S, et al. Incidence and management of cranial nerve impairments in patients with multiple myeloma treated with ciltacabtagene autoleucel in CARTITUDE studies. Presented at the 49th Annual Oncology Nursing Society Conference; April 24-28, 2024; Washington, DC.