There is still no cure for multiple myeloma (MM), but the treatment modalities available are vast and ever-improving. Chemotherapy is no longer the only choice, and treatments such as immunotherapy, radiation therapy, stem cell transplant, and chimeric-antigen T cell therapy can be used separately or in tandem to aggressively treat MM. Many emerging targeted therapies, such as bispecific antibodies, can augment and improve treatment efficacy. However, with each new therapy comes new challenges.
Because MM has a high relapse rate, most people with MM will require ongoing therapy. Cumulative exposure over multiple rounds of treatment can lead to toxicity, and each drug class has different toxicity profiles. In addition, each drug has its own administration guidelines, with different methods, in-chair times, and monitoring times. Given the speed at which new treatments are being developed, nurses are under extreme pressure to learn each drug’s efficacy, outcomes, risks, and toxicity mitigation strategies.
Monica Epstein and Candis Morrison of the National Cancer Institute and US Food and Drug Administration, respectively, recently published a review intended to give a synopsis of MM drug development and present data for each targeted therapy currently available. Their article should be used as a guide for nurses during patient care. The review, published in Seminars in Oncology, includes “efficacy data from pivotal trials and highlights of the risks that were demonstrated in trials, as well as during post-marketing surveillance.”
In addition, the authors state, “Specific risks associated with agents within the classes, that are not shared with all new class members, are described. A table presenting these potential risks, with recommended nursing actions to mitigate toxicity, is provided as a quick reference.”
To read the abstract and download the full text, click here.