Managing Acute Immune Complications | Krina Patel, MD | IMS 2023

Hi, I'm Dr. Karina Patel, associate professor at MD Anderson Cancer Center in Houston, Texas. And we are here at IMS. And I just gave a talk on acute toxicity and complications after immune therapy earlier today. And I think it's really important that, you know, with these amazing therapies we have, bispecifics, CAR T cells, that we really make sure we understand toxicity, that, you know, there are patients who do get some complications. And I think we've learned that if we intervene with those complications sooner, you can actually turn it around and make sure patients do well. So most of the talk was about CRS, cytokine release syndrome, as well as neurotoxicity. And you know, these are things that we don't see as much in myeloma, or at least not the really complicated versions, which is great. And we really do know how to treat it early. There are some other ones that are a little different than other cancers, such as delayed neurotoxicity. And so that's a little bit more specific to BCMA, CAR T's, and bispecifics, where we treat patients. And sometimes patients can get things like Parkinsonianism. And what we mean by that is patients can have a hard time holding onto things and writing, they could have a hard time walking. And this can happen a little bit later. And this is more with CAR T's than bispecifics. But again, we need to know what's happening soon so we can try to intervene. And we have ways to prevent it now, too. So we've learned a lot after our first studies. And so the rates of all these things have gone down. But again, if you're that patient that gets it, we want to make sure we know right away so we can turn it around. And then the other big one is infections, which Dr. Richter talked about today, too. But you can get infections early on, as well as the acute side of things. So we really make sure people are on antibiotics. We're putting people on supportive medications just to kind of prevent those things from happening. So in general, again, things that we've learned from our lymphoma and leukemia colleagues, a few things that are more specific to myeloma and the CAR T's and the bispecifics we use, but still doing much, much better every time we keep doing the next round of trials. So exciting times. And hopefully we'll have it where no one will have toxicity and everyone will get CAR T's and bispecifics and great responses.