ESMO Asia 2025 | Managing CRS, ICANS & dysgeusia associated with bispecific T-cell engagers

So we know that tarlatamab, which is the bispecific T-cell engager, has entered the clinic. It’s approved in certain jurisdictions in the world. And certainly it’s a unique drug with unique side effects, especially cytokine release syndrome and ICANS, which is sort of dictated by neurological toxicity symptoms. My talk with Professor Ahn at the ESMO symposium is really to deep dive into bispecific T-cell engagers. My talk is very much about managing side effects. I’m also going to be detailing about four different patient case studies and different side effects and how we manage them I’m also going to be talking about short monitoring versus long monitoring and some of the nuances around that uh sort of way of administering the therapy um so yeah so um actually the most common side effect from um see, well, the two most common side effects from a bispecific T-cell engager are CRS and also dyspnea. CRS tends to happen in the first two weeks of the tarlatamab administration. And usually patients can get fevers, but sort of more uncommonly can develop hypotension or hypoxia. And the management for that would involve basically using paracetamol, acetaminophen, and potentially steroids may enter the state of play depending on the grade of the CRS. This disease is difficult to manage, admittedly, and there are no clear guidelines to managing it. And certainly, I think there are patients, different doctors have tried different things, but there’s nothing in the guidelines. ICANS, which is extremely rare, also tends to happen in the first few weeks of the tarlatamab treatment. And once again, steroids is the mainstay of treatment for that.

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