Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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BiTE Infections for Myeloma?
Does BiTe (bispecific T-cell engagers) therapy enhance the risk of infection for myeloma patients? Yes, according to the research linked below.
What is/are BiTe (bispecific T-cell engagers)? Bispecific T-cell engager (BiTE) therapy is a type of immunotherapy that helps the body’s immune system attack cancer cells in multiple myeloma.
Examples of BiTe therapy are:
- Talquetamab-tgvs (Talvey): Approved by the FDA for patients with multiple myeloma that did not respond to or relapsed after at least four prior lines of treatment
- Teclistamab-cqyv (Tecvayli): Approved by the FDA for patients with multiple myeloma
- Pacanalotamab (AMG 420, BI 836909): The first BiTE developed for myeloma treatment
This is just my opinion but when your oncologist tells you that “BiTe therapy is a type of immunotherapy that helps the body’s immune system attach cancer cells” MM patients may think that their immune system will be enhanced by BiTe therapy.
The research linked below seems to say that any immune enhancement does not last long. And that once BiTe therapy ends, MM patients could be vulneable to COVID-19.
I was surprised when I came across a study showing that half of all MM patients die from infection and not a MM related issue such as bone or kidney damage.
I came to realize that continually enhancing your immune system is just as important to MM patients and survivors as killing their MM is.
Email me at David.PeopleBeatingCance@gmail.com with your questions about enhancing your immune system.
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Elevated LIF and JAK-STAT activation drive severe COVID-19 in myeloma patients receiving the BCMA-CD3 bispecific antibody Elranatamab
Background
Immunotherapy is a significant risk factor for severe COVID-19 in multiple myeloma (MM) patients. Understanding how immunotherapies lead to severe COVID-19 is crucial for improving patient outcomes.
Methods
Human protein microarrays were used to examine the expression of 440 protein molecules in MM patients treated with bispecific T-cell engagers (BiTe) (n = 9), anti-CD38 monoclonal antibodies (mAbs) (n = 10), and proteasome inhibitor (PI)-based regimens (n = 10). Differentially expressed proteins (DEPs) were identified and analyzed using bioinformatics.
Results
BiTe therapy was associated with a higher incidence of severe COVID-19. We identified 21 and 29 DEPs between BiTe and anti-CD38 mAbs group, and BiTe and PI-based group, respectively, along with 25 DEPs between the anti-CD38 and PI groups.
Principal component analysis and clustering showed distinct protein expression profiles between the BiTe and PI groups. Gene Ontology (GO) analysis revealed that DEPs between the BiTe and PI groups were related to cytokine activity and leukocyte migration.
Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that these DEPs were enriched in cytokine-cytokine receptor interaction and JAK-STAT signaling pathways. Leukemia inhibitory factor (LIF) is the most correlated with other DEPs and thus may play a key role in both enriched pathways, and the level of LIF protein was highest in the BiTe group.
Conclusions
BiTe therapy is linked to a higher risk of severe COVID-19 due to an inflammatory cytokine storm, with LIF and the JAK-STAT pathway playing key roles. Targeting LIF and JAK-STAT pathway may help reduce severe COVID-19 in MM patients treated with BiTe.
Additionally, the latest international consensus on BiTe treatment-related infections indicates that bispecific antibody therapy presents an elevated risk of infections and severe conditions compared to conventional MM treatment regimens [19].
The guidelines emphasize that the most likely explanation is that BiTe treatment significantly activates T-cells, leading to CRS and immune system dysregulation, resulting in serious infections.
This mechanism is not limited to COVID-19 but is also observed in various other serious infections. Studies have reported cases of:
- reactivation of cytomegalovirus (CMV)
- and hepatitis B virus (HBV),
- severe bacterial infections such as pneumonia, sepsis, and urinary tract infections following BiTe treatment [20].
- Fungal infections have also been noted, particularly aspergillosis and candidiasis, which can lead to challenging systemic disseminated infections [21].
In summary, understanding the specific mechanisms by which BiTe therapy leads to serious infections can help implement comprehensive infection monitoring and management strategies in MM patients, ultimately improving patient prognosis…
BiTe infections BiTe infections BiTe infections