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Currently, triplet therapy seems to be the standard of care, but what is evolving is whether we should give quadruplet regimens with monoclonal antibodies in addition to those same 3 classes of drugs I mentioned. Research. It is approved for use in patients with follicular lymphoma, diffuse large B-cell lymphoma, and chronic lymphocytic leukemia. The agent was only tested in patients who had 4 or more lines of therapy. This drug can cause some of the same side effects as other antibodies that target CD20, including infusion reactions (see above). The most common side effects are fever, chills, nausea, and rashes. Although [these agents] are not completely devoid of other toxicities, they focus predominantly on myeloma cells. 10th ed. Furthermore, T-cell subset composition and function determine the response to BiTE treatment.32,33 However, in the case of CAR T cells, T-cell composition and function at time of leukapheresis also influence CAR T function and are further modulated through patient- and disease-related parameters after transfusion. Then we come back with salvage therapy, usually with triplet regimens, of which there are a number approved by the FDA for patients who have had 1 to 3 prior lines of therapy. Right now, belantamab mafodotin is being given as a single agent. They demonstrated remarkable efficacy in B cell hematologic malignancies, thus paving the way for their development in solid tumors. How do you approach sequencing in your own practice? Essentially, [the trials] are taking all the known drugs that we currently use to treat patients with multiple myeloma and adding them to belantamab mafodotin in some form. We didnt have that option when I started. This drug can be used along with lenalidomide (see Immunomodulating drugs, below) to treat diffuse large B-cell lymphoma (DLBCL) that has come back or is no longer responding to other treatments, in people who cant have a stem cell transplant for some reason. There is a trial by the Multiple Myeloma Research Consortium that is using standard therapies and then doing next-generation sequencing to find out if there are specific gene mutations for which specific drugs can be directed toward. It is exciting to know that we have these monoclonal antibodies, which target specific surface components of myeloma cells.