Correct usage and medication instructions of teclistamab

Teritolumab (Teclistamab) is a new bispecific T cell-linked antibody, mainly used to treat patients with relapsed or refractory multiple myeloma (RRMM). The drug works by simultaneously targeting CD3 (T cell surface) and BCMA (B< span>Cell maturation antigen, myeloma cell surface) two targets, so that the patient's own T cells can be "pulled" to the surface of tumor cells, thereby activating the T cell killing function and inducing myeloma cell lysis and clearance. Due to its unique mechanism and significant effect, teritusumab has become a new hope for immunotherapy of multiple myeloma. The following are the correct usage and medication instructions for the reference of patients and medical staff.

1. Medication form and administration method

Territuzumab is an injectable biological preparation. The commonly used international specification is 153 mg/1.7 ml. It is usually administered by subcutaneous injection (subcutaneous injection). Compared with intravenous infusion, subcutaneous injection has the advantages of being easier to operate, more comfortable for the patient, and easier to control side effects. The bioavailability of subcutaneous injection has been proven to be sufficient to support clinically required concentrations and is therefore the recommended dosing method.

In order to reduce the risk of **cytokine release syndrome (CRS)** that may occur during initial treatment, a "dose escalation strategy (step-up dosing)" is usually adopted clinically to establish patient tolerance. For example, before starting a full treatment cycle, inject at a smaller dose (such as day 10.06 mg/kg, day 20.3 mg/kg), after observing no serious adverse reactions, start the maintenance treatment dose (such as 1.5 mg/kg) on day 4 and administer it once a week. The specific dose will be determined by a doctor based on weight, condition, and side effects management.

2. Medication cycle and duration

Teritusumab is usually continued on a once-weekly schedule until disease progression or unacceptable adverse effects. In some patients, if stable complete remission is achieved and maintained for a long time, doctors may consider adjusting the dosing interval, such as once every two weeks or suspending dosing. The specific decision needs to be based on efficacy evaluation and immune-related indicators. The duration of the entire course of treatment may range from a few months to more than a year.

Since this drug acts on the immune system, patients need to undergo regular hematology tests, liver and kidney function tests, and immune function assessments during the medication period to ensure the safety of the medication and to detect potential toxic reactions in a timely manner.

3. Side effects that require special attention during medication

1.Cytokine release syndrome (CRS)

CRSis the most common adverse reaction of Teclistamab and usually occurs within 48 hours of the first dose. Typical symptoms include fever, chills, hypotension, shortness of breath, etc. For this reason, it is recommended that patients be observed in the hospital for at least 48 hours during the initial dose period (step-up phase). Symptomatic drugs such as tocilizumab (Tocilizumab) can be used for intervention when necessary.

2.Nervous system toxicity (ICANS)

Teritusumab may also cause neurotoxicity related to immune effects, such as disturbance of consciousness, language disorder, epilepsy, etc. Although the incidence is relatively low, high vigilance is required. Early recognition, discontinuation of medication, and symptomatic treatment can reduce risk.

3.Infection risk

Because T cells are activated and the BCMA target also affects normal plasma cells, patients are at higher risk of infection, especially viral and fungal infections. Therefore, it is recommended to use preventive antibiotics and antiviral drugs during the medication period, and supplement immune globulin when necessary.

4.Hematological toxicity

Including neutropenia, anemia, thrombocytopenia, etc., it is necessary to monitor blood routine and adjust the dose or suspend medication according to the grade.

4. Patient medication guidance and suggestions

1.Strictly adhere to the administration time and dosage: Teclistamab should be injected regularly under the guidance of a professional doctor. It is strictly prohibited to change the dosage or stop the medication on your own. It is recommended that the first dose and dose escalation be performed in an experienced cancer center.

2.Preparation before medication: Before the first dose and the dose escalation period, doctors may recommend the use of antihistamines, acetaminophen and glucocorticoids as pretreatment to reduce the incidence and severity of CRS.

3.Maintain observation and follow-up: Even if symptoms improve, regular laboratory tests and imaging evaluations are still required. If fever, fatigue, mental changes, etc. occur, you should seek medical treatment immediately without delay.

4. Preventing infection and maintaining nutrition: During the period of medication, the patient's immunity declines, so he or she needs to avoid contact with crowded places, pay attention to oral and respiratory hygiene, and appropriately increase protein intake in the diet, which will help improve the body's immunity.

Teritusumab is a revolutionary immunotherapy drug that has shown excellent efficacy in the treatment of multiple myeloma, especially for patients who have failed multiple lines of treatment. Due to its complex mechanism of action and high potential risk of side effects, standardized medication and close monitoring are particularly important. Through standard dose escalation strategies, professional side effect management and individualized treatment plans, teritusumab is expected to bring significant survival benefits to more patients with refractory myeloma. During the period of using this drug, patients should actively cooperate with their doctors, pay attention to drug reactions, scientifically manage the disease, and maximize the efficacy while ensuring drug safety.

Reference materials:https://www.drugs.com/