Mitigating time toxicity in lymphoma and multiple myeloma

Abstract

The concept of time toxicity in oncology refers to the presence of frequent healthcare-related interactions that can interfere with patient well-being. In this review, we examine several manifestations of time toxicity in non-Hodgkin lymphoma and multiple myeloma and discuss their impact on decision-making with patients. For example, time toxicity may influence the choice of chemoimmunotherapy versus lenalidomide-rituximab in follicular lymphoma. In myeloma, it may inform the optimal dosing schedule for proteasome inhibitors and bisphosphonates. In both malignancies, varying time toxicity profiles are a key distinction between chimeric antigen receptor T-cell therapies and bispecific antibodies. We outline the challenges with measuring time toxicity as a trial endpoint but discuss its importance as a consideration for patient care, both in standard-of-care settings and in clinical trials. Throughout the review, we highlight strategies to lower the time toxicity of therapies in lymphoma and myeloma without compromising their efficacy or patient safety.

Keywords:

• Time toxicity
• lymphoma
• follicular lymphoma
• multiple myeloma
• car-t
• bispecific antibodies

Acknowledgments

None.

Authorship statement

MD and RB wrote the first draft. All authors provided critical feedback and approved of the final draft of the manuscript.

Disclosure statement

M.D. reports honorarium: Intellisphere, LLC; research: Schrodinger, Inc. A.J.C. reports consulting: BMS, Adaptive; Research: Adaptive Biotechnologies, Harpoon, Nektar, BMS, Janssen, Sanofi, AbbVie. A.K.G. reports research funding from Merck, I-Mab bio, IgM Bio, Takeda, Gilead, Astra-Zeneca, Agios, Janssen, BMS, SeaGen, Teva, Genmab; Consultancy/Honoraria: Incyte, Kite, Morphosys/Incyte, ADCT, Acrotech, Merck, Karyopharm, Servier, Beigene, Cellectar, Janssen, SeaGen, Epizyme, I-Mab bio, Gilead, Genentech, Lilly, Caribou, Fresenius-Kabi, Scitek; Stock Options: Compliment Corporation. R.B. reports consulting: Adaptive, BMS, Caribou Biosciences, Genentech, Janssen, Karyopharm, Legend Biotech, Pfizer, Sanofi, SparkCures; Research: Novartis, Pack Health. The remaining authors have no interests to disclose.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.