With the introduction of many new therapies, the management of multiple myeloma (MM) is rapidly changing. Clinicians would benefit from additional education on the available agents and understanding how to individualize treatment to improve outcomes of patients with MM.

The advances in immunotherapy in cancer care are ever-changing and complex. It is integral for nurses to have current knowledge of bispecific antibody therapies in hematologic malignancies and to understand their mechanisms of action and side effect profiles to support optimal patient outcomes.

With improvement in treatment options and supportive care, patients with multiple myeloma (MM) are living longer. The majority of patients with MM are at risk for osteolytic bone lesions, osteoporosis, and infections among other complications. The outcomes of patients with MM can be improved by effective management of infections; recognizing and managing side effects of bone modifying therapy; and implementing plans of care to promote health, safety, mobility, and overall improved quality of life.

While there have been significant advancements in the management of multiple myeloma (MM) over the past decade, it is important to recognize that disparities in treatment and survival persist. Identifying patients who may be at risk for health inequity and implementing strategies to improve access and quality of care can help bridge current practice gaps and ensure equitable outcomes for all patients.

Relapsed/refractory multiple myeloma is a challenging disease state to treat and there are now numerous approved agents for this patient population. Clinicians would greatly benefit from additional education on the available agents and their place in therapy given the different modalities of treatment employed in relapsed/refractory disease.

Clinicians must understand the treatment evolution and guidelines for when to administer two-, three- or four- drug regimens as initial therapy in the context of the patient's therapeutic and disease history. Understanding how to individualize treatment will improve outcomes of patients with newly diagnosed MM.

A better understanding of the pathogenesis of hematologic malignancies has led to the identification of new cytogenetic and molecular markers that distinguish between the various subtypes of hematologic malignancies. Informing hematologists and oncologists about the updated WHO5 classification and the new ICC will aid in the accurate diagnosis and development of a treatment plan to the specific subtype of hematologic malignancy.

While cytokine release syndrome and neurotoxicity are widely reported as the most common acute CAR T-cell toxicities, it is essential for providers to understand that CAR T-cell therapy may also result in other toxicities (such as infections, cytopenias, or B-cell aplasia), some of which could persist for months to years after infusion.

Bispecific T-cell engagers are emerging as promising treatment options for patients with heavily pretreated multiple myeloma and B-cell lymphomas, especially for patients with disease relapse following CAR T-cell therapy. Careful monitoring of adverse events and implementing appropriate supportive care strategies is important to maximize the clinical benefit associated with bispecific T-cell engager therapy.

Understanding optimal sequencing for patients with relapsed/refractory multiple myeloma can be a challenge in clinical practice. A uniform treatment approach cannot be applied to all patients. Physicians and other care providers must understand the evolving therapeutic options in the context of the patient's therapeutic and disease history to navigate through the complex treatment landscape.