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Ciltacabtagene Autoleucel Dosage

Medically reviewed by Drugs.com. Last updated on Nov 4, 2024.

Usual Adult Dose for Multiple Myeloma

0.5 to 1 x 10(6) chimeric antigen receptor (CAR)-positive viable T cells/kg IV once
Maximum dose: 1 x 10(8) CAR-positive viable T cells/single infusion

Comments:


Use: For the treatment of patients with relapsed/refractory multiple myeloma who have received at least 1 prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent, and are refractory to lenalidomide

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

MANAGEMENT OF SEVERE ADVERSE REACTIONS AFTER INFUSION OF THIS DRUG:
CYTOKINE RELEASE SYNDROME (CRS):


Management with tocilizumab/corticosteroids:

CRS Grading and Management Guidance:
Grade 1 CRS (temperature at least 38C [100.4F] due to CRS):

Grade 2 CRS (symptoms require and respond to moderate intervention; temperature at least 38C [due to CRS] with: hypotension not requiring vasopressors, and/or hypoxia requiring oxygen via cannula [low-flow nasal cannula is up to 6 L/min; high-flow nasal cannula is greater than 6 L/min]/blow-by, or grade 2 organ toxicity):

Grade 3 CRS (symptoms require and respond to aggressive intervention; temperature at least 38C [due to CRS] with: hypotension requiring 1 vasopressor with or without vasopressin, and/or hypoxia requiring oxygen via high-flow nasal cannula [greater than 6 L/min]/facemask/non-rebreather mask/Venturi mask, or grade 3 organ toxicity/grade 4 transaminitis):

Grade 4 CRS (life-threatening symptoms; requirements for ventilator support, continuous venovenous hemodialysis; temperature at least 38C [due to CRS] with: hypotension requiring multiple vasopressors [excluding vasopressin], and/or hypoxia requiring positive pressure [e.g., continuous positive airway pressure, bilevel positive airway pressure, intubation, mechanical ventilation], or grade 4 organ toxicity [excluding transaminitis]):

NEUROLOGIC TOXICITIES:

ICANS Grading and Management Guidance:
Grade 1 ICANS (immune effector cell-associated encephalopathy [ICE] score 7 to 9 or depressed level of consciousness [awakens spontaneously]):

Grade 2 ICANS (ICE score 3 to 6 or depressed level of consciousness [awakens to voice]):

Grade 3 ICANS (ICE score 0 to 2 [if ICE score is 0, but patient is arousable (e.g., awake with global aphasia) and able to perform assessment], or depressed level of consciousness [awakens only to tactile stimulus], or seizures [either any clinical seizure, focal or generalized, that resolves rapidly, or nonconvulsive seizures on electroencephalogram that resolve with intervention], or raised intracranial pressure [ICP] [focal/local edema on neuroimaging]):

Grade 4 ICANS (ICE score 0 [patient is unarousable and unable to perform ICE assessment] or depressed level of consciousness [either patient is unarousable or requires vigorous/repetitive tactile stimuli to arouse, or stupor/coma], or seizures [either life-threatening prolonged seizure (greater than 5 minutes), or repetitive clinical or electrical seizures without return to baseline in between], or motor findings [deep focal motor weakness such as hemiparesis or paraparesis], or raised ICP/cerebral edema, with signs/symptoms [e.g., diffuse cerebral edema on neuroimaging, decerebrate/decorticate posturing, cranial nerve VI palsy, papilledema, Cushing's triad]):

CRS AND NEUROLOGIC TOXICITIES:

Precautions

The US FDA requires a Risk Evaluation and Mitigation Strategy (REMS) for ciltacabtagene autoleucel. It includes elements to assure safe use and an implementation system. For additional information: www.accessdata.fda.gov/scripts/cder/rems/index.cfm

US BOXED WARNINGS:


CONTRAINDICATIONS: None

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:


Pretreatment:

Premedication:

Storage requirements:

Reconstitution/preparation techniques:

General:

Monitoring:

Patient advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.