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New research · Hematology
Oncology research and treatment · 23h
Systematic reviewOncology research and treatment · 2026

Efficacy and Safety of Prophylactic Tocilizumab in Patients with Multiple Myeloma Receiving Bispecific Antibodies: A Systematic Review and Meta-Analysis.

Angeline Tancherla, Fernando Dharmaraja, Andree Kurniawan
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HematologySystematic review

Prophylactic tocilizumab is associated with lower all-grade cytokine release syndrome.

Efficacy and Safety of Prophylactic Tocilizumab in Patients with Multiple Myeloma Receiving Bispecific Antibodies: A Systematic Review and Meta-Analysis.

Angeline Tancherla et al. · Oncology research and treatment · 2026
Background

Cytokine release syndrome (CRS) remains a major toxicity associated with bispecific antibody (BsAb) therapy in relapsed/refractory multiple myeloma (RRMM).

Methods

Databases were searched for studies evaluating prophylactic tocilizumab in patients with RRMM receiving BsAb therapy.

n = 704 patients
Results

preventive tocilizumab is linked to a much lower risk of cytokine release syndrome

RR by subgroup · 95% CI
null = 1
all-grade CRS incidence
0.29
although this did not reach statistical
0.22
More results

A pooled analysis of two studies evaluating grade ≥2 CRS showed a numerically lower risk with prophylaxis, although this did not reach statistical significance (RR 0.22, 95% CI 0.02-2.57; p = 0.23).

CRS events were predominantly low grade, short-lived, and occurred during step-up dosing.

More results

ICANS was uncommon, and infection and hematologic toxicity rates were comparable between groups.

No signal of reduced overall response rate was observed (RR 1.21, 95% CI 0.91-1.62; p = 0.19).

“
Conclusion · 1 of 2

Prophylactic tocilizumab is associated with lower CRS incidence without compromising efficacy in RRMM patients receiving BsAb therapy.

Conclusion · 2 of 2

Prospective randomized studies are warranted to confirm these findings and refine prophylactic strategies.

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