Clinicians mitigate Belantamab's ocular toxicity by extending dosing intervals to every 8-12 weeks. This is effective due to the drug's long half-life and often allows vision to recover between doses, sometimes even deepening responses without sacrificing disease control.

Current Quality of Life (QoL) assessments in cancer trials fail to capture severe, long-term toxicities. They are designed for short-term effects and data collection often ceases after a patient experiences a life-changing adverse event, thus painting an inaccurately rosy picture of a drug's tolerability.

To improve long-term tolerability of amivantamab, some experts advocate for a "marathon, not a sprint" approach. This involves aggressive dose holds or reductions at the earliest signs of toxicity, even low-grade, to prevent side effects from escalating and ensure patients can remain on effective therapy longer.

A critical reason patients stop ADC treatments is the burden of side effects like skin toxicity or GI issues, not just disease progression. This underscores the urgent need to develop ADCs with better safety profiles, enabling patients to stay on effective therapy longer.

Though ADCs like Sacituzumab Govitekan cause notable side effects like diarrhea and neutropenia, patient-reported outcome data shows they provide a meaningful and sustained improvement in quality of life compared to standard chemotherapy. This was observed even with longer treatment durations and lower discontinuation rates.

Long-term data from the DEFI trial shows continuing niragasestat beyond one year increases overall response rates from 34% to 46%. Counterintuitively, the incidence and severity of common side effects like diarrhea and nausea tend to diminish after the first year of treatment.

The most significant, lasting effects of treatment toxicities on quality of life often become most apparent *after* therapy has concluded. Clinical trials that stop collecting data shortly after treatment completion miss this crucial long-term impact, underestimating the true burden of side effects.

Current quality of life assessments in trials are inadequate for immunotherapy. They fail to track life-altering toxicities that persist long after patients stop treatment, as data collection often ceases. This systemic flaw dilutes the true patient burden and calls for new methods to measure long-term, post-treatment quality of life.

Real-world data shows higher rates of cytokine release syndrome (CRS) with tarlatumab than trials reported, especially in sicker patients. Despite this, the drug's risk-benefit profile is often better than chemotherapy for poor-performance patients, sometimes leading to durable, life-changing outcomes where no other options exist.