Talquetamab in Relapsed/Refractory Multiple Myeloma: Extended Follow-Up From MonumenTAL-1 and Real-World Outpatient Step-Up Dosing

Panelists discuss the unmet need for effective therapies in early-relapse multiple myeloma, where patients have exhausted standard treatments but do not yet qualify for bispecific therapies or CAR T cells.

Panelists discuss how talquetamab targets GPRC5D, which is heavily expressed on malignant plasma cells but not normal B cells, potentially explaining lower infection rates compared with B-cell maturation antigen (BCMA)–targeted therapies.

Panelists discuss how the extended follow-up data show unprecedented overall survival outcomes, with the every-2-week dosing appearing more tolerable and leading to better long-term outcomes than weekly dosing.

Panelists discuss how talquetamab demonstrates remarkable efficacy in patients previously exposed to T-cell redirecting (TCR) therapies, with response rates and duration comparable to treatment-naive patients.

Panelists discuss how talquetamab shows a more favorable safety profile with significantly lower high-grade infection rates compared with B-cell maturation antigen (BCMA)–directed bispecifics, although a new cerebellar toxicity signal requires monitoring.

Panelists discuss how cytokine release syndrome can be managed through early intervention with tocilizumab and steroids, and emphasize the importance of patient and staff education for safe outpatient administration.

Panelists discuss how findings from a Mayo Clinic retrospective study demonstrate the feasibility and safety of outpatient step-up dosing for talquetamab, with minimal hospitalizations required.

Panelists discuss how successful outpatient bispecific therapy requires robust infrastructure, including 24-hour monitoring capabilities, emergency department coordination, and liberal use of supportive medications.

Panelists discuss how talquetamab’s unique targeting mechanism offers significant advantages for patients with prior T-cell therapy exposure, whereas future research should focus on combination strategies and understanding primary resistance mechanisms.