Insights From MonumenTAL-1: Impressions of Updated Efficacy Outcomes
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.
The extended follow-up data from MonumenTAL-1 demonstrate impressive long-term outcomes with talquetamab therapy. Overall response rates reached 74% across all cohorts, with remarkable consistency between dosing regimens (74% for 0.4 mg/kg weekly vs 69% for 0.8 mg/kg every other week). Notably, patients with prior T-cell redirecting therapy exposure achieved a 67% response rate, nearly matching the outcomes seen in treatment-naive patients, indicating retained efficacy despite previous exposure to similar mechanisms of action.
The durability of responses proved particularly striking, with median duration of response approaching 18 to 19 months across cohorts. The 0.8-mg/kg every-other-week regimen showed superior durability with an 18-month median duration of response, whereas the prior T-cell redirecting therapy cohort achieved a 19.2-month median duration. These extended response durations represent significant improvements over historical controls and demonstrate the potential for durable disease control with GPRC5D targeting.
Perhaps most importantly, the 36-month overall survival data revealed unprecedented outcomes, with 61% of T-cell redirecting therapy-naive patients and 45% of previously exposed patients remaining alive at 3 years. This survival benefit represents a substantial improvement over historical benchmarks, where similar patient populations typically survived less than 1 year. The data strongly support the clinical benefit of GPRC5D targeting, particularly for patients with limited treatment options and prior exposure to T-cell redirecting therapies.
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