MonumenTAL-1: Implications of Talquetamab, Prior TCR, and Sequencing for R/R MM
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.
The comparison between weekly and every-other-week dosing regimens reveals important clinical practice implications for talquetamab administration. Although weekly dosing (0.4 mg/kg) showed slightly higher initial response rates, particularly in patients with fewer prior lines of therapy, the every-other-week regimen (0.8 mg/kg) demonstrated superior progression-free survival and overall survival outcomes. This suggests that the every-other-week schedule may offer better tolerability, allowing patients to remain on treatment longer and derive continued benefit from ongoing therapy.
Clinical experience indicates that the every-other-week dosing schedule provides greater patient convenience while maintaining therapeutic efficacy. Many practitioners have adopted liberal dose modification strategies, allowing treatment delays for toxicity management and even extending dosing intervals to every 3 to 4 weeks for patients experiencing significant adverse effects. This flexibility in dosing represents a key advantage of bispecific antibody therapy, where continued treatment administration is necessary to maintain therapeutic benefit, unlike CAR T-cell therapy’s single-infusion approach.
The extended follow-up data reinforce that earlier intervention with effective therapies like talquetamab produces superior outcomes. Patients with fewer than 4 prior lines of therapy achieved 85% response rates with nearly 21-month median duration of response, emphasizing the importance of not delaying highly effective treatments. This observation aligns with the broader principle in multiple myeloma treatment: Moving effective therapies to earlier treatment lines improves patient outcomes and prevents significant patient attrition between successive treatment lines.
Newsletter
Stay up to date on recent advances in the multidisciplinary approach to cancer.
