Neurological AEs Not Significantly Affiliated with Talquetamab Treatment

CancerNetwork® spoke with Samantha Shenoy, NP, MSN, a nurse practitioner at the Cancer Immunotherapy Clinic of University of California San Francisco Health (UCSF), about whether neurological effects were associated with talquetamab (Talvey) treatment for patients with multiple myeloma.

Shenoy began by acknowledging the potential for neurological effects to occur with talquetamab but stated that she has not personally seen instances herself. She expressed that UCSF conducts immune effector cell encephalopathy (ICE) scores every 12 hours, as is standard across other institutions, indicating that patients are assessed for the presence of neurological effects. Shenoy concluded by emphasizing that neurological effects may occur infrequently with bispecific antibodies.

In the phase 1/2 MonumenTAL-1 study (NCT03399799; NCT04634552) assessing talquetamab in heavily pretreated patients with multiple myeloma, investigators found that common toxicities included hypogammaglobulinemia, oral adverse effects (AEs), infections, anemia, and asthenia.

According to a review published in Haematologica, neurological effects were not listed among the most common AEs across dose levels. Neurotoxicity was reported in 10% and 5% of the 405 and 800 mcg talquetamab dose groups, respectively, all of which were low grade and resolved. In the phase 2 portion of the trial, immune effector cell-associated neurotoxicity syndrome occurred in 10.7% of patients who received talquetamab at 0.4 mg/kg and in 11% of those received the agent at 0.8 mg/kg.

Transcript:

There can be [neurological effects], but I personally have not seen it. It is a bispecific antibody, so neurotoxicity has occurred. It can occur, but it [occurs in] such a small percentage of patients. We, at our institution, as I am sure is similar to other institutions, do ICE scores every 12 hours. That is another role that nurses play…doing those ICE scores with patients and watching them very closely. Yes, it can occur. Is it an issue? Generally, not with bispecifics. A small percentage of patients experience neurotoxicity.

Reference

Liu L, Krishnan A. Talquetamab in multiple myeloma. Haematologica. 2024;109(3):718-724. doi:10.3324/haematol.2023.283931