Relapsed/Refractory Multiple Myeloma: Recognizing and Managing Neurologic Events With GPRC5D-Directed Therapy

Description - Dr. Ajai Chari and Dr. Rahul Banerjee discuss the evolving understanding of neurologic adverse events associated with GPRC5D-directed therapies in relapsed/refractory multiple myeloma (RRMM). The conversation focuses on reports of cerebellar and vestibular symptoms, including dizziness, ataxia, gait instability, dysarthria, and other neurologic findings that have emerged during clinical development. Dr. Banerjee reviews observations from MonumenTAL-3 and the broader GPRC5D experience, emphasizing the importance of distinguishing treatment-related neurologic events from more common causes of dizziness and imbalance frequently encountered in clinical practice. Dr. Chari shares insights from his experience with talquetamab, noting the relatively low incidence of confirmed cerebellar toxicity and highlighting the need for careful clinical evaluation when symptoms arise. The faculty discuss practical management strategies, including treatment interruption, assessment of contributing factors such as blood pressure medications and comorbidities, and collaboration with neurology specialists when appropriate. They conclude by emphasizing the importance of ongoing research to better characterize these uncommon but clinically relevant safety events as experience with GPRC5D-targeted therapies continues to grow in RRMM.