Talquetamab in relapsed refractory multiple myeloma: multi-institutional real-world study
Samer Al Hadidi, Anikó Szabó, Bhavesh Mohan Lal, Aishee Bag, Simon Zhen, Yetunde Ogunsesan, Evanka Annyapu, Binod Dhakal, Divaya Bhutani, Sharmilan Thanendrarajan, Maurizio Zangari, Anita D’Souza, Suzanne Lentzsch, Frits van Rhee, Rajshekhar Chakraborty, Carolina Schinke, Meera Mohan, Mansi Shah
Abstract
Talquetamab is a first-in-class GPRC5DxCD3 bispecific antibody approved for heavily pretreated relapsed/refractory multiple myeloma (RRMM), and this multicenter retrospective analysis of 114 RRMM patients treated between October 2023 and January 2025 demonstrated significant efficacy in a heavily pretreated population with median 6 prior therapies. All patients were triple-class refractory, 79% were penta-refractory, and 65% had received prior BCMA-targeted therapy. The overall response rate was 73%, including complete response in 26% and very good partial response in 26%, with six-month progression-free and overall survival rates of 56 and 86% respectively and median progression-free survival of 10 months. Common adverse events included cytokine release syndrome (CRS; 54% with grade ≥2 in 7.3%), infections (27%), and immune effector cell-associated neurotoxicity syndrome (9.8%). The 3-month cumulative infection incidence of 14% for both bacterial and viral infections, where 59% were viral and 41% bacterial, grade ≥3 infections occurred in 18%, and intravenous immunoglobulin was used in 61% of patients. Significant weight loss was observed, with a mean 8.8% decrease at 6 months. This real-world analysis confirms talquetamab's efficacy in heavily pretreated RRMM while highlighting notable toxicities, including progressive weight loss and infections, which require rigorous monitoring and proactive supportive care.