Real World Outcomes with Talquetamab, a T-Cell-Redirecting GPRC5D Bispecific Antibody: A Single Center Experience for Relapsed/ Refractory Multiple Myeloma (RRMM)

• Published in: Blood 2024-11, Vol.144 (Supplement 1), p.7047-7047
• Main Authors: Gill, Sarvarinder Kaur, Fleming, Erika, Gebre, Helen, Bangolo, Ayrton I, Siegel, David S., Vesole, David H., Biran, Noa, Parmar, Harsh, Phull, Pooja
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2024-210350

Background: Despite the advent of novel therapies including chimeric antigen receptor T-cell (CAR-T) therapy that have provided unprecedented clinical benefit for patients with RRMM, multiple myeloma remains an incurable malignancy in which patients eventually experience relapse. G protein-coupled receptor, family C, group 5, member D (GPRC5D) is an orphan receptor that is expressed in malignant plasma cells. Talquetamab, a bispecific IgG4 antibody, binds to both GPRC5D and CD3 to induce killing of GPRC5D-expressing myeloma cells by means of T-cell recruitment and activation. In this single center retrospective study, we aim to evaluate the real-world effectiveness and outcomes of patients who received talquetamab since the drug received FDA approval in August 2023. Methods: Following institutional review board approval, we included all patients with MM who were treated with commercially approved Talquetamab therapy. Demographic characteristics, molecular studies, treatment and response information were recorded and included in the study. Safety outcomes included the incidence and severity of adverse events (AEs). AEs were graded using National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 (NCI-CTCAE 5.0). Cytokine release syndrome (CRS) and immune effector associated neurotoxicity syndrome (ICANS) were graded as per the American Society for Transplantation and Cellular Therapy criteria. Efficacy outcomes included overall response rates (ORR), progression free survival (PFS), overall survival (OS) and best response achieved. Survival analysis was performed using the Kaplan-Meir method including PFS and OS. The IMW response criteria were utilized for response assessment. Results: We identified 27 pts who were treated consecutively at Hackensack University Medical Center with talquetamab between September 2023 and May 2024. Pts had a median age of 72 years (range 45-81). Importantly, four (15%) pts had CNS involvement and six (22%) pts had extramedullary disease. Pts had received a median of 8 (range 3-19) prior lines of therapy. 26(94.3%) pts were triple class refractory, and all except two pts (98.1%) had a prior autologous stem cell transplant (ASCT). Fourteen (52%) pts had high-risk FISH defined as those with t(4;14), t(14;16), 17p(-) or 1q(+), eighteen (67%) pts were R-ISS-2 or 3 at diagnosis. Thirteen (59%) pts had prior T-cell receptor therapy with twelve (44%) pts having prior CAR-T, five (19%) pts had prior Bispecific T