Talquetamab in Multiple Myeloma: Efficacy, Safety, and Future Directions

• Published in: European journal of haematology 2024-11
• Main Authors: Labanca, Caterina, Martino, Enrica Antonia, Vigna, Ernesto, Bruzzese, Antonella, Mendicino, Francesco, Lucia, Eugenio, Olivito, Virginia, Puccio, Noemi, Neri, Antonino, Morabito, Fortunato, Gentile, Massimo
• Format: Article
• Language: English
• ISSN: 1600-0609; 1600-0609
• DOI: 10.1111/ejh.14353

Relapsed and refractory multiple myeloma (RRMM) remains a challenging condition despite advances in immunotherapies. Novel bispecific antibodies (BsAbs), including talquetamab, have shown promising efficacy in heavily pretreated patients, even those with triple- and penta-refractory disease. Talquetamab, recently approved by the FDA and EMA, is indicated for patients who have progressed after at least three or four prior lines of therapy (LOTs). Administered following a step-up dosing phase to manage cytokine release syndrome (CRS), talquetamab demonstrated a high overall response rate (ORR) of approximately 70%, including in patients previously treated with T-cell redirecting therapies. Its safety profile is consistent with other BsAbs, with hematologic adverse events such as anemia and neutropenia commonly reported, alongside unique on-target off-tumor toxicities like dysgeusia and skin-related events. Infections were less frequent compared to other BsAbs. The optimal sequencing of talquetamab and other therapies, including CAR-T cell treatments, remains an area of active research, as resistance to anti-BCMA therapies presents ongoing clinical challenges. Current trials are exploring the use of talquetamab in combination therapies, as well as therapeutic strategies post-treating progression. The real-world data further support talquetamab's efficacy, making it a valuable addition to the RRMM treatment landscape.