Diving Deeper: Long-Term Safety With Talquetamab

EP: 1.Setting the Stage and New Milestones in Talquetamab Data

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EP: 2.Diving Deeper: Long-Term Safety With Talquetamab

Recent advancements in bispecific antibody therapies for relapsed/refractory multiple myeloma have shown promising results, particularly with a GPRC5D-targeting bispecific antibody. Clinical trials have demonstrated high response rates around 70%, with improved durability of response when administered every two weeks compared to weekly dosing. Notably, patients previously treated with B-cell maturation antigen (BCMA)–targeted therapies also responded well, suggesting that sequencing these immune therapies can extend survival and improve outcomes. Combining bispecifics or moving their use to earlier treatment lines are active areas of research aiming to enhance efficacy further.

When selecting between BCMA-targeting and GPRC5D-targeting bispecific antibodies, individual patient factors play a crucial role. Patients with a history of lung disease, prior drug toxicity, smoking, or other conditions that increase infection risk may benefit from starting treatment with the GPRC5D-targeting antibody, which appears to have a more favorable infection safety profile. Severe infections are less common and less fatal with this agent compared to BCMA-directed therapies. However, patients susceptible to infections are often frail and malnourished, which complicates treatment choices and management of adverse effects such as taste disturbances.

To mitigate infection risks, prophylactic measures including monthly intravenous immunoglobulin and antibiotics to prevent opportunistic infections are recommended for both therapies. Infection susceptibility typically becomes apparent within the first few months of treatment, guiding ongoing management decisions. Ultimately, therapy choice involves a shared decision-making process between clinician and patient, balancing efficacy, safety, and individual vulnerabilities. The availability of these bispecific antibodies with distinct toxicity profiles enables personalized approaches to optimize outcomes in multiple myeloma care.