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Talquetamab: GPRC5D-CD3 Bispecific Antibody for Multiple Myeloma

Novel GPRC5D-targeted bispecific T-cell engager antibody for relapsed refractory multiple myeloma offering different target than BCMA-directed therapies

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Talquetamab: GPRC5D-CD3 Bispecific Antibody for Multiple Myeloma?

Talquetamab is FDA-approved GPRC5D-CD3 bispecific T-cell engager antibody for relapsed refractory multiple myeloma.

GPRC5D is highly expressed on plasma cells offering distinct target from BCMA-directed therapies.

MonumenTAL-1 trial showed approximately 70% overall response rate in heavily pretreated patients.

Important salvage option for patients who progressed on BCMA-targeted therapies.

Step-up dosing schedule mitigates cytokine release syndrome with subsequent weekly maintenance.

Symptoms

Cytokine release syndrome typically grade 1-2 during step-up dosing requires monitoring.
Skin toxicity including rash, dry skin, nail changes from GPRC5D expression on keratinocytes.
Oral toxicity with dysgeusia, dysphagia, weight loss from GPRC5D expression on tongue epithelium.
Infections, hypogammaglobulinemia, cytopenias common requiring monitoring and supportive care.
Neurotoxicity including ICANS-like syndrome requires recognition and management.

Risk Factors

Multiple myeloma after at least four prior lines of therapy including immunomodulatory drug, proteasome inhibitor, anti-CD38 antibody.
Triple-class refractory disease defines patients with very limited treatment options.
Prior BCMA-directed therapy is acceptable as GPRC5D represents distinct target.
Adequate organ function and performance status required for treatment.
Active infections require resolution before initiation given immunosuppressive nature.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Multiple myeloma patients with relapsed disease after multiple prior therapies including BCMA-directed warrant talquetamab consideration.
  • Specialized myeloma center referral with experienced multidisciplinary teams optimizes outcomes.
  • Severe cytokine release syndrome, neurotoxicity, infections require urgent evaluation.
  • Severe oral or skin toxicity may warrant dose modification or alternative therapy.
  • Disease progression on talquetamab may warrant alternative bispecific antibodies or clinical trials.

Treatment Methods

01
Step-up dosing with day 1 (0.01 mg/kg), day 4 (0.06 mg/kg), day 7 (0.4 mg/kg) before maintenance.
02
Maintenance dose 0.4 mg/kg weekly or 0.8 mg/kg biweekly subcutaneously until progression.
03
Hospitalization recommended for step-up doses to monitor for cytokine release syndrome.
04
Supportive care for oral toxicity including saliva substitutes, oral hygiene, nutritional support.
05
Comprehensive multidisciplinary care with experienced myeloma center, nutrition support for weight loss and dysgeusia, dermatology consultation for skin toxicity, dental evaluation, infection prophylaxis with antiviral, antibacterial, antifungal agents, IVIG replacement for hypogammaglobulinemia, monitoring for cytopenias, active surveillance for cytokine release syndrome and neurotoxicity, weekly subcutaneous administration with possible transition to biweekly dosing, response assessment with monoclonal protein and free light chain monitoring, salvage therapy planning at progression, and survivorship care addressing chronic effects of immunotherapy provides optimal outcomes for patients with heavily pretreated multiple myeloma.

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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