Posted: Friday, June 23, 2023
Therapeutic intervention with the bispecific antibody talquetamab, which targets the G protein–coupled receptor family C group 5 member D (GPRC5D), resulted in lower rates of infection for patients with relapsed or refractory multiple myeloma compared with the standard B-cell maturation antigen–targeted T-cell–based therapies, according to the results from the MonumenTAL-1 trial presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 8020). Patients had reduced rates of opportunistic infections and death, and these findings further support the use of talquetamab as a treatment strategy in this patient population, suggested Paula Rodríguez-Otero, MD, of the Clínica Universidad de Navarra, Pamplona, Spain, and colleagues.
A total of 339 patients with relapsed or refractory multiple myeloma were recruited for the study. All patients had previously received at least three lines of therapy. Patients were randomly assigned to receive 0.4 mg/kg of talquetamab weekly or 0.8 mg/kg biweekly. Whole-blood and serum samples were obtained to assess the quantity of B-cell subpopulations and the levels of immunoglobulin G (IgG). If patients experienced infection attributable to the treatment, they were managed according to local guidelines.
The study findings revealed decreased infection rates in patients receiving weekly talquetamab (58.0%) and biweekly talquetamab (64.8%) compared with those receiving standard therapy (70.6%). In addition, grade 3 or 4 infections were identified in 21.7% of patients receiving weekly talquetamab, 15.9% of patients receiving biweekly talquetamab, and 25.5% of patients receiving standard therapy. Furthermore, grade 3 or 4 neutropenia was observed in 30.8%, 22.1%, and 52.9% of patients receiving weekly talquetamab, biweekly talquetamab, and standard therapy, respectively. Moreover, measurement of IgG levels revealed hypogammaglobulinemia in 64.3% of patients receiving weekly talquetamab, 65.5% of those receiving biweekly talquetamab, and 70.6% of those receiving standard therapy.
Disclosure: Full full disclosures of the study authors, visit coi.asco.org.