What should myeloma patients know about talquetamab? (https://www.myeloma.org/videos/should-myeloma-patients-know-about-talquetamab)
Talquetamab Is A Bispecific Antibody Targeting GPRC5D
This week's "Ask Dr. Durie" comes from somone who has heard about a new immune therapy, a bispecific therapy, which is directed not against the traditional B-cell maturation antigen (BCMA), but another antigen on the surface of the myeloma called GPRC5D. A different target on the surface of the myeloma. The bispecific that she is interested in is talquetamab.
THE BOTTOM LINE: Talquetamab, a bispecific therapy targeting the GPRC5D antigen on myeloma cells, has demonstrated significant efficacy in treating resistant extramedullary disease.
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These are all very tricky. There are lots of "maps" available right now. This talquetamab though, is quite exciting. It is a bispecific, which means that it has two arms in the monoclonal antibody, maybe as monoclonal antibody. One arm is directed toward T cells against an antigen called CD3, and the other arm of the antibody is directed against the myeloma using the new antibody.
So this, this is an exciting new approach and has the potential to treat patients who are resistant to treatment directed against the BCMA antigen. So there has been tremendous interest in a recent study that was conducted and presented at the recent 2023 ASCO and EHA meetings called the RedirecTT-1 trial. And this was a trial in which teclistamab, which is a bispecific directed against BCMA, was given along with the talquetamab.
And this combination turned out to be remarkably effective. The overall results were truly striking and particularly of great interest is that they were very exciting in the area of resistant disease, particularly patients with so-called extramedullary disease. And this is myeloma, which is growing outside of the bone marrow. And in patients who have become resistant to other forms of therapy.
And in this setting, the overall response (OR) rate was over 85%. And the complete remission (CR) rate was around 25%. And so, this was remarkably effective in patients with this type of resistant extramedullary disease. And so the BOTTOM LINE is that talquetamab used alone, but particularly in this combination and possibly in some other kinds of combinations is remarkably effective.
Now, there are downsides. There are side effects with this type of an aggressive combination, including fatigue, increased risk of infection, and obviously reduced blood counts, anemia, reduced white cells, and or reduced blood platelets. However, the BOTTOM LINE is that this is a very good question and we are going to hear more about this bispecific antibody talk.
What are my mostly in combinations, combinations that may turn out to be very effective in patients with disease, with myeloma, which is resistant to other forms of therapy. So look forward to new and exciting results with this bispecific antibody.
Dr. Brian G.M. Durie (1942-2025) was the co-founder of the IMF. He was a Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels.