Bispecifics in Multiple Myeloma: Patient Journey and Clinical Insights

Panelists discuss how multiple myeloma patients navigate complex treatment journeys through multiple relapses, clinical trials, and the transformative potential of bispecific antibody therapies like talquetamab, with patient Karen Kehl sharing her 15-year experience from initial diagnosis through 19 treatment cycles including three transplants and various clinical trials.

Panelists discuss how bispecific antibodies like talquetamab work through dual targeting mechanisms that bring T-cells and cancer cells together for tumor destruction, with patient Karen sharing her decision-making process based on treatment convenience, manageable adverse effects like taste loss and nail changes, and the therapy's effectiveness after initial severe reactions during step-up dosing.

Panelists discuss how talquetamab demonstrates impressive clinical efficacy with approximately 70% response rates in the pivotal MONUMENTAL-1 trial, including patients previously treated with other immunotherapies, and how real-world data from studies like Real Italy corroborate these trial results with similar 67% response rates across diverse patient populations including high-risk subgroups.

Panelists discuss how clinical decision-making between GPRC5D and BCMA-targeting bispecific antibodies involves considering prior treatment history, target switching strategies, and patient-specific factors, with Karen explaining her preference for talquetamab's targeted approach that spares healthy cells, subcutaneous administration convenience, and the advantage of switching to a different antigen target after previous BCMA therapy.

Panelists discuss how the step-up dosing strategy for talquetamab involves graduated dose escalation from 0.01 to 0.06 mg/kg before reaching therapeutic levels to minimize severe cytokine release syndrome, with real-world data showing 85% to 86% of patients can safely receive outpatient step-up dosing, though one patient’s inpatient experience was chosen due to her drug allergies and travel distance considerations.

Panelists discuss how comprehensive supportive care strategies for GPRC5D bispecifics like talquetamab involve managing unique toxicities including taste and smell changes, skin and nail effects, and gastrointestinal issues, with one patient emphasizing her philosophy of addressing adverse effects as they arise rather than anticipating them, while highlighting the importance of continued research funding for innovative treatments that have extended her survival beyond initial prognosis.

Panelists discuss how patients with multiple myeloma can achieve excellent quality of life with bispecific therapies like talquetamab despite manageable adverse effects, with Karen sharing her advice to embrace treatment opportunities, accept a "new normal," and focus on the meaningful life experiences these innovative therapies enable, including her recent trip to Italy and time with 6 grandchildren she wouldn't have met without these advancing treatments.