Comprehensive Care: Essential Supportive Care Strategies for GPRC5D Bispecifics
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.
EP: 1.Karen's Story: Navigating Multiple Myeloma Treatment Lines
EP: 2.Understanding Bispecific Mechanisms and Dual Targeting in Multiple Myeloma: Why talquetamab for This Patient Journey
EP: 3.talquetamab Clinical Evidence: MONUMENTAL-1 to Real-World Data
EP: 4.Between Real-World Decisions: Selecting GPRC5D vs BCMA-Targeting Bispecific
EP: 5.Inside the Clinic: The Step-Up Strategy in talquetamab Therapy
EP: 6.Comprehensive Care: Essential Supportive Care Strategies for GPRC5D Bispecifics
Comprehensive Supportive Care Framework
The management of talquetamab therapy extends beyond the primary treatment to include robust supportive care strategies for managing unique adverse effects. The treatment center offers 24-hour clinic access for outpatient management, allowing patients with local caregiver support to complete step-up dosing without hospitalization. Some centers have begun prophylactic administration of tocilizumab before bispecific antibody treatment to prevent cytokine release syndrome, though this practice varies by institution. The approach emphasizes comprehensive patient education about expected toxicities, including skin, nail, and oral complications, with dietitian consultations to address taste changes and potential weight loss. This multidisciplinary support system enables effective outpatient management of most treatment-related complications.
Managing Treatment-Related Toxicities
Karen's experience with talquetamab adverse effects demonstrates the manageable nature of most complications. Complete loss of taste and smell represents her most significant challenge, though she maintains stable weight through protein-focused nutrition despite reduced eating enjoyment. Nail changes have been minimal and cosmetically manageable. She experiences intermittent diarrhea, particularly with high-fiber foods, though this likely stems from prior intensive chemotherapy and transplant-related intestinal damage rather than current treatment. Notably, Karen has maintained her hair throughout talquetamab therapy, contrasting with her 3 previous episodes of chemotherapy-induced hair loss. Her overall quality of life remains excellent, with health care providers noting her healthy appearance despite extensive treatment history.
Patient Philosophy and Future Perspectives
Karen advocates a pragmatic approach to treatment, advising against researching potential adverse effects online and instead addressing complications as they arise with medical team support. Her philosophy, developed through multiple transplant experiences, focuses on maintaining positivity while relying on faith, family, and medical expertise. She emphasizes concern about potential future research funding cuts that could limit access to innovative treatments, recognizing that continued research programs have been instrumental in extending her survival well beyond initial prognosis expectations.
