Visual abstract | MonumenTAL-1: Long-term follow-up of talquetamab for the treatment of RRMM

The Multiple Myeloma Hub presents a visual abstract of the phase I/II MonumenTAL-1 study (NCT04634552), which evaluated the efficacy and safety of talquetamab, a G-protein coupled receptor family C group 5 member D (GPRC5D)-directed bispecific T-cell engager, for the treatment of patients with relapsed/refractory multiple myeloma (RRMM). MonumenTAL-1 assessed talquetamab across various dosing schedules and analyzed how prior T-cell redirection (TCR) therapy influenced clinical outcomes and toxicity.

Key takeaways

• Talquetamab is the first approved bispecific T-cell engager, targeting GPRC5D in patients with RRMM.

• With longer-term follow-up, talquetamab continued to demonstrate deep, durable responses and a consistent safety profile across dosing schedules and patient subgroups, including those with prior TCR.

• The highest rates of response were observed in patients naïve to prior TCR at 74.1% with weekly dosing (QW) and 69.5% with dosing every 2 weeks (Q2W), compared with 66.7% in patients with prior TCR.

• Durability of response was longer in patients receiving the Q2W regimen, with a median duration of response of 17.5 months in the Q2W cohort vs 9.5 months in the QW cohort and 19.2 months in patients with prior TCR QW and Q2W.

• Progression-free survival and overall survival were also increased in the cohort of patients naïve to TCR, dosed Q2W.

• The safety profile was consistent with prior reports, with no new safety signals identified in longer-term follow-up.

• There were no new treatment discontinuations as a result of GPRC5D-related adverse events.

• Flexibility in dosing schedules allows for individualized treatment decisions, balancing efficacy, tolerability, and patient preference.

• These data support the continued use of talquetamab as an effective non-B-cell maturation antigen (BCMA) option, expanding options for patients who are heavily pretreated.