Talquetamab was just approved 8/23 by the FDA for the treatment of myeloma. Approval was granted after a study called MonumenTAL-1 showed impressive response rates of over 70% in myeloma patients who had already received multiple prior treatments. Talquetamab belongs to a new class of cancer treatment drugs called bispecific antibodies. These treatments utilize the body’s own white blood cells, called T lymphocytes, to kill off cancer cells. The ability of T lymphocytes to seek and destroy cancer cells is the body’s best defense against cancer. Bispecific antibodies are designed to harness the power of T lymphocytes, and Talquetamab is the latest bispecific antibody to become available. It has an ingenious design with a very interesting mechanism of action. It binds to a protein on a myeloma cell called GPRC5D as well as to a protein on a T lymphocyte called CD3. By binding to both proteins simultaneously, it brings a T lymphocyte in close proximity to a myeloma cell. The T lymphocyte then initiates the destruction of the myeloma cell. 

Talquetmab is administered by subcutaneous injection every one to two weeks. Side effects include infections fever, fatigue, rash, nail changes, and diarrhea. The most concerning side effect is a condition called cytokine release syndrome (CRS) which can be severe and life-threatening. Fortunately, cytokine release syndrome can usually be diagnosed early and managed with steroids.

My Rating: 4 out of 5 stars

Talquetamab is an exciting new treatment for myeloma. T-cell therapies are here to stay! They are replacing traditional treatments of chemotherapy and bone marrow transplantation for lymphoma and myeloma. Talquetamab has a very impressive response rate of over 70% in myeloma patients who have received many prior treatment regimens. Despite its intriguing mechanism of action, it is not the first bispecific antibody approved for myeloma. Another drug, Teclistamab was approved 10/22 and had similar promising results. Talquietambab’s binding to the GPRC5D antigen on myeloma cells is unique.  If Talquitabma was the first bispecific antibody to be approved, I would have given it 5 stars. Bispecific antibodies will continue to evolve and be used sooner and more frequently in the treatment of myeloma and lymphoma. These therapies are poised to revolutionize cancer treatment!

Rating Guide 

5 stars: First drug in class/indication with a new mechanism of action, major improvement over existing treatments

4 stars: First drug in class/indication with a new mechanism of action, minor improvement over existing treatments

3 stars:  Additional drug in class/indication, offers some advantages over existing drugs in class 

2 stars:  Additional drug in class/indication, no real advantage over existing drugs

1 star:  Why was this even approved?