Dr Matous on the Use Talquetamab/Pomalidomide in Relapsed/Refractory Multiple Myeloma

Jeffrey Matous, MD, member physician, Colorado Blood Cancer Institute, clinical professor of medicine, University of Colorado, discusses outcomes from the phase 1b MonumenTAL-2 trial (NCT05050097) with the combination of talquetamab-tgvs (Talvey) and pomalidomide (Pomalyst) in patients with relapsed/refractory multiple myeloma.

Results demonstrated that the median progression-free survival (PFS) was not reached in patients treated with 0.4 mg/kg of talquetamab plus pomalidomide every week (95% CI, 14.09- NR) as well as patients treated with 0.8 mg/kg of the study combination once every other week (95% CI, 7.43-NR). Additionally, talquetamab and pomalidomide demonstrated rapid, deep, and durable responses, with 93.8% of patients treated weekly and 84.2% of those treated biweekly experiencing benefit.

Importantly, there were no additional hematologic safety signals when talquetamab and pomalidomide were used in combination. Most of taste-, skin-, nail-, and rash-related adverse effects (AEs) were grade 1 or 2, with no instances of treatment discontinuation. A phase 3 trial investigating talquetamab and pomalidomide is planned for early 2024.

It is important to consider how combining a well-known agent with a novel therapeutic may impact toxicity, Matous begins. The hematologic AEs observed were consistent with the expected individual profiles of pomalidomide and talquetamab. These includedmanageable anemia and thrombocytopenia, he noted. Although cytokine release syndrome (CRS) was experienced by a majority of patients, it was mostly grade 1, and patients received tocilizumab for effective CRS management, Matous emphasizes.

Furthermore, infections—an established AE of concern for patients treated with BCMA-related bispecific antibodies—were relatively infrequent in this trial. This may be attributed to the absence of B-cell depletion with talquetamab and pomalidomide, he expands. This observation further substantiates the combination’s favorable safety profile. Overall, this research engenders future investigations of,and clinical applications for, talquetamab and pomalidomide, Matous concludes.