TALVEY (talquetamab) demonstrated highly durable, longer-term responses in patients with relapsed or refractory multiple myeloma
June 17, 2024 – Biotechnology, Drug Discovery – multiple myeloma
24-month overall survival rate of 67% achieved with talquetamab 0.8mg/kg biweekly dosing in the phase 1/2 MonumenTAL-1 study
14 June 2024 – Beerse, Belgium – Janssen-Cilag International NV, a Johnson & Johnson company announced today that long-term data from the phase 1/2 MonumenTAL-1 study showed that with 20 to 30 months of median follow-up, triple class exposed patients with relapsed or refractory multiple myeloma (RRMM) who were treated with TALVEY (talquetamab) maintained high overall response rates (ORR) and durable responses, irrespective of whether they had received prior T-cell redirection therapy. These data, featured in a poster presentation at the 2024 European Hematology Association (EHA) Congress, taking place in Madrid from 13-16 June (Abstract #P915), demonstrate the efficacy and durability of talquetamab when used before or after chimeric antigen receptor T-cell (CAR T) therapy or bispecific antibody therapies in triple class exposed patients with RRMM.
“Results from the MonumenTAL-1 study continue to show deeper response levels and a longer duration of response in patients treated with either of the approved dose options of talquetamab, while the median overall survival has yet to be reached at two years,” said Dr Leo Rasche, attending physician on the myeloma service, University Hospital of Würzburg. “It is encouraging to see no notable increases in treatment-related discontinuations with this longer follow-up across cohorts.”
In MonumenTAL-1, 297 patients with no prior exposure to T cell redirection therapy received talquetamab at the recommended phase 2 dose (RP2D) of 0.8 mg/kg biweekly (Q2W) (n=154) or 0.4 mg/kg weekly (QW) (n=143). At a median follow-up of 23.4 months, patients in the Q2W cohort demonstrated a median duration of response (DOR) of 17.5 months, with median DOR not reached in patients with complete response (CR) or better. For patients in the QW arm, a median follow-up of 29.8 months showed a median DOR of 9.5 months, with a median DOR of 28.6 months in patients with a CR or better. At 24 months, 67.1% and 60.6% of patients were alive from the two dosing cohorts, respectively.
At a median follow-up of 20.5 months, talquetamab continued to show strong efficacy in patients with prior T-cell redirection therapy exposure (n=78), with 55.1% of patients achieving very good partial response (VGPR) or better and 57.3% alive at 24.2 months.
Infection rates remained lower than in studies of B cell maturation antigen (BCMA)-targeted bispecific antibodies, consistent with previous reports. No increase in grade 3/4 infections was observed with longer follow-up. GPRC5D associated adverse events (AEs) led to few dose reductions and discontinuations. One additional patient discontinued treatment due to AEs since the previous report. Weight loss, as assessed by vital signs, was evident early but stabilised and improved over time, including in patients with oral toxicities.
“There remains a high unmet need for patients with heavily pretreated multiple myeloma as with each new line of therapy, patients tend to experience decreased responses, resulting in more frequent relapses,” said Edmond Chan MBChB MD (Res), EMEA therapeutic area lead Haematology, Johnson & Johnson Innovative Medicine. “By targeting the novel receptor GPRC5D, and offering a biweekly dosing option, talquetamab plays an important role in the multiple myeloma treatment pathway. We remain focused on harnessing the potential of this pioneering therapy as we build on our ambition to transform outcomes for patients and eliminate cancer.”
Data from MonumenTAL-2 supports continued durable responses at one year, with investigational combination of talquetamab and pomalidomide, in patients with RRMM who had two or more prior lines of therapy
Longer follow-up from the Phase 1b MonumenTAL-2 study of the investigational use of talquetamab and pomalidomide showed deep responses and a manageable safety profile in patients with RRMM and support the potential to combine talquetamab with an immunomodulatory agent (IMiD). These updated data, from the first study of a regimen combining a GPRC5D-targeted therapy and an immunomodulatory agent, were featured as a poster presentation at the 2024 EHA Congress (Abstract #P911).
Patients in the Phase 1b MonumenTAL-2 study (n=35) were treated with subcutaneous (SC) talquetamab at the RP2D of 0.8 mg/kg Q2W (n=19) or 0.4 mg/kg QW (n=16) with step-up doses, plus 2.0 mg of oral pomalidomide daily. At a median follow-up of 16.8 months (range, 1.2-25.1), response-evaluable patients demonstrated an ORR of 88.6% (VGPR or better, 80%).
“With multiple dosing options and the ability to be used both before or after CAR-T therapy and BCMA bispecifics, talquetamab is an important and versatile treatment option for the treatment of relapsed or refractory multiple myeloma,” said Jordan Schecter MD, vice president, Disease Area Leader, Multiple Myeloma, at Johnson & Johnson Innovative Medicine. “The manageable rate of grade 3/4 infections seen in MonumenTAL-2 suggests the flexibility of talquetamab as a combination partner with an immunomodulatory agent for patients who continue to face limited treatment options with this complex haematologic disease.”
At 12 months, 80.4% of patients who achieved a CR or better maintained their response.2 The progression-free survival (PFS) rate at 12 months was 72.6%. The most common grade 3/4 haematologic AEs were neutropenia (57.1%), anaemia (25.7%), and thrombocytopenia (20%). Taste, nail, skin, and rash toxicities of any grade occurred in 85.7%, 68.6%, 74.3%, and 28.6% of patients, respectively; the majority were grade 1/2 with few discontinuations.2 Cytokine release syndrome (CRS) occurred in 74.3% and infections occurred in 80% (22.9% grade 3/4) of patients.

