On-target, off-tumor oral toxicities of talquetamab in heavily pretreated multiple myeloma - PubMed
4 hours ago
- #Talquetamab
- #Oral Toxicities
- #Multiple Myeloma
- Talquetamab (TAL) is a bispecific antibody targeting GPRC5D and CD3, showing ~70% response rates in heavily pretreated RRMM.
- TAL frequently causes on-target, off-tumor oral toxicities, including dysgeusia (72%), dry mouth (39%), and dysphagia (24%).
- Oral toxicities arise from immune activation against GPRC5D-expressing epithelial cells in the tongue, salivary glands, and keratinized tissues.
- Toxicities typically appear within weeks of starting TAL, persist, and can lead to significant weight loss (>6% of baseline).
- Management is supportive: corticosteroid mouthwashes, saliva stimulants, nutritional counseling, and dose adjustments, with limited efficacy.
- The TALISMAN trial is evaluating prophylactic interventions like dexamethasone mouthwash and pregabalin.
- Early recognition, preventive care, and multidisciplinary management are crucial to mitigate complications and preserve quality of life.