Talquetamab improves patient reported symptoms and health related quality of life in relapsed or refractory multiple myeloma Results from the phase 12 MonumenTAL1 study summary

Today on PACULit, we review the Phase 2 MonumenTAL-1 trial evaluating talquetamab, a bispecific antibody targeting GPRC5D and CD3, in relapsed or refractory multiple myeloma (RRMM). We discuss patient-reported outcomes and health-related quality of life data collected over up to ~42 weeks, using validated tools (EORTC QLQ-C30, EQ-5D-5L VAS, and PGIS). Key findings show an initial transient worsening in PROs during cycle 1, followed by meaningful improvements by cycle 21, including global health status up by 4.9 points and emotional functioning up by 12.5 points; pain decreased by 11.4 points and fatigue by 4.0 points. The single-arm, open-label design included 118 heavily pretreated patients, some with high-risk cytogenetics and extramedullary disease, highlighting real-world applicability. While PRO improvements align with disease control, limitations include lack of a comparator and a relatively small sample for long-term PROs, underscoring the need for real-world data and future comparative trials. Practical takeaways emphasize integrating PROs into clinical decisions, proactive symptom management, multidisciplinary care, and monitoring early adverse events such as cytokine release syndrome to maximize patient benefit. The discussion also covers dosing (0.8 mg/kg every other week), safety considerations, and potential future directions, including combination strategies and direct PRO comparisons in future studies.