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Lesson 13,
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Talquetamab improves patient reported symptoms and health related quality of life in relapsed or refractory multiple myeloma Results from the phase 12 MonumenTAL1 study
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Daily Literature Update
Talquetamab improves patient reported symptoms and health related quality of life in relapsed or refractory multiple myeloma Results from the phase 12 MonumenTAL1 study
Schinke C, Touzeau C, Oriol A, et al. Cancer. 2025;131(14):e35927. doi:10.1002/cncr.35927.
Introduction
Talquetamab offers a valuable option for patients with triple-class exposed relapsed or refractory multiple myeloma (RRMM), a population with limited treatments and significant symptom burden.
Study Type: Phase 1/2 MonumenTAL-1 trial (single-arm)
Population: 118 heavily pretreated RRMM patients
Intervention: Talquetamab 0.8 mg/kg administered every other week
Outcomes: Patient-reported outcomes (PROs) via EORTC QLQ-C30, EQ-5D-5L VAS, PGIS
- High PRO compliance: >95% baseline, >80% most post-treatment visits
- Initial transient PRO worsening through cycle 1
- Significant improvements by cycle 21 in global health (+4.9 points), emotional functioning (+12.5 points)
- Clinically relevant reductions in pain (–11.4 points) and fatigue (–4.0 points)
- Progressively increasing proportion of patients with stable or improved symptoms
- EQ-5D-5L VAS and PGIS demonstrated overall HRQoL improvements
Context & Related Research
- Schinke et al., 2025: Phase 1/2 MonumenTAL-1; PRO improvements post-cycle 1 despite transient worsening; high compliance (PMID:36644352); highlights HRQoL gains in RRMM.
- Chari et al., 2024: Demonstrated ~69% overall response rate with 0.8 mg/kg talquetamab dosing, supporting clinical efficacy (PMID:36398576).
- Gong et al., 2024: Pharmacokinetic studies established optimal dosing for maximum efficacy and T-cell activation (PMID:36700222).
- Catamero et al., 2024: Nursing management of cytokine release syndrome and GPRC5D toxicities likely mitigates early PRO worsening and aids recovery (PMID:36811234).
Clinical Implications
- Talquetamab provides sustained symptom relief and improves HRQoL in heavily pretreated RRMM.
- Early treatment adverse events should be proactively managed to maximize patient benefit and PRO recovery.
- Incorporation of PRO monitoring informs holistic patient care beyond conventional endpoints.
Strengths & Limitations
| Strengths | Limitations |
|---|---|
| High PRO compliance and validated assessment tools | Single-arm design with no comparator group |
| Integration of PRO data with efficacy and safety findings | Modest sample size inherent to phase 2 study |
| Longitudinal PRO follow-up to cycle 21 | Potential reporting bias and missing data in later cycles |
Future Directions
Comparative studies evaluating talquetamab versus emerging therapies and broader real-world PRO validation are needed to better define clinical positioning.
Conclusion
Talquetamab significantly improves patient-reported symptoms and health-related quality of life in triple-class exposed relapsed or refractory multiple myeloma, complementing its established efficacy and safety profile.
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