Talquetamab 治疗复发/难治性多发性骨髓瘤：疗效、安全性与真实世界证据综述

INTRODUCTION: Talquetamab is a GPRC5DxCD3 T-cell-engaging bispecific antibody approved for the treatment of relapsed/refractory multiple myeloma. GPRC5D represents a novel and emerging target in antimyeloma therapy, and there is substantial drug development for new therapies targeting this antigen. AREAS COVERED: Herein, we review the efficacy, safety, and future development directions of talquetamab, including emerging talquetamab-based combination regimens and ongoing clinical trials.

We will also review the growing landscape of GPRC5D-targeting immunotherapies in development for multiple myeloma, including CAR-T and trispecific antibodies. EXPERT OPINION: Talquetamab, a GPRC5D-targeting bispecific antibody, was FDA-approved in 2023 for relapsed/refractory multiple myeloma after 4 or more prior lines of therapy. In contrast to the historic overall response rate (ORR) of 29. 5%, talquetamab monotherapy achieved a promising ORR of ~70% in a triple-class-exposed population.

Real-world evidence supports talquetamab as a bridging therapy to CAR-T. Notable adverse drug reactions include CRS, dysgeusia, nail/skin toxicities, and infections, which are often manageable but can be persistent.

Sequencing studies suggest talquetamab retains efficacy before or after BCMA-directed therapies without diminishing effectiveness. Potential future directions for talquetamab include combination regimens with other antimyeloma therapies. Additional GPRC5D-directed therapies are also under development, including trispecific antibodies and CAR-T.