Talquetamab
Talquetamab is the first drug against GPRC5D, a second myeloma target used after BCMA therapies stop working; taste and skin side effects are its signature.
MonumenTAL-1: ORR ~73% at both weekly and biweekly doses, including ~65% in patients after prior T-cell redirection. Accelerated approval August 2023. Combinations with teclistamab (RedirecTT-1: ORR ~80% with extramedullary disease) and daratumumab (TRIMM-2) in phase 3 (MonumenTAL-3/-5/-6).
- Route
- Subcutaneous
- Schedule
- Step-up then 0.4 mg/kg weekly or 0.8 mg/kg every 2 weeks
- Monitoring
- CRS, dysgeusia and weight loss, skin/nail toxicity, infections (lower than BCMA agents)
- Medicare
- Part B (clinician-administered)
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Step-up dosing is often started in hospital (Part A) because of cytokine release syndrome monitoring, then continued in the outpatient setting.
- Commercial insurance
- covered with prior authorisation
Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.
- Assistance programmes
- Johnson & Johnson withMe
- Johnson & Johnson Patient Assistance Foundation
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
- Leukemia & Lymphoma Society financial support
20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
- Notes
- Licensed 2024; NICE appraisal 2024-25. Check NICE.
Sources: NICE search: talquetamab. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2023 | Relapsed/refractory myeloma after ≥4 lines (accelerated) |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Dysgeusia | 72% | — |
| Skin toxicity | 67% | — |
| Nail disorders | 54% | — |
| Cytokine release syndrome | 77% | 2% |
MonumenTAL-1. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Landmark trials in OnCo
Elranatamab confirmed that BCMA bispecifics are a class, not a one-off, and its protocol-built dose reduction after response set a precedent for lowering the immunosuppressive burden of T-cell engagers. Patients now have two approved BCMA bispecifics and one against GPRC5D (talquetamab). Choosing between them, and sequencing them with CAR-T, remains guided by availability and toxicity profile rather than head-to-head data.
Teclistamab showed that an off-the-shelf bispecific can approach CAR-T-like response rates in late myeloma, giving patients who cannot wait for or access cell therapy a real option. It also exposed the price: prolonged T-cell engagement causes profound immunosuppression, so infection prophylaxis and immunoglobulin replacement are now routine. Less frequent dosing after response is being adopted to reduce this burden.
Latest papers
topQuery for this drug: (TITLE:"Talquetamab" OR ABSTRACT:"Talquetamab" OR TITLE:"Talvey" OR ABSTRACT:"Talvey") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Talquetamab, not a curated reading list.