Talquetamab Efficacy & Toxicity in African American Myeloma Patients | Carolina Schinke, MD | #ASH24

Hello.

My name is Carolina Schinke from the University of Arkansas.

Where I treat, multiple myeloma patients.

Another work we're presenting here at ASH is, was done within a clinical trial, the TAL-1 trial, which tested the talquetamab, the GPRC5D bispecific antibody, which is now FDA approved in multiple myeloma patients.

In fact, this trial led to the approval of talquetamab, in multiple myeloma patients, who have had already at least 3 or 4 lines of treatment.

In this particular work, which I'm presenting, it's not so much on, you know, general outcomes, I think that has been already presented. We know that talquetamab works very well. 70% overall response rate. A prolonged, lengthy 12-month progression-free and overall survival.

But what we really are focusing on now is other differences in toxicity and efficacy, in African-American patients compared to Caucasians.

Research now, which is actually looking at response rates, between races, has become really prominent because we've seen that there might be different effects depending, you know, what, what your genetic background is and, for talquetamab, it's particularly important, because it attacks or it targets GPRC5D.

It's a long name. It's a protein. It's a target on the plasma cells, on myeloma cells. That, the antibody, the bispecific antibody binds to and then the immune cells come and destroy the myeloma cells.

However, it's not solely expressed on plasma cells. It's also expressed on skin cells and on taste buds.

And so naturally, side effects from the drug are going to be related to the skin and the taste.

So we see, patients having skin rashes, itchiness, dryness as well as what we call dysgeusia. Yeah. So change in taste or dry mouth. And these are the most prominent side effects of talquetamab.

Why that might matter more in black patients. So in Black Americans is because their skin tends to have more layers. So it's thicker. So they have more of this protein expressed probably on the skin, maybe also on the taste buds.

And so the question is, is there a difference in side effects? In this particular work what we do, which we did, is we looked at the clinical trial and looked at, Black American patients and tried to see, compared to the white patients, is there a difference?

And it's just, you know, overall, it's only a small proportion of patients who were Black Americans on the trial, roughly in phase one and two, roughly only 10%. That occurs for, you know, 17 patients out of 100 and plus patients. So it's not a big population.

And the results, you know, are not statistically relevant. So we couldn't really get good statistics just because it is a small population. But it gives us an idea, a little bit of what happens.

And what we saw is that talquetamab, it works well both in Caucasians as well as in African or Black Americans.

There were no side effects in terms of, you know, hematologic toxicities. So cytopenias were similar. Cytokine release syndrome was similar between, Black and White Americans, but as we kind of thought, there were more skin-related toxicities as well as taste-related toxicities in Black Americans.

And this was reported in more than 90% Black Americans, whereas in Caucasians it's still common 70 to 80%, but maybe a little bit less. Whereas efficacy, we didn't really see a lot of difference. It works again, both very well in Black and White Americans.

So it's something to keep in mind. The side effect profile is something to keep in mind when you go on to treat patients with these bispecific antibodies.

So if, you know, depending on what race they are you might want to choose one over the other. So we have talquetamab which is the GPRC5D. We have other bispecific antibodies which target other proteins.

And so maybe to prevent these side effects that particularly seem to be more evident in Black Americans, maybe we can choose, another bispecific antibody in these patients.

I think that would maybe be a conclusion. However, again, the data is very early on. It's still quite premature. It was a very small patient population.

There is a chance that, maybe there are more side effects in Black Americans, maybe it would also work better. So these are things we still need to elaborate on a little bit more.

Right now, what we can say is it works very well in Black Americans, but, you know, there is a risk of developing these side effects dysgeusia. Yeah. So taste, taste changes as well as skin rashes.

But with that in mind, you know, things were very well. And treatment is advancing very rapidly for multiple myeloma patients.

So it's exciting.