Real-World Results from Talquetamab and Bispecific Antibodies | Carolina Schinke, MD | ASH 2023

My name is Carolina Schinke. I'm an associate professor at the University of Arkansas for medical sciences and I mainly treat multiple myeloma patients. So that's really my area of expertise. This year here at ASH we're going to have some really interesting data on bispecific antibody treatment. You might all know that there were two antibodies, two bispecific antibodies that were recently approved by the FDA. JuclistaMAP is one of those that targets BCMA and then now the TelketaMAP recently approved targeting GPRC15. Now we know that these bispecific antibody treatments are very effective in relapsed and refractory multiple myeloma. We had really exciting data on those over the last one, two years. 70% response rates, long duration of response. So now that it's going into real world we kind of wanted to look at well does that differ from clinical trials. We often know that clinical trial patients are a little bit, you know, sometimes a little bit different from the real world. They tend to be preselected, you know, these are fit patients that have to have certain requirements to go into clinical trials. Now if we can give it to everybody how does that hold up? So we looked at JuclistaMAP which was approved in late 2022, so almost a year and hour ago. We've had now a lot of patients taking this drug and in collaboration with other sites, Medical College of Wisconsin, Columbia University, MSK, MonteFury. So we had a couple of sites with which we collaborated. We looked at response rates and also at infections because that was really one main issue, one side effect of this, to close the map causing sometimes even severe infections leading to death. Overall response rate I think is still great for this really heavily relapsed, sorry relapsed, pre-treated patient population. It's up to 60%, almost 70 like in the clinical trials. We don't have a whole lot of follow-up yet so we don't know exactly how long that response will last in these patients. We hope to have that soon. Infectious rate was actually a little bit better than what it was reported in these clinical trials and that was because we now proactively use infection prevention. So a lot of patients get IVIG, a lot of patients are treated with Bactrim, Dapsone, all these antibiotics that tend to prevent infections and that was not necessarily always done on clinical trials because at that time they didn't really know what was going to happen. So now knowing that patients run into infections, these prophylactic treatments really have helped to prevent infections down the line. So we show in our abstract that the administration of IVIG really can reduce, significantly reduce severe infections and also reduces all infections. So in that sense we can make the administration of Ticlystomab much safer with using these prophylactic measures. So I think that is a really important, clinically important takeaway that Ticlystomab is effective in the real world and can be better tolerated if using prophylactic measures. As to the TelcataMap, the GPRC-15 antibody, so we don't have any real world data on that yet but we are presenting follow-ups from the clinical trials where we also just kind of confirmed the efficacy. We had 70% overall response rate on the TAL-1 trials. Quite also long duration of response, I believe it's now for those that actually respond to TelcataMap, this disease does not tend to relapse for at least 12 months or even longer so that's great. Even patients who had prior exposure to BCMA targeting treatment like CAR-T or bispecifics, they tend to have a longer response time. So we have a very long response time. Again, I think that's great news. With TelcataMap, the side effects mainly are the loss of taste, which can be quite bothersome to the patient. Worst case scenarios, even significant weight loss. So these are side effects that I think we're trying to improve over the course of time. I think with maybe the real world, what we do is maybe try a little bit alternate dosing. Right now it's every two weeks, maybe once the patient achieves complete response, we try to go to monthly treatment. We've tried a lot of potential medicines that could improve taste. I mean, we've tried anti or these medicines that we use for neuropathy like Lyrica, Galapentin. We have not seen any results of that. We have not seen any results of that. We have not seen any results of that. We have not seen a lot of success, I can say, but that's just my subjective opinion. We've tried vitamin B, 12 supplements, zinc. I think that's also not going to be a magic bullet. So I think trying to mitigate this side effect of taste not being able to taste well is still an issue, but on the myeloma, it definitely works very well. So we're very, really excited to have these specific treatments now available to the whole population. I think as the field expands, it will be very exciting in the multiple myeloma field. And now they are trying combining Techlostomol, Talcetamab, using them in combination, especially for patients with very aggressive disease. So I think the future looks bright and we're excited to see what's going to be here next year at the ASH 2024 meeting. Thank you very much.