Study Analyzes Step-Up Dosing With Talquetamab in Real-World Patients

Although most real-world patients in the United States receiving talquetamab for multiple myeloma completed step-up dosing in the inpatient setting, length of stay (LOS) declined over time and the use of outpatient or hybrid (inpatient plus outpatient) models was observed, according to a study presented at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas.

That said, given that “most cytokine release syndrome (CRS) events were low grade with no tocilizumab use after the first three doses,” the proportion of patients receiving outpatient or hybrid step-up dosing may rise in coming years, suggested the study’s lead author, Rahul Banerjee, MD, FACP, of the Fred Hutchinson Cancer Center.

Dr. Banerjee and colleagues evaluated talquetamab step-up dosing among deidentified patients in the all-payer U.S. hospital administrative Premier Healthcare Database. Patients were treated between August 2023 and March 2024.

The study included 89 patients who had one or more hospital encounters with one or more talquetamab administrations at the index dose (3 mg/1.5 mL). The cohort was 66.3% male, 55.1% White, and 79.8% non-Hispanic. In addition, 55.1% were on Medicare, and 11.2% were 75 years or older.

Among the 81 patients with one or more hospitalizations during step-up dosing, the researchers reported hybrid dosing in 12 (14.8%), once-weekly dosing in 32 (39.5%), and once-every-two-weeks dosing in 37 (45.7%).

The overall mean LOS was 8.4 days (median, eight days)—consistent with the 48-hour guideline to manage CRS—though it declined from a mean of 8.9 days (median, eight days) from August 2023 through September 2023 to a mean of 7.6 days (median, seven days) from December 2023 to February 2024.

In 80 patients who initiated step-up dosing in the inpatient setting, 47 (58.8%) had CRS (grade 1, 37; grade 2, three; grade ≥3, zero; unknown/unspecified, seven), of which 41 (51.3%) received tocilizumab either once (n=13), twice (n=23), or three times (n=6).

In closing, Dr. Banerjee and colleagues noted that this was the first real-world study of talquetamab step-up dosing in patients with relapsed or refractory multiple myeloma.

Reference

Banerjee R, Chang HY, Liu YH, et al. Step-up dosing experience with talquetamab: a US real-world analysis. Abstract #MM-422. Presented at the Society of Hematologic Oncology Annual Meeting; September 4-7, 2024; Houston, Texas.