Real-World Talquetamab Utilization Patterns and Dose Schedules in the United States: An Analysis Using Claims Data

Introduction:Talquetamab (Tal) is the first-in-class GPRC5D-targeting bispecific antibody recently approved in the United States (US) for treating patients with multiple myeloma (MM) after ≥4 prior lines of therapy (LOTs). Tal initiation includes step-up dosing (SUD) prior to establishment of either a weekly (QW) or biweekly (Q2W) treatment schedule based on prescribing information. Recently, Q4W talquetamab dosing was described (Chari et al, ASH 2023). However, there are limited data regarding real-world patterns of Tal administration and patient characteristics for those receiving Tal in real-world settings. This study describes patterns of Tal administration in real-world settings among US patients.

Methods: This analysis queried the Komodo Healthcare Map^TM for data from adult patients with ≥1 diagnosis code for multiple myeloma between October 1, 2015 and June 8, 2024 and ≥1 medical claim for commercial Tal between Aug 9, 2023 [US approval date] and June 8, 2024 [latest data cut]. The index date was defined as either the date of the first outpatient Tal SUD (3mg/1.5mL) or the date of an inpatient Tal encounter. Patient demographics and clinical characteristics were described for the baseline period of 6 months prior to index date. Tal utilization patterns and patient characteristics were reported descriptively.

Results: Overall, 141 MM patients treated with Tal were identified, with a median follow-up of 3.3 months and a median (interquartile range [IQR]) age at index of 67 years (59, 74). Among these, 53.9% were male, 63.2% were white, and 63.8% had Medicare. Baseline comorbidities prior to Tal treatment were common, including recent infections (47.5%) and pre-existing hypogammaglobulinemia (44.0%).

The median (IQR) time from MM diagnosis to index date was 5.9 (4.0, 7.9) years and number of prior LOTs was 5 (4, 6). Overall, 44.7% were naïve to prior T-cell redirection therapies, and prior exposure to commercial BCMA-targeted therapy was reported in 84 (59.6%) patients: 7.8% of patients received ciltacabtagene autoleucel, 17.7% idecabtagene vicleucel, 35.5% teclistamab (Tec), 2.1% elranatamab, and 14.2% belantamab mafodotin. Tal monotherapy was administered for a majority of the patients (n=127, 90.1%), and 3 (2.1%) patients received commercial Tal+Tec. Following SUD, 26.6% of patients were receiving QW dosing, and 61.7% were receiving Q2W dosing. Of patients who received ≥3 treatment doses (not including SUD) before data cutoff, 15 of the 25 patients receiving QW dosing had switched to ≥Q2W and 12 of the 58 patients receiving Q2W dosing had switched to ≥Q3W. At data cutoff, 14 (14.9%), 62 (66.0%), and 9 (9.6%) patients were on QW, Q2W, and Q4W dosing, respectively.

Conclusion: This study reports the largest real-world analysis of Tal dosing and patient characteristics since its US approval. As expected, the patients identified as receiving Tal were heavily pretreated, although approximately 40% of patients had not received a prior commercial BCMA therapy. The majority of patients received Tal as monotherapy, while a small number received Tal in combination with Tec. Q2W was the most common dosing schedule, and some patients de-escalated to less frequent dosing. Further real-world research into Tal clinical outcomes is ongoing to provide insights into long-term use practices for this novel treatment option.

Banerjee:Abbvie; JNJ; Novartis; Pack Health; Prothena; Sanofi: Research Funding; Adaptive; BMS; Caribou Biosciences; Genentech; GSK; JNJ / Janssen; Karyopharm; Legend Biotech; Pfizer; Sanofi; SparkCures: Consultancy. Wang:Johnson & Johnson Innovative Medicine: Current Employment, Current equity holder in publicly-traded company. Liu:Johnson & Johnson Innovative Medicine: Current Employment, Current equity holder in publicly-traded company. He:Johnson & Johnson Innovative Medicine: Current Employment; Johnson & Johnson: Current equity holder in publicly-traded company; Merck & Co. Inc.: Current equity holder in publicly-traded company. Le:Johnson & Johnson Innovative Medicine: Current Employment, Current equity holder in publicly-traded company. Patel:Johnson & Johnson Innovative Medicine: Current Employment, Current equity holder in publicly-traded company. Zhang:Johnson & Johnson Innovative Medicine: Current Employment, Current equity holder in publicly-traded company.

Talquetamab is a recently approved bispecific antibody for treating patients with multiple myeloma. Prescribing information for talquetamab includes weekly and biweekly dosing schedules. This study specifically looked at dosing patterns and clinical use scenarios in real-world setting.