talquetamab: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
talquetamab: clinical details
Prescribing considerations
- Initiate and supervise treatment through a multiple-myeloma service with trained personnel and facilities for managing severe CRS and neurological toxicity.
- Use the specified step-up process and premedication; assess carefully after prior severe CRS from another T-cell-redirection therapy.
- Do not begin the step-up phase during active infection; consider infection prophylaxis according to local specialist protocols.
- Review vaccination status, pregnancy potential, concomitant CYP substrates and the patient's ability to follow urgent safety instructions.
- Advise patients to carry their alert card and avoid driving during the step-up phase and whenever neurological symptoms occur.
Contraindications and cautions
- Hypersensitivity to talquetamab or any excipient.
- Exercise caution where polysorbate hypersensitivity is suspected.
Monitoring
- Clinical monitoring for CRS and ICANS, particularly during the step-up phase and after treatment interruption.
- Full blood count at baseline and periodically; assess promptly for febrile neutropenia, bleeding and infection.
- Immunoglobulin levels and need for infection precautions, prophylaxis or replacement therapy.
- Oral symptoms, swallowing, nutritional intake and weight.
- Skin, rash progression and nail toxicity.
- Pregnancy status before initiation where relevant.
Clinical pharmacology
Humanised IgG4-PAA bispecific antibody targeting GPRC5D and CD3. It recruits and activates T cells against GPRC5D-expressing cells; subcutaneous bioavailability is incomplete, and clearance includes time-dependent and linear components.
Formulation and product differences
- The selected 2 mg/mL presentation is a ready-to-use solution supplied in a single-use vial and does not require dilution.
- Different talquetamab concentrations must not be combined when preparing an injection.
- The solution should be colourless to light yellow; do not use it if cloudy, discoloured or particulate.
talquetamab preparations and strengths
Injection
Route: Parenteral
Strengths: 2 mg/mL, 40 mg/mL
talquetamab interactions
Formal interaction studies have not been performed. Give the specialist team a complete list of prescribed, non-prescribed and herbal products.
Sensitive CYP2C9, CYP2C19, CYP3A4/5 or CYP2D6 substrates
Cytokine release may temporarily reduce CYP activity and increase exposure; medicines for which small concentration changes are hazardous require closer toxicity or concentration monitoring.
Live viral vaccines
Immune responses may be reduced and live viral vaccination is not recommended around or during talquetamab treatment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.