TALISMAN Trial: Prophylactic Treatments of Talquetamab-Related Oral Toxicities in R/R MM

EP: 1.Advanced Practice Decision-Making: Patient Selection and Baseline Assessment for Bispecific Therapies

EP: 2.Introducing GPRC5D and MonumenTAL-1 Trial for R/R Multiple Myeloma

EP: 3.Extended Follow-Up From MonumenTAL-1 and APP Clinical Insights on Talquetamab Efficacy Outcomes

EP: 4.Updated Safety Profile of Talquetamab & Concluding Thoughts from MonumenTAL-1

EP: 5.GPRC5D-Related Adverse Effects: Clinical Strategies for Monitoring Patient Care and Safety of Talquetamab

EP: 6.Best Practices for Monitoring Response to Talquetamab and Optimizing Dosing

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EP: 7.TALISMAN Trial: Prophylactic Treatments of Talquetamab-Related Oral Toxicities in R/R MM

EP: 8.Future Outlooks and Next Steps in Later R/R MM

The phase 2 TALISMAN trial investigated strategies to prevent severe oral toxicities, such as dysgeusia and dysesthesia, in patients receiving talquetamab. This randomized, multicenter, open-label study tested 3 prophylactic interventions: dexamethasone mouthwash, oral pregabalin, and clonazepam dissolving tablets, all initiated seven days prior to dose escalation. The trial excluded patients with a history of these oral symptoms and focused on measuring the incidence, time to onset, and duration of severe taste and sensory disturbances. This approach is notable as oral toxicities associated with talquetamab can be challenging to evaluate and manage.

Clinicians emphasize the importance of early patient education regarding the likelihood and impact of oral toxicities. Patients are encouraged to continue eating despite changes in taste perception to maintain adequate nutrition, although those who are already frail may find this difficult. Regular follow-up with oral medicine specialists facilitates early detection and management of these symptoms. When breakthrough toxicities occur despite prophylaxis, treatment adjustments such as holding the medication or discontinuing therapy may be necessary, depending on severity.

Nutrition support plays a vital role in managing oral toxicities, with dietitians providing individualized recommendations and assistance. Some patients benefit from innovative approaches, including the use of “miracle berries,” which can temporarily improve taste perception and make eating more tolerable. Overall, a multidisciplinary approach involving early intervention, patient education, and nutritional support is key to optimizing care for patients experiencing oral adverse effects during talquetamab treatment.