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真实世界中 talquetamab 治疗复发/难治性多发性骨髓瘤的临床管理经验:美国医疗保健提供者的定性研究。

Real-world experience with clinical management of talquetamab in relapsed/refractory multiple myeloma: a qualitative study of US healthcare providers.

机构信息

University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

Curr Med Res Opin. 2024 Oct;40(10):1705-1711. doi: 10.1080/03007995.2024.2387183. Epub 2024 Aug 23.

Abstract

OBJECTIVE

Talquetamab is the first-in-class GPRC5DxCD3 bispecific antibody for relapsed/refractory multiple myeloma. Given limited real-world data, this study was conducted with US healthcare providers (HCPs) to understand real-world talquetamab dosing and symptom management.

METHODS

In February/March 2024, individual in-depth interviews (IDIs;  = 10) were conducted with HCPs administering talquetamab in real-world settings. A subsequent expert panel ( = 6) further discussed current practices.

RESULTS

The IDIs reported a variety of settings for step-up dosing (SUD), including inpatient ( = 5), outpatient ( = 3), and hybrid models ( = 2), with a trend toward shorter SUD length to reduce healthcare resource utilization. Most HCPs used a biweekly (Q2W) schedule in SUD ( = 7) and treatment phases ( = 8). Six participants explored reducing dose frequency to every 4 weeks (Q4W) in patients following positive disease response to treatment, considering patient convenience and relieving GPRC5D-related symptoms. Panelists recommended symptom management and prophylactic strategies, such as dexamethasone and nystatin mouthwash or zinc and vitamin B complex for oral symptoms, and topical steroids and cosmetic products for skin and nail symptoms.

CONCLUSION

This study outlines current real-world practices for talquetamab. Findings indicate variation in the SUD care setting. The 0.8 mg/kg Q2W dosing schedule was most common, although switching to Q4W is a real-world symptom management strategy for some patients with responses to therapy. GPRC5D-related symptom management approaches are evolving; prophylactic use of dexamethasone and nystatin mouthwash or zinc and vitamin B complex may be effective strategies to alleviate oral symptoms. Further real-world evidence is needed to inform optimal dosing schedules while mitigating symptom impact.

摘要

目的

Talquetamab 是首个用于治疗复发/难治性多发性骨髓瘤的 GPRC5DxCD3 双特异性抗体。鉴于实际数据有限,本研究对美国医疗保健提供者(HCP)进行了调查,以了解 Talquetamab 的实际剂量和症状管理情况。

方法

2024 年 2 月/3 月,对在实际环境中使用 Talquetamab 的 HCP 进行了 10 次深入访谈(IDIs)。随后,一个专家小组(n=6)进一步讨论了当前的实践情况。

结果

IDIs 报告了各种升阶剂量(SUD)的设置,包括住院(n=5)、门诊(n=3)和混合模式(n=2),倾向于缩短 SUD 长度以减少医疗资源的利用。大多数 HCP 在 SUD(n=7)和治疗阶段(n=8)中使用每两周(Q2W)的方案。6 名参与者探索了在治疗后疾病反应良好的患者中减少剂量频率至每四周(Q4W),考虑到患者的便利性和减轻 GPRC5D 相关症状。小组成员建议进行症状管理和预防策略,例如地塞米松和制霉菌素漱口液或锌和维生素 B 复合物用于口腔症状,以及局部类固醇和化妆品用于皮肤和指甲症状。

结论

本研究概述了 Talquetamab 的当前实际实践情况。研究结果表明,SUD 护理设置存在差异。最常见的剂量方案是 0.8mg/kg Q2W,但对于一些对治疗有反应的患者,转换为 Q4W 是一种现实的症状管理策略。GPRC5D 相关症状管理方法正在不断发展;预防性使用地塞米松和制霉菌素漱口液或锌和维生素 B 复合物可能是缓解口腔症状的有效策略。需要进一步的真实世界证据来确定最佳剂量方案,同时减轻症状的影响。

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