Navigating A number of Myeloma Therapy: What Sufferers Want To Know

Relapsed and refractory a number of myeloma will be troublesome to handle, particularly as sufferers progress by way of a number of traces of remedy and remedy choices could turn out to be extra restricted.¹ Because the illness can behave in a different way from individual to individual, it’s necessary for sufferers and their care companions to grasp their choices and what to anticipate in the course of the remedy journey.²

CURE sat down with Marlee Bogema, MSN, FNP-C, from The Most cancers and Hematology Facilities, who shared her views on a remedy possibility for adults residing with relapsed and refractory a number of myeloma and what sufferers and their care companions ought to know as they navigate their choices.

This text is sponsored by Johnson & Johnson. Marlee Bogema, MSN, FNP-C, is a paid guide for Johnson & Johnson and should current data in accordance with U.S. Meals & Drug Administration (FDA) necessities relevant to Johnson & Johnson.

CURE: For folks residing with a number of myeloma, what’s most necessary for them to know in regards to the illness and their remedy choices right now?

Marlee Bogema, MSN, FNP-C: The way in which we strategy and deal with a number of myeloma has modified drastically previously ten years. After I first began attending to know this complicated illness, there have been just a few therapies to select from.³ Now, we’ve extra choices than ever earlier than – and we’re seeing many sufferers stay longer past their analysis than previously.³ Nevertheless, each affected person’s expertise is completely different, so it’s necessary that they work carefully with their care group to seek out the remedy strategy that’s proper for them.

We even have extra superior diagnostics and testing capabilities that assist us higher perceive how effectively therapies are working.⁴ Which means we will tailor care extra exactly. For instance, we will higher goal remedy based mostly on a affected person’s cytogenetics – which tells us about particular modifications of their most cancers cells – and minimal residual illness (MRD) testing, which refers back to the small variety of most cancers cells that stay within the physique throughout and after most cancers remedy.^5,6

One remedy possibility that has entered the world and which might play an necessary half in a affected person’s care plan is TALVEY® (talquetamab-tgvs), which is authorized for the remedy of grownup sufferers with relapsed or refractory a number of myeloma who’ve acquired no less than 4 prior traces of remedy, together with a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody to deal with their a number of myeloma.⁷ This indication is authorized beneath accelerated approval based mostly on response price and sturdiness of response.⁷ Continued approval for this indication could also be contingent upon verification and outline of medical profit in a confirmatory trial(s).⁷

TALVEY^® was studied in 219 sufferers within the Part 1/2 MonumenTAL-1 trial.⁷ Outcomes confirmed that 73% and 73.6% of sufferers receiving TALVEY^® weekly and biweekly, respectively, responded to remedy.⁷

TALVEY^® is obtainable as an every-two-week or once-weekly subcutaneous injection after an preliminary step-up dosing section.⁷ As soon as the affected person and their care group have chosen a remedy plan, they start a step-up dosing schedule the place the affected person receives the primary two or three doses of TALVEY^® at a smaller dose and will increase as much as the complete remedy dose.⁷ Sufferers ought to be hospitalized for no less than 48 hours after administration of all doses inside the step-up dosing schedule, which permits them to be monitored for any potential severe or life-threatening uncomfortable side effects, together with cytokine launch syndrome (CRS) and neurologic issues like immune effector cell-associated neurotoxicity syndrome (ICANS).⁷

CURE: How would you describe TALVEY^® to a affected person or care companion who’s listening to about it for the primary time? What are the important thing factors you emphasize for sufferers?

Bogema: I often begin by telling sufferers, “I’m going to offer you a drugs that I like to consider as alphabet soup.” Then I clarify that TALVEY^® targets one thing known as “GPRC5D” – a protein discovered on a number of myeloma cells, in addition to some wholesome cells within the physique.⁸ This can be a goal that their myeloma hasn’t seen earlier than, which suggests we’re going after it another way than earlier therapies. Actually, TALVEY^® is the first-in-class FDA-approved GPRC5D concentrating on agent.^8,9

TALVEY^® is what’s generally known as a bispecific antibody. Which means it binds to 2 proteins without delay – GPRC5D on the a number of myeloma cells and “CD3” on the T-cells, that are a part of the immune system. This twin concentrating on could assist activate the physique’s immune system to acknowledge and assault the a number of myeloma cells.⁸

Bispecifics are an thrilling class of medicines in oncology care; nonetheless, there are particular uncomfortable side effects we carefully look ahead to once we activate the immune system, similar to CRS and neurologic issues like ICANS (which might happen in the course of the step-up dosing section), in addition to style, pores and skin, and nail modifications. I prefer to set expectations round security immediately when discussing remedy with bispecific antibodies – we ensure sufferers and their care companions know what uncomfortable side effects to look out for thus we will work collectively to handle them.

CURE: Who could be a superb candidate for TALVEY^®, and when within the a number of myeloma remedy journey is it usually thought-about?

Bogema: TALVEY^® is FDA-approved for adults residing with relapsed or refractory a number of myeloma who’ve already acquired no less than 4 completely different sorts of remedy, together with a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody.⁷ At this level in remedy, choices could turn out to be extra restricted, and TALVEY^® might be able to assist by concentrating on the illness in a brand new means.¹⁰ I additionally have a tendency to achieve for TALVEY^® in sufferers who’ve relapsed from B-cell maturation antigen (BCMA)-targeted therapies.

CURE: What uncomfortable side effects do you generally see with TALVEY^®, and why is it necessary for sufferers and their family members to know what they could count on? How can they work with their remedy group to handle any uncomfortable side effects they expertise?

Bogema: I spend time speaking with sufferers and their care companions about a few of the extra widespread uncomfortable side effects that may have an effect on every day life – significantly style, pores and skin, and nail points.⁸ Many sufferers discover that candy meals and meats style completely different, which might result in lowered urge for food and weight reduction.¹¹ We monitor weight fluctuations very carefully and contain dietitians, if wanted, to make sure sufferers are sustaining correct vitamin. Nail and pores and skin modifications – like peeling or discoloration – will be seen and emotionally troublesome, so I do my greatest to organize sufferers forward of time.

These uncomfortable side effects will be widespread whereas present process remedy with TALVEY^®, and we’ve methods to assist handle them – however provided that we find out about them early.⁷ These methods embody sure lotions and mouth rinses that may assist defend and lubricate the affected areas. We may additionally give the affected person a break in remedy, however I often maintain this as a final resort.

I all the time ask sufferers and their care companions to trace how they’re feeling and to contact us as they discover a change, even when it feels small. The sooner the care group is alerted to potential uncomfortable side effects, the higher likelihood we could have of dealing with them. We are able to regulate care, provide help, and make the expertise extra manageable once we work collectively from the beginning.

CURE: What recommendation would you give to sufferers contemplating TALVEY^® or discussing it with their care group?

Bogema: When contemplating any new a number of myeloma treatment, I encourage sufferers to consider two primary issues: their remedy targets, like illness management, together with the uncomfortable side effects.

When being handled with TALVEY^®, most individuals can count on sturdy responses.⁷ The MonumenTAL-1 trial confirmed that the median period of response (DOR) for the weekly cohort was 9.5 months, whereas the median DOR was not estimable for the biweekly cohort, and 85% of sufferers who responded maintained a response for no less than 9 months.⁷ Most sufferers may also count on modifications with their style, pores and skin, and nails, on condition that 70%, 41%, and 50% of members skilled some type of these opposed occasions, respectively, within the MonumenTAL-1 research.⁷

These uncomfortable side effects are widespread and manageable, particularly when working with a nutritionist or dermatologist, however they nonetheless affect day-to-day life.⁸ For instance, if somebody actually values meals and cooking, it helps to know forward of time that they could expertise modifications in style and that they could wish to experiment with completely different recipes. Having life like expectations makes a giant distinction.

Sufferers also needs to think about their dose desire. TALVEY^® presents versatile dosing – both weekly or each two weeks after the step-up section.⁷ Some sufferers desire fewer visits, whereas others really feel extra comfy being monitored extra incessantly. It will depend on what feels proper for them and the place they’re on their remedy journey. As a result of TALVEY^® includes step-up dosing and carries dangers like CRS and ICANS, it’s necessary that each the affected person and their care companions really feel prepared and supported by way of that a part of remedy.⁷

In my position, I’ve guided sufferers receiving bispecific antibodies in step-up dosing throughout a variety of care settings, as I imagine it’s necessary for sufferers to have entry to those superior therapies of their native care settings. This perception led me to ascertain protocols to appropriately help sufferers getting access to important remedy in my very own area people.

Finally, sufferers ought to work with their physician and ask questions to grasp all of the remedy choices obtainable to them to allow them to make an knowledgeable alternative that displays their particular person wants and targets.

CURE: Do you’ve any recommendation for care companions, particularly with family members, who’re contemplating beginning remedy with a bispecific antibody?

Bogema: In my expertise, a number of myeloma care companions are sometimes involved about their family members’ weight and eating regimen whereas they’re present process remedy. Meals is one thing tangible they’ll management and contribute to, and weight is a metric they’ll simply monitor. However when sufferers expertise style modifications or urge for food loss on account of their medicines, it may possibly create frustration on each side. Typically which means working towards a particular calorie or protein consumption goal collectively or exploring alternative ways to consider vitamin.

These moments will be emotionally troublesome. That’s why I attempt to work with each the affected person and their care companions to set life like targets and reframe expectations. I additionally assist the affected person and care companion perceive the affect of remedy on illness management, monitoring lab values, and checking how they’re feeling. This open dialogue offers me the partnership to assist help them in making an attempt to steadiness efficacy and high quality of life targets.

My largest piece of recommendation for care companions is that this: lean into your care group and your group – different households could possibly be going by way of an identical expertise, and connecting with them generally is a highly effective supply of consolation and energy. Modifications and uncomfortable side effects are anticipated, and we’re right here to help you. This can be a shared effort, and we’ll work by way of it – collectively.

CURE: What offers you hope when you consider the way forward for a number of myeloma remedy?

Bogema: What offers me hope is how far we’ve already are available treating a number of myeloma – and the way a lot potential there may be for continued progress. I take into consideration the obtainable choices we’ve seen developed over the past 5 years and am enthusiastic about what the subsequent 5 may convey.

New therapies are being developed throughout completely different remedy courses, together with extra bispecific antibodies and even “trispecific antibodies,” that are designed to interact the immune system in additional complicated methods.¹² As our understanding of the illness deepens, therapies have gotten extra customized and extra focused.

With continued analysis and innovation, I imagine the a number of myeloma remedy panorama will proceed to evolve, giving sufferers entry to extra choices that meet their particular person wants at completely different factors of their a number of myeloma journey.

Please evaluate the Essential Security Data and see the complete Prescribing Data together with the Boxed Warning under. You possibly can discuss to your physician you probably have any questions or for extra data, go to www.Talvey.com.

INDICATION

What’s TALVEY^® (talquetamab-tgvs)?

TALVEY^® is a prescription drugs to deal with adults with a number of myeloma who:

• have already acquired no less than 4 remedy regimens, together with a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody to deal with their a number of myeloma, and
• their most cancers has come again or didn’t reply to prior remedy

TALVEY^® is authorized based mostly on affected person response. Knowledge aren’t but obtainable to point out if TALVEY^® improves survival or signs.

It’s not recognized if TALVEY^® is secure and efficient in kids.

IMPORTANT SAFETY INFORMATION

What’s crucial data I ought to find out about TALVEY^®?

TALVEY^® could trigger uncomfortable side effects which are severe, life-threatening, or result in loss of life, together with Cytokine Launch Syndrome (CRS) and neurologic issues.

Name your healthcare supplier or get medical assist immediately in case you develop any of the indicators or signs of CRS or neurologic issues listed under at any time throughout your remedy with TALVEY^®:

Cytokine Launch Syndrome (CRS). CRS is widespread throughout remedy with TALVEY^® and will also be severe, life-threatening, or result in loss of life. Indicators and signs of CRS could embody:

Neurologic issues. Signs of neurologic issues with TALVEY^® could embody:

• Because of the danger of CRS and neurologic issues, you need to be hospitalized for 48 hours in spite of everything doses of TALVEY^® which are a part of the “step-up dosing schedule.” The “step-up dosing schedule” is whenever you obtain the primary 2 or 3 doses of TALVEY^®, that are smaller “step-up” doses, and in addition the primary full “remedy dose” of TALVEY^®.
• TALVEY^® is given weekly or each 2 weeks. Your healthcare supplier will resolve the variety of days to attend between your doses of TALVEY^® in addition to what number of therapies you’ll obtain.
  • When you obtain TALVEY^® weekly, “Step-up dose 1” is given on day 1 of remedy. “Step-up dose 2” is often given on day 4 of remedy. The primary “remedy dose” is often given on day 7 of remedy.
  • When you obtain TALVEY^® each 2 weeks, “Step-up dose 1” is given on day 1 of remedy. “Step-up dose 2” is often given on day 4 of remedy. “Step-up dose 3” is often given on day 7 of remedy. The primary “remedy dose” is often given on day 10 of remedy.
• In case your dose of TALVEY^® is delayed for any purpose, you could must repeat the “step-up dosing schedule” to obtain TALVEY^®.
• Earlier than every “step up” dose of TALVEY^®, you’ll obtain medicines to assist scale back your danger of CRS. Your healthcare supplier will resolve if it is advisable to obtain medicines to assist scale back your danger of CRS with future doses.
• Your healthcare supplier will monitor you for indicators and signs of CRS and neurologic issues in addition to different uncomfortable side effects, and deal with you as wanted.

TALVEY^® is obtainable solely by way of the TECVAYLI^® and TALVEY^® Threat Analysis and Mitigation Technique (REMS) as a result of danger of CRS and neurologic issues.

You’ll obtain a Affected person Pockets Card out of your healthcare supplier. Carry the Affected person Pockets Card with you always and present it to your entire healthcare suppliers. The Affected person Pockets Card lists indicators and signs of CRS and neurologic issues.

Get medical assist immediately in case you develop any of the indicators and signs listed on the Affected person Pockets Card. Chances are you’ll have to be handled in a hospital.

• In case you have any questions on TALVEY^®, ask your healthcare supplier.
• Your healthcare supplier could briefly cease or fully cease your remedy with TALVEY^® in case you develop CRS, neurologic issues, or every other uncomfortable side effects which are extreme.

See “What are the attainable uncomfortable side effects of TALVEY^®?” for extra details about uncomfortable side effects.

Earlier than you obtain TALVEY^®, inform your healthcare supplier about your entire medical situations, together with in case you:

• have an an infection
• are pregnant or plan to turn out to be pregnant. TALVEY^® could hurt your unborn child. Inform your healthcare supplier in case you turn out to be pregnant or suppose that you could be be pregnant throughout remedy with TALVEY^®.
  Females who’re capable of turn out to be pregnant:
  • Your healthcare supplier ought to do a being pregnant check earlier than you begin remedy with TALVEY^®.
  • You need to use efficient contraception (contraception) throughout remedy and for 3 months after your final dose of TALVEY^®.
• are breastfeeding or plan to breastfeed. It’s not recognized if TALVEY^® passes into your breast milk. Don’t breastfeed throughout remedy and for 3 months after your final dose of TALVEY^®.

Inform your healthcare supplier about all of the medicines you’re taking, together with prescription and over-the-counter medicines, nutritional vitamins, and natural dietary supplements.

How will I obtain TALVEY^®?

• TALVEY^® shall be given to you by your healthcare supplier as an injection beneath your pores and skin (subcutaneous injection), often within the abdomen space (stomach). TALVEY^® may additionally be injected into your thigh or one other space of your physique.
• See “What’s crucial data I ought to find out about TALVEY^®?” initially of the Treatment Information for details about how you’ll obtain TALVEY^®.
• When you miss any appointments, name your healthcare supplier as quickly as attainable to reschedule your appointment.

What ought to I keep away from whereas receiving TALVEY^®?

Don’t drive, function heavy equipment, or do different harmful actions throughout and for 48 hours after your TALVEY^® “step-up dose” is accomplished or at any time throughout remedy with TALVEY^®, in case you develop dizziness, confusion, tremors, sleepiness, or every other signs of neurologic issues till your signs go away.

See “What’s crucial data I ought to find out about TALVEY^®?” for extra details about indicators and signs of CRS and neurologic issues.

What are the attainable uncomfortable side effects of TALVEY^®?

TALVEY^® could trigger severe uncomfortable side effects, together with:

• See “What’s crucial data I ought to find out about TALVEY^®?”
• Mouth issues and weight reduction. Inform your healthcare supplier or get medical assist immediately in case you develop any of the next signs of mouth issues:

Your healthcare supplier will monitor you for these signs and can monitor your weight throughout remedy with TALVEY^®. Inform your healthcare supplier in case you drop some pounds throughout remedy with TALVEY^®.

• Infections. TALVEY^® could cause severe infections that may be life-threatening and should result in loss of life. Your healthcare supplier will monitor you for indicators and signs of an infection earlier than and through remedy with TALVEY^®. Inform your healthcare supplier immediately in case you get or develop any indicators or signs of an infection throughout remedy with TALVEY^®, together with:

• Decreased blood cell counts. Decreased blood cell counts are widespread throughout remedy with TALVEY^® and will also be extreme. Your healthcare supplier will examine your blood cell counts throughout remedy with TALVEY^®. Inform your healthcare supplier in case you get any signs of an infection or uncommon bleeding or bruising.
• Pores and skin issues. Pores and skin issues are widespread throughout remedy with TALVEY^® and will also be severe. Inform your healthcare supplier in case you get pores and skin issues similar to pores and skin rash, raised purple bumps, or redness of the pores and skin.
• Liver issues. Irregular liver exams can occur throughout remedy with TALVEY^®.Your healthcare supplier will do blood exams earlier than and through remedy with TALVEY^® to examine your liver. Inform your healthcare supplier in case you develop any of the next signs of liver issues:

The most typical uncomfortable side effects of TALVEY^® embody:

The most typical extreme irregular lab check outcomes with TALVEY^® embody decreased white blood cells and purple blood cells. These aren’t all of the attainable uncomfortable side effects of TALVEY^®.

Name your physician for medical recommendation about uncomfortable side effects. Chances are you’ll report uncomfortable side effects to FDA at 1-800-FDA-1088.

Please learn full Prescribing Data, together with Boxed Warning, for TALVEY^®.

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© Johnson & Johnson and its associates 2025 11/25 cp-535814v1

References:

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2. A number of Myeloma Analysis Basis. Accessed August 13, 2025. https://themmrf.org/multiple-myeloma/
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4. Gutiérrez-González A, Del Hierro I, Cariaga-Martínez AE. Developments in A number of Myeloma Analysis: Excessive-Throughput Sequencing Applied sciences, Omics, and the Position of Synthetic Intelligence. Biology (Basel). 2024;13(11):923. doi:10.3390/biology13110923
5. Sonneveld P, Avet-Loiseau H, Lonial S, et al. Therapy of a number of myeloma with high-risk cytogenetics: a consensus of the Worldwide Myeloma Working Group. Blood. 2016;127(24):2955-2962. doi:10.1182/blood-2016-01-631200
6. Dana Farber Most cancers Institute. August 13, 2025. https://weblog.dana-farber.org/perception/2018/03/minimal-residual-disease-negativity-multiple-myeloma/
7. TALVEY^® [Prescribing Information]. Horsham, PA: Janssen Biotech, Inc.
8. Worldwide Myeloma Basis. Accessed August 13, 2025. https://www.myeloma.org/remedy/multiple-myeloma-medications/talvey-talquetamab
9. Knowledge on file. RF-412855. Janssen Biotech, Inc.
10. Oriol A, Abril L, Ibarra G, et al. Restricted remedy choices in refractory a number of myeloma: promising therapeutic developments. Professional Rev Anticancer Ther. 2020;20(1):31-44. doi:10.1080/14737140.2020.1708721
11. American Most cancers Society. Accessed August 13, 2025. https://www.most cancers.org/most cancers/managing-cancer/side-effects/eating-problems/taste-smell-changes.html
12. van de Donk NWCJ, O’Neill C, de Ruijter MEM, et al. T-cell redirecting bispecific and trispecific antibodies in a number of myeloma past BCMA. Curr Opin Oncol. 2023;35(6):601-611. doi:10.1097/CCO.0000000000000983