Imaging, QoL and Patient-Reported Outcome and Supportive Care

Category: Imaging, QoL and Patient-Reported Outcome and Supportive Care

Changes in Patient-reported Distress and Symptom Burden During Talquetamab Therapy in Multiple Myeloma: A Descriptive Analysis

(PA-109) Changes in Patient-reported Distress and Symptom Burden During Talquetamab Therapy in Multiple Myeloma: A Descriptive Analysis

Thursday, September 18, 2025

Elizabeth M. Aughey, MD (she/her/hers)

Internal Medicine Resident
Medical College of Wisconsin

Introduction: Talquetamab (TAL) is a first-in-class bispecific T-cell engager targeting GPRC5D and CD3, approved for relapsed/refractory multiple myeloma. While it has promising efficacy, its novel mechanism is associated with a distinct toxicity profile. The impact of TAL on patient-reported distress and symptom burden has not been previously described. This study evaluates real-world changes in distress and symptoms during TAL therapy.

Methods:   We analyzed 47 MM patients treated with TAL at a single institution. Distress was assessed using the NCCN Distress Thermometer and problem checklist, capturing practical, social, spiritual, emotional, and physical concerns. This is administered routinely to clinic patients. 32 patients who completed at least one assessment before and after initiating TAL therapy are included in the analysis below.

Results:   The median age was 64.2 years with 62.5 % males. The majority were non-Hispanic (NH) White (88.2.%), followed by NH Black (5.9%), and other racial/ethnic groups (5.9%). High-risk cytogenetics were present in 46.9% of patients, and 51.8% had ISS stage II/III disease. The median number of prior lines was six. Patients remained on TAL for a median of 3.7 months and experienced a median weight loss of 13.2 pounds.

Distress increased in 53.0% of patients (17/32) compared to 47% (15/32) with stable or improved scores. The overall median distress increased from 1.0 at baseline to 2.0 on treatment. Among those with worsening distress, scores rose from 1.0 to 4.0; in contrast, the improved group saw scores decline from 1.0 to 0.0. Practical, social, and spiritual concerns remained largely unchanged. Emotional symptoms, such as worry and nervousness, generally improved, with nervousness decreasing from 15.6% pre-TAL to 3.1% during therapy.

In contrast, physical symptom burden increased in both groups. Fatigue rose from 34.4% to 50.0%, eating-related concerns emerged in 28.1% (previously 0%), dry/itchy skin increased from 15.6% to 46.9%, mouth sores from 3.1% to 15.6%, and breathing difficulties from 6.3% to 12.5%. These effects were more pronounced among patients with increased distress: fatigue rose from 41.2% to 76.5%, dry/itchy skin from 11.8% to 64.7%, and eating concerns from 0.0% to 41.2%.

Conclusions:   TAL is associated with an increase in symptom burden, particularly fatigue, dermatologic effects, and eating-related concerns. While over half of patients experienced worsening distress, nearly half had stable or improved scores, with many noting reductions in emotional symptoms such as nervousness and worry. These findings highlight the complexity of the treatment experience, where disease control may coexist with declining physical well-being but preserved or even improved emotional adjustment. Routine distress screening and proactive supportive care are paramount to identifying patients at risk for symptom deterioration during TAL therapy.