Early Resolution of Talquetamab Oral Side Effects in Relapsed/refractory Multiple Myeloma (rrmm): Updated Waterless Empirical Taste Test (wett) and Patient Reported Outcomes (pro) Data From Talisman
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Background In the phase 1/2 MonumenTAL-1 study, talquetamab (Tal) achieved high response rates and durable survival in RRMM. Although taste changes and other oral toxicities are common, their longitudinal assessment remains limited. The WETT is a novel tool that objectively measures dysgeusia onset, severity, and resolution and evaluates prophylactic interventions. Initial TALisman results showed early dysgeusia onset (∼2 weeks) with improvement beginning after 3 months. Here, we report updated TALisman results with extended follow-up and a 3-month futility analysis of dexamethasone oral rinse prophylaxis (prophy Dex) versus control. Methods TALisman (NCT06500884) is an ongoing phase 2 study in RRMM patients previously exposed to a PI, IMiD, and anti-CD38 antibody. Patients with severe baseline dysgeusia (per WETT) are excluded. Participants are randomized to control or experimental prophylaxis (eg, dexamethasone) for Tal-related oral toxicities starting 7 days before the first step-up dose and are assessed longitudinally. Patients achieving ≥VGPR may reduce talquetamab dosing from 0.8 mg/kg Q2W to Q4W from cycle 5. Co-primary endpoints are dysgeusia incidence, severity, time to first severe dysgeusia, and dysgeusia improvement/resolution at 3 and 6 months per WETT. Results As of December 2025, 30 pts were randomized (15 per group) median age was 62.5 years; 56.7% were male. 25 pts completed ≥3 cycles and 11 completed ≥6 cycles. Overall 86.7% had dysgeusia and 76.7% had severe dysgeusia at any time point. The highest proportion of pts with any grade dysgeusia occurred at C3D8 with the control (80.0%) and at C2D1 with prophy Dex (92.3%). Median time to first dysgeusia was 15 days (control) and 8 days (prophy Dex) median time to first severe dysgeusia was 68 days and 9 days, respectively. Prophy Dex did not result in improved outcomes vs the control in a futility analysis at the end of month 3 improvement/resolution of dysgeusia was observed in 63.6% (control) vs 27.3% (prophy Dex) at the end of month 3, and in 60.0% vs 40.0% respectively, at the end of month 5. Overall, the highest proportion of pts with severe dysgeusia (∼60%) by WETT was detected earlier (C1D15) vs severe/complete loss by the Scale of Subjective Total Taste Acuity (STTA; C4D1). Additional safety, PRO, and salivary data, and initial pregabalin prophylaxis data, will be presented at the congress. Conclusion TALisman data confirm that dysgeusia measured by WETT begins to improve/resolve after 3 months of Tal, with 60% showing improvement/resolution at the end of 5 months. Severe dysgeusia measured by objective WETT preceded subjective severe/complete loss by STTA. Prophy Dex did not improve rates of dysgeusia resolution, although small numbers limit definitive conclusions. Emerging data from TALisman help to inform management strategies and clarify expectations for pts, caregivers, and healthcare providers to facilitate ongoing treatment and clinical benefit from Tal. TALisman is ongoing and exploring additional interventions to prevent dysgeusia and improve pt experience.
Authors: Niels Wcj VAN DE DONK, Rakesh POPAT, Beth FAIMAN, Junichiro YUDA, Kihyun KIM, Abel DA COSTA, Alexa LAHEIJ, Richard DOTY, James OMEL, Brea LIPE, Larysa SANCHEZ, Ajai CHARI, Alexander LIN, Herve SROUSSI, Mariana FERNANDEZ, Kathleen S GRAY, Svetlana GAVRILOV, Gloria AGUILAR, Kasey BOLYARD, Jennifer SCHULTZ, Keqin QI, Diana CORTES-SELVA, Jacqueline FABRY, Sheri SKERGET, Jenny ZHANG, Chris HEUCK, Kelly HAWKS, Mark WILDGUST, Lori PARISI, Leo RASCHE
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Funder: Johnson and Johnson
OpenAlex ID: W7223149264