Restoring Remission in RRMM: Present and Future of Sequential Immunotherapy With GPRC5D-Targeting Options

Chair, Shaji K. Kumar, MD, and patient Vikki, discuss multiple myeloma in this CME/NCPD/AAPA/IPCE activity titled “Restoring Remission in RRMM: Present and Future of Sequential Immunotherapy With GPRC5D-Targeting Options.” For the full presentation, downloadable Practice Aids, and complete CME/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4fYDKkj. CME/NCPD/AAPA/IPCE credit will be available until February 23, 2026.

1. Restoring Remission in RRMM

Present and Future of Sequential Immunotherapy
With GPRC5D-Targeting Options

by

Shaji K. Kumar, MD

Mark and Judy Mullins Professor of Hematological Malignancies
Consultant, Division of Hematology

Professor of Medicine

Mayo Clinic

Rochester, Minnesota

Go online to access full CME/NCPD/AAPA/IPCE information, including faculty disclosures.

Copyright © 2000-2025, PeerView

2. Our Goals for Today

Help you understand the biology of GPRCSD in the context of therapeutic
targeting of multiple myeloma

Improve your knowledge of the mechanisms and efficacy evidence for
non-BCMA immunotherapies in RRMM

Enhance your skills for developing personalized, sequential treatment plans
that feature non-BCMA options in relapsed disease

Provide you with guidance on team-based safety, dosing, and other practical
aspects of care with GPRC5D-based treatment in MM

‘© 2000-2025, PeerView

3. forMultiple Myeloma

pf. we

> ur

Personalized Support & Tools To Navigate
Multiple Myeloma

LIFETIME PERSONALIZED SUPPORT MEANINGFUL PATIENT-TO-PATIENT POWERFUL PATIENT DATA REGISTRY
& EDUCATION CONNECTIONS.

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© worinars Fe Dr © track your Disease

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nn A co

cancer topics © sotsice effects solutions

© Hecithtreo university Pen
@ specicitDirectory Volunteer opportunities In your area @ Fina our visease Twin
Healthtree REACH

Support for Hispanic, Black & rural
communities

@ tive support with Patient Navigators © Finaciinica trate

© Financial Help Resources

pyright © 2000 eerView

4. Enabling transformative research
in blood cancers

a HealthTree
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The HealthTree Cure Hub Registry
supports physician-researchers with
unparalleled access to the largest and

most complete dataset available in
blood cancers.

Scan to learn more:
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5. HealthTree E u a
Foundation The support patients need at their fingertips

Patient education and navigation tools

Programs that create patient connections
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Patients are empowered to be
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6. Progress With BCMA:

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nd GPRC5D-Directed Therapy

2022-2023
2021-2022 BCMA and GPRC5D 2024
CAR-T arrives x CD3 bispecific
antibodies
Ide-cel and cilta-cel Teclistamab, Ide-cel (3L) and

approved in RRMM/
later relapse (5L+)

elranatamab, and
talquetamab approved

cilta-cel (2L+) approved
in early relapse

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7. Real-World Studies Have Enrolled Patients During the BCMA Era

Melphalan
Pomalidomide flufenamide
Carfilzomib Ide-cel Teclistamab
Deralumumab Lisetma | |
Panobinostat H
Elotuzumab i [ Belantamab | | Charco
Ixazomib ! mafodotin H Elranatamab
T Selinexor | H Talquetamab

LocoMMotion MoMMent-1 MoMMent-2
enrollment enrollment enrollment
‘Aug 2019-Oct 2020 Nov 2021-July 2022 July 2022-Feb 2023

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8. Real-World Evid

in BCMA-Exposed Patients With MM!
ORR PFS
1007 =PR aVGPR 100
mPFS: 3 mo
on 80 (95% Cl, 2.2-3.8)
2 60 8
4 40 ¢ 40
o ORR = 24.6 a
20 20
0
Pooled (N = 57) 0 3 6 9 12 15 18 21

Time, mo

No. at Risk
57 2 ss 2 4 0

1. WoisolK ot al. EHA 2024. Postor 913.

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ce Shows a Need for Better Thera

os

MOS: 8.9 mo
(95% CI, 6.7-14.5)

0 3 6 9 121518212427 303336
Time, mo

No. at Risk
5745311415 3 3 2 2 2 0

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9. e Key Facts Al GPRC

1. GPRCSD is highly expressed in MM cells and is abundant in the bone marrow
from patients with MM and smoldering MM

2. GPRC5D and BCMA have similar expression on CD138+ cells, but the expression
patterns are independent of each other, offering distinct clinical targets

3. GPRCSD expression is also unaffected by BCMA loss; this may support

Zot. combining GPRCSD-targeting and BCMA-targeting T-cell-redirecting agents
sz to address the heterogeneity of MM
ES o o... °
83
23
58
o
Fa
a
1. Smith EL ot Se Trans Mod, 201900007746 PeerView

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10. alquetamab: The First Bispecific to Target CD3 and

Talquetamab
GPRCSD x CD3 antibody

Myeloma cell

T-cell activation
Cytokine release
Perforin/granzymes

1. Char A tal NEng Mod. 2022387 22022244 PeerView

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11. Foundations for Effective Sequential
Care With GPRC5D-Targeting Therapy

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12. In 2025, Newer Therapies Have Been Completely Integrated
Into MM Treatment for Transplan

Newly Diagnosed, Transplant Eligible

Standard risk

Early ASCT Early ASCT

Core options include: IMiDs, Pis, and CD38 antibodies

1. Rajumar V ét a. Am J Hematol 202499:1802-1824 PeerView

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13. In 2025, Newer Therapies Have Been Completely Integrated
Into MM Treatment for Transplant Ine

Newly Diagnosed, Transplant Ineligible

Core options include: IMiDs, Pis, and CD38 antibodies

1. Rafumar Veta. Am J Hemet 202439.1802:1824. PeerView

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14. For Early Relapse, the NCCN Suggests Use of BCMA CAR-T
and SOC Options Depending on Prior Therapy!

Therapy for Previously Treated RRMM After 1-3 Prior Therapies
Preferred Regimens

+ Daratumumab-refractory: KRd, KPd, Pom-Vd, EPd, IxaPd

+ Bortezomib-refractory: KRd, KPd, triplets with daratumumab or isatuximab, Elo-Pd

+ Lenalidomide-refractory: triplets with daratumumab or isatuximab, KPd, Elo-Pd, IxaPd
CAR-T Cell Therapy

After 1 prior therapy including an IMiD and a PI, and refractory to lenalidomide
+ Ciltacabtagene autoleucel (category 1)

After 2 prior therapies including an IMiD, a Pl, and an anti-CD38 monoclonal antibody
+ Idecabtagene vicleucel (category 1)

However, there is a need for newer MOAs in the later relapse setting
1.NCCN Cinial Practice Guielnos in Oncology Multiple Myeloma, Version 1.2025. Hipo -wmncon org/prolesionalsphyscan_ l/pdmyclome.. PeerView

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15. NCCN Guidelines Recommend CAR-T and Bispecific Antibodies
for Late Relapses!

Therapies for Patients With Late Relapses (>3 Prior Therapies)
Preferred Regimens

CAR-T Cell Therapy
+ Ciltacabtagene autoleucel
+ Idecabtagene vicleucel

After at least 4 prior therapies, including an anti-CD38 mAb, a PI,
and an IMiD

Bispecific antibodies
+ Elranatamab-bemm

+ Talquetamal
+ Teclistamab-cqyv

NON Cial Prctce Guidains in Oncology Mati Myeloma, Versio 12025. MR rm ce cg poesia sti. samen PeerView

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16. Talquetamab Was Approved Based on Its Efficacy
e MonumenTAL-1 Study

+ Long-term results show deep and durable responses with talquetamab in RRMM
+ ORR of 270% in patients naive to T-cell redirecting therapies (TCR) at different doses
+ ORR of 67% in 52 patients with prior TCR therapy

A "PR =VGPR "CR msCR
so 741 wae
80 (106/143 patients) À 66.7
70 CO7AS beter) (52/78 patients)
E 234
E 50
5 98
2VGPR = 59.4
go 2VGPR = 59.1 2VGPR = 55.1
30 26.6
20
10 =
o
0.4 mg/kg SC QW 0.8 mg/kg SC Q2W Prior TCR
1. dohubowiok À ea ASH 2023, Abst! 337. 2. Eosche Letal. EHA 2024. Abstract POI. PeerView

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17. ab in Patients

Chart review of patients with RRMM previously receiving T-cell directed
therapies (TCDT) now receiving talquetamab (N = 21 evaluable patients)!

Patient Demographics

Median of 7 (4-11) prior lines of therapy
85.7% (n = 18) triple-class refractory
57.1% (n = 12) penta-class refractory
76.2% (n = 16) received prior CAR-T

85.7% (n = 18) did not meet inclusion
criteria for the MonumenTAL-1 study

1. Grater A etal, ASCO 2024. Abstract 7524

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In this heavily pretreated population

Use of talquetamab demonstrated
favorable ORR (71.4%) and

CR rate (28.6%)

Comparable to patients in the
MonumenTAL-1 trial with and without
exposure to prior TCDT

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18. Common AEs With Talquetamab Were Primarily Low Grade and

Resolved Over Time

Summary of Key AEs Associated With Talquetamab

Resolved,

Immune AEs
CRS 76.7 15 26-28 h 99.8 5.9-14.5 0.3
ICANS te 1.8 24-115h 83.8 0-1.8 09
Infection 64 18.6 96-148 d 89 19.6-22.4 09
Oral AEs
Dysgeusia 72.3 N/A 13-20 d 38.3 5.5-11.8 06
Dysphagia 24.2 0.9 21-29d 65.9 1.4-5.9 0
Dry mouth 36 0 19-26 d 39 1.4-5.9 0
Weight decrease 39.5 32 87-91 d 38.7 NR 0.9
Skin AEs
Rashes 38.4 35 20-27 d 78.9 3.9-6.3 0
Nonrashes 65.2 0.3 26-30 d 59.4 0.7-8.4 0.9
Nail-related AEs 55.5 0 64-69 d 29.5 0-2 0
2 Faber ar Prog rotor ps mm accedan govdrgsaéo_dostabel202/761942s0006 pat PeerView

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19. RedirecTT-1: Can Talquetamab Be Combined With BCMA
Therapy in Pretreated MM?!

+ N = 94 patients with RRMM

+ Talquetamab-teclistamab combination is highly active at all dose levels, with durable
responses in the RP2 dose cohort

Overall Response
=PR mVGPR mCR =sCR

80
(35/44 patients)

Patients, %

Recommended Phase 2
Regimen

1. Cohen YO ot al. Engl J Mod. 2025,302:138-149,

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78
(73/94 patients)

All Dose Levels oa 6

DOR in All Patients With a PR or Better

Recommended
phase 2 regimen

Dose levels 1-4

Patients, %
083888883888

9 12 15 18 21 24 27 d0 33 %
Time, mo

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20. Talquetamab + pomalidomide
(n= 265)

Key Eligibility Criteria
+ RRMM Pose
+ 1-4 prior LOT “= treatment
+ ECOGPS0-2 28) follow-up
(N=795)

Talquetamab + teclistamab

Investigator's choi
EPd or PVd (n = 2

1. Nooka AK etal ASH 2024. Abstract 4757 PeerView

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21. Is There Potential for GPRC5D in the Upfront Setting?’

+» The novel, immune-based combination regimen of Tal-Dara-Len elicited high and rapid responses that
were deep in patients with NDMM with 6-13 months of follow-up

ORR Tal(06mgkg Tal(08 mag
100 en an) am)

(8/8 patients) 2 -Dara-Len -Dara-Len

100 (25126 patients) ne) (n= 26)

90
& avorr=a0.a Medantolomwm. 21a) 58(17:120)
70 Median time to frst
Seo men response, mo 10923) 10949)
2 FR 2VGPR = 87.5 "CR (range)
2 =VGPR Median time to
2 PR best response, mo 3.8 (1.0-11.6) 1.9 (0.9-9.2)
30 (range)
20 6-mo DOR rate, %
10 (95% Cl) 100 (100.0-100.0) 100 (100.0-100.0)
© 6-mo PFS rate, %
Tal (0.6 mg/kg Q2W)-DaraLen — Tal(0.8 mg/kg Q4W)-DaraLen (65% Ch 100 (1000-1000) 95.8 (73.9-99.4)
ook AK ot a ASH 2028, Abstract 1075 PeerView

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22. What Are the Emerging GPRC5D
Strategies for MM?

2000-2025, PeerView

23. Forimtamig Is a GPRC5D Bispecific Antibody Active
in Early Studies in RRMM'2

1 +1 GPRC5D TCB exhi monovalent
binding to GPRC5D on myeloma cells =PR mVGPR BCR #sCR
60 sert 10/14 2CR patients (71.4%)
(95% Cl, 56.7-83.4) ORR = 63.6
70 (95% Cl, 49.6-76.2)
ozo *
ern 4
concso ren ES E
tei toms $6
E
40 2VGPR = 52.8
30
20
10
GPRCSD zB o
Forimtam verein“
ee
1. Echmamn Jt al Blood. 2025:145:202219. 2. Carl-Slla Ct al. ASH 2022. Abat 101. PeerView

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24. Construct

ClinicalTrials.gov
Phase
Population size

Dosing

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MCARH109

GPRC5D-targeted
CAR-T

NCT04555551
1
17
1 infusion of 25 x 108,

50 x 10%, 150 x 108, or
450 x 106 CAR-T cells

OriCAR-017 BMS-986393
GPRC5D-targeted GPRCSD-targeted
CAR-T CAR-T
NCT05016778 NCT04674813
il 1
10 33

1 infusion of 25 x 108,
75 x 108, 150 x 108,
300 x 10%, or
450 x 105 CAR-T cells

1 infusion of 1 x 10%/kg,
3 x 10%kg, or
6 x 10%/kg CAR-T cells

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25. BMS-986393 (Arlo-cel) Is Being Tested for Safety and Tolerability

in RRMM!

Part A and B, Cohort A:
Key Eligibility Criteria ‘Manufacturing successful

A e =
IMWG criteria

an

ee

regimens, including: Time on Study, à |
- Pl
N Leukapheresis
= Ani-CD38 H
7 Optional bridging therapy First post-treatment
ASCT (unless ineligible) required for disease cont; disease assessment
+ Prior BCMA-directed therapies "mitad to 528 days and
allowed, including CAR-T cell discontinued 219 days
therapies before Infusion

+ ECOG PS 0-1

+ Primary objective: Safety and tolerability (MTD/RP2D)
+ Secondary objectives: ORR, CRR, DOR, TTR by IMWG criteri
+ Exploratory objectives: MRD-negative status, pharmacodynamics

FS; OS

1. Bal Sot ASH 2024. Abarat 922 PeerView

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26. Early Efficacy Evidence With BMS-986393 (Arlo-cel) in RRMM'

Efficacy-Evaluable Population

Disease Characteristic “1 | SES

100 APR aVGPR nCR =sCR ia cimsTehastany H
ORR=91 Yes ——— 5260 rasen
3 ORR = 87 No — 179 8967-99)

à Extramedullary disease H
$ Yes ——A— 313686 (71-95)
8 No — > 38/43 88 (75-96)

9 High-risk cytogenetics |
e Yes —— 2631 84(66-95)
£ No —+— 4348 9077-97)

= Previous BCMA-targeted therapy H
2 Yes —— 30/38 7963-00)
H No u 1 95(84-99)
3 Yes; refractory — 136 81(54-96)

&
60 70 80 90 100
ORR, %
Overall (n=79) — 150 x 10* CAR-T Cells
(n=23)

1. Bal Sot ASH 2024 Abstract 922 PeerView

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27. Principles, Practice, and Partnerships
for Delivering Effective Sequential
Care With Non-BCMA Immunotherapy

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28. The Role of Wider Management Team for Sequential Care in MM

Treatment selection and
‘sequencing in collaboration
with patients

Oncologist
and
hematologist

Radiation
oncologist

A Patient
With RRMM

Orthopedic
surgeon

i

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Patient education,

adverse event

management, counseling

‘on dosing, care >
coordination

Patient education,
logistical considerations,
adverse event
management,
counseling, psychosocial

Social
worker

Psychiatrist
and
psychologist

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29. Susan is a 76-year-old patient
with MM

1L: CD38 quad, ASCT, R maintenance
= Standard-risk cytogenetics 2L: KRd; 11 month DOR (CAR-T planned)
3L: Selinexor-Vd; 3 month DOR
«Progressive disease after 4L: BCMA CAR-T therapy

4 prior LOT Progression <1 year after infusion

Susan presents with worsening functional status and requires immediate therapy.

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30. RC5D?

Cas

| Susan is a 76-year-old patient

with MM 1L: CD38 quad, ASCT, R maintenance

wStandard-risk cytogenetics

AL: BCMA CAR-T therapy
Progression <1 year after infusion

wProgressive disease after
4 prior LOT

Susan presents with worsening functional status and requires immediate therapy.

Discussion:
+ Is using another BCMA option recommended?
+ Or sequence to GPRC5D?

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31. RC5D?

Cas Next Steps in Treatment—BCMA or

Susan is a 76-year-old patient Treatment history
with MM 1L: CD38 quad, ASCT, R maintenance

#Standard-risk cytogenetics + 2L: KRd; 11 month DOR (CAR-T planned)
+ 3L: Selinexor-Vd; 3 month DOR
«Progressive disease after + 4L: BCMA CAR-T therapy

4 prior LOT Progression <1 year after infusion

Susan presents with worsening functional status and requires immediate therapy.

Recap:

+ SOC non-immunotherapy options have been exhausted

+ Susan is a candidate for talquetamab (GPRC5D) based on treatment history and
BCMA-exposure

+ Clinical trials are also an option

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32. With Talquetamab

Susan is a 76-year-old patient

with aM 1L: CD38 quad, ASCT, R maintenance
= Standard-risk cytogenetics 2L: KRd; 11 month DOR (CAR-T planned)
3L: Selinexor-Vd; 3 month DOR
«Progressive disease after 4L: BCMA CAR-T therapy
4 prior LOT Progression <1 year after infusion

Susan prepares for treatment with talquetamab, but scheduling step-up dosing
proves challenging due to travel considerations.

Discussion:
+ What principles should inform team counseling over step-up and

subsequent dosing?

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33. Talquetamab Step-Up Dosing and Administration Principles!’

Treatment dose 1

Ds Subsequent treatment doses: 0 4 mg/kg QW

1 week after first dose
0.8 mg/kg Q2W

Step-up dose 3: Treatment dose 1 ‘Subsequent treatment doses:
0.4 mg/kg nglkg

Day1 Day 4 Day 7° Day 10° 2weeks after first dose

Patients should be hospitalized for 48 hours after all doses within the step-up dosing schedule

Based on actual body weight * Dose may be administered between an 4 days ater the previous dose and may be given upto 7 days afer the previous dose to alow
{or resolution of avers reactors. «Dose maybe administered betwoen 2 an 7 days ator Stepp dose 3. «Maintain minimum of 12 days between Q2W doses. DoarVi ew
1. Talvoy (lalguetamab) Prescrbing Information. hips www accesscala da govidrugsatda_docsfabel 2023761342500 pa.

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34. PeerView.com/ESB827

tion Is Key to Addressing Inpatient-Outpatient
ic Antibody Therapy

Three Principles for Community Practice
and Navigating the Step-Up Period

. Consider collaboration with larger centers for step-up dosing

. Create bispecific treatment teams (eg, to deliver bispecifics

in the outpatient setting)

. Collaborate with nearby emergency departments

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35. Case: Counseling Patients on CRS Useful Resources for
AE Management

Susan is a 76-year-old patient Treatment history

with MM 1L: CD38 quad, ASCT, R maintenance
wStandard-risk cytogenetics 2L: KRd; 11 month DOR (CAR-T planned)
3L: Selinexor-Vd; 3 month DOR

Progressive disease after 4L: BCMA CAR-T therapy
4 prior LOT Progression <1 year after infusion

Assume Susan asks for counseling about CRS and other toxicities.

Discussion:

+ How would you counsel Susan on toxicities such as CRS?

+ What resources can be used to help support Susan as she prepares for therapy?
+ Is there a role for flexible dosing for AE management?

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36. General Monitoring Principles h Talquetamab!

Pre-Injection Post-Injection Subsequent Visits
+ Evaluate patients for signs + Monitor vitals every 4 h per Monitor patients for weight
of infection or symptoms of institutional guidelines loss; consider nutritionist
unresolved CRS/ICANS from + Watch closely for signs and consultation
previous dose symptoms of CRS Evaluate doses of
+ Administer premedications 1-3 h | . Monitor for signs of neurotoxicity weight-based medications if
before talquetamab dose and consider neurology significant weight loss occurs

+ Ensure correct drug and dosage
are prepared

evaluation at first sign of
confusion or disorientation

Instruct patients to report any
taste or skin/nail changes

Evaluate dermatologic/

oral AES

Discuss supportive measures
for dermatologic/oral AEs
Monitor for secondary skin
infection

1. Catamaro D et al. Somin Oncol Nurs. 2024:40:151712.

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37. CRS Management Recommendations on the Use of

Tocilizumab and Steroids‘

Parameter for

Rar Grade 1 Grade 2 Grade 3 Grade 4
ma Temp 238 °C Temp 238 * Temp 238 Temp 238 °C
(100.4 °F) (100.4 °F) (100.4 °F) (100.4 °F)
with
Not requiring Requiring a vasopressor Requiring multiple vasopressors.
(Ypo on höre vasopressors vasopressin (excluding vasopressin)
And/or
as Requiring high-flow nasal cannula, Requiring positive pressure (eg.
Hypoxia None pi facemask, nonrebreather mask, CPAP, BIPAP, intubation, and
or Venturi mask mechanical ventilation)
+ Tocilizumab = Telzumeb
+ Tocilizumab may be a + Tocilizumab + If no improvement, administer
cier > : methylprednisolone or dex;
guidelines if no + no improvement, administer Heel deta oidor
+ Steroids not applicable improvement on toi methylprednisolone or dex HE
GUESS immunosuppressants
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1. Leo D ot al. Bo! Blood Morrow Transplant. 2019.25:625:558.

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38. ons on the Use of
Tocilizumab and Steroids With Talquetamab*

CRS Management Recommenda

Parameter for

ee Grade 1 Grade 2 Grade 3 Grade 4
rover Temp 238 °C Temp 238 °C Temp 238 °C Temp 238 °C
(100.4 °F) (100.4 °F) (100.4 °F) (100.4 *F)
With
Requiring multiple
Hypotension None Not requiring vasopressors. Requiring a vasopressor + vasopressin vasopressors (excluding
vasopressin)
And/or
Requiring Requiring high-low nasal cannula, Requiring posiive pressure
Hypoxia None low-flow nasal cannula facemask, nonrebreather mask, or Venturi (eg, CPAP, BiPAP, intubation,
‘or blow-by mask ‘and mechanical ventilation)
+ Duration <48 h: Withhold talquetamab
: until CRS resolves + supportive
| | + Withhold talquetamab until therapy; premedication prior to next
+ Withhold talquetamab until CRS CRS resolves; dose; 48-h hospitalization following + Permanently discontinue
resolves; premedication prior to premedication prior to next ES talquetamab; provide
next dose dose; 48-h hospitalization supportive care
Font rele des + Recurrent or duration >48 h:
Permanently discontinue talquetamab;
provide supportive care
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1. Gatamero D et al. Somin Oncol Nurs. 2024:40:151712.

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39. Patient Information Sheets Can

With Bispecifics in MM!

Help Prepare for TEAEs

Temperature 100.4 F or greater

Patient name: Dos:
Diagnosis: ‘Current treatment:

Treatment start date: My highest risk of side effects Is on (ae).
“Treatment team:

(Contact information:

CRS symptoms to monitor or

Neurotoxicity symptoms to monitor for

e son

En A eSB ange tor bacon :

2 Dostese n SBP >10 mg tom basen andor SBP «Bikey vat epee
<90 mmHg I seyn!

+ Increased heart rate >110 or >20 bpm from baseline while od
ai

Wat ol ronior at hone? Vow oon do montar?

an

Ar

+ Hem

gentes

Wen do | cal my doctor' office?
+ Any symptom of CRS or change in thinking or speech

men should | o straight to the ER?

‘What number should 1 cal?
+ During office hours:
+ After office hours:

1. Crombie J ot Blood. 2024,143:1865-1575

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40. Recommendations for Managing Specific Toxicities Associated

With Talquetamab in RRMM!

Baking soda/salt water/magic mouth rinse

Dysgeusia + Alternative sources of protein if adverse to meat

Hydration

Soft/bland foods, cold or

Dry Mouth room temperature

Moisten food with broth or sauces
Limit caffeine and alcohol intake

Small bites

Frequent small meals

+ Avoid meat and dry foods, take sips
of liquid between bites

Dysphagia

1. Gatamero D et al. Somin Oncel Nurs. 2024:40:1817 12

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Add flavor with citrus, herbs, spices, wine-based marinades

Gum or hard candy, frozen fruit,
ice chips, tart drinks

Monitor for oral candidiasis
Recommend routine dental exams

Soft or mashed foods
Food purees

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41. Skin Toxicity

Nail Toxicities

Recommendations for Managing Specific Toxicities Associated
With Talquetamab in RRMM' (Cont'd)

Small frequent meals and snacks with protein

Nutrient- dense foods

Add calorie-boosting foods (olive oil, nut butter, etc.)

Oral appetite stimulants

Hydration

Emollients

Lukewarm or cold showers
Ammonium lactate for pruritus

Oral antihistamines or topical steroids

Nail/finger cots or gloves

File nails to smooth edges and corners.
Frequent applications of emollients
Nail hardeners

1. Gatamero D et al. Somin Oncel Nurs. 2024.40:181712.

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Soaps for sensitive skin

Colloidal oatmeal baths

Can be escalated to triamcinolone
cream or methylprednisolone

Vitamin E oil
Biotin supplement
Monitor for secondary nail infections

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42. Patient Ed

ation Is an Important Part of a Holistic AE

Management Plan With Talquetamab

{le

Three Key Principles

Set patients’ expectations early (eg, to help with the emotional aspect
of taste and skin/nail changes)

. Suggest support groups (eg, HealthTree.org) that can provide education

3.

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and peer communication forums to share insights on specific issues
related to treatment

Educate patients that the AEs are manageable and will lessen over time

tr Example: counsel patients that once a response has been achieved,
the dosage and/or frequency of talquetamab may be reduced, which
may help mitigate the side effects in many patients

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43. Evidence Supporting Flexible Dosing and Manageme

of GPRC5D-Related AEs'

a Prospective Dose Intensity Reduction Cohorts —
+ Responses were maintained Response Maintained After Switch

in patients who reduced dose ORR

=PR =VGPR =CR =sCR

intensity in MonumenTAL-1, 100
providing rationale to 80
prospectively evaluate
dose reduction

2VGPR=75

ORR, %

+ Data support flexibility to
adjust dosing of talquetamab
in responders to potentially
improve patient experience
while maintaining efficacy

PFS, %

o
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1. Chari A tal. COMy 2024. Oral presentation

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44. res Her Story

Let's watch Vikki's story

HealthTree Foundation .
FOR MULTIPLE MYELOMA PeerView

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45. umming Up Se ial Treatment in RRMM

j er With RRMM progressing after 3-5 prior LOT who are unable
Candidates for to access CAR-T or at high-risk of manufacturing failure

bispecifics can
include patients ... |” With rapidly progressing/aggressive MM (unable to wait for CAR-T)

er Failing treatment with CAR-T

Thoughts on sequencing between BCMA and GPRC5D platforms

BCMA BCMA
“
os

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46. Concluding Th ts on GPRC5D-Targeted T

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GPRC5D-targeted therapy is a reasonable choice after CAR-T
or BCMA-targeted bispecific therapy in RRMM

Patient preferences, logistics, and potential toxicities need to be
considered when sequencing therapies in RRMM

More needs to be learned from ongoing, real-world studies on
sequencing of therapies

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