Clinical Nurse Specialist University College London Hospitals London, England, United Kingdom
Introduction: Talquetamab is a bispecific T cell antibody targeting GPRC5D/ CD3 and is approved for patients with relapsed and refractory multiple myeloma (RRMM). Whilst it has significant efficacy, patients experience on target off tumour toxicities affecting the mouth, skin and nails. Quality of life (QOL) data is limited to the MonumenTal 1 trial with global and myeloma specific patient reported outcomes. We therefore aimed to characterise the real world patient experience to improve the quality of our service.
Methods: Qualitative semi-structured interviews were performed at a single time point on a sub-group of patients with RRMM treated with Talquetamab through a named patient programme at a single institution between July 2023- May 2024. Interviews were performed by a Clinical Nurse Specialist (CNS) with questions centred around experiences of treatment, support received, aspirations of patients before being treated and effect on quality of life. Data was analysed using a Braun and Clarke's thematic analysis approach from recordings of telephone or in person interviews. Themes were generated and grouped prior to analysis.
Results: 9 patients participated in interviews (5 male, 4 female; 6 White, 2 Black, 1 Asian) at a median of 9 months from treatment.
Themes identified included physical side effects, effects on QoL and psychological effects. 33% reported that Talquetamab had improved their quality of life and 45% felt that the treatment gave them hope for the future and might improve their overall outcomes. 33% found the subcutaneous administration convenient, allowing them to continue with their usual activities of daily living.
Common side effects identified included nail changes (89%) dysgeusia (67%), skin changes (89%) and weight loss (45%), similar to trial reported outcomes. 67% of patients felt that the supportive therapy received concomitantly with Talquetamab ameliorated symptoms. 56% of patients experienced anxiety around social events due to difficulty eating, and 33% developed low mood due to physical effects. 22% of patients felt socially isolated due to changes in their physical appearance, whilst 22% felt they would benefit from better dietician support.
Overall, patients felt they received adequate support from clinicians and in particular the CNS teams which significantly improved their overall experience. 67% of patients felt they had received appropriate information prior to commencing Talquetamab but 33% did not feel prepared for the side effects.
Conclusions: Talquetamab was able to bring hope and improve QOL in patients with no other treatment options. Side effects were a major reported theme; however supportive medications and particularly CNS input were beneficial to coping strategies. This data serves to highlights the needs for patients receiving Talquetamab.
