Health ArticleEducational review — not personal medical advice

Bispecific Antibodies and CAR-T Cell Therapy in Multiple Myeloma: A Patient's Guide to New Immunotherapy Approaches

21 min

Multiple myeloma (MM) remains an incurable blood cancer, but two groundbreaking immunotherapy strategies—bispecific antibodies and CAR-T cell therapy—are transforming treatment options, especially for patients whose disease has stopped responding to standard therapies. This medical review covers the approved drugs Talquetamab, Teclistamab, Elranatamab, and the CAR-T therapies idecabtagene vicleucel (Ide-cel) and ciltacabtagene autoleucel (Cilta-cel), reporting overall response rates ranging from 61% to 97% across key clinical trials. Notably, 89% of patients successfully used Talquetamab as a "bridge" to CAR-T therapy, and studies show that age alone should not disqualify older patients from receiving these powerful treatments.

Table of Contents

Key Points

  • In a 134-patient study, 89% successfully used Talquetamab as a bridge to CAR-T therapy.
  • Older patients over 75 responded well to Teclistamab, with no grade 4 toxicity.
  • Outpatient Teclistamab step-up dosing was feasible; CRS-related hospital stays averaged 2 days.
  • Cilta-cel showed higher response rates than Ide-cel but with more severe toxicity.
  • Elranatamab produced a 61% response rate with no severe cytokine release syndrome.

What Is Multiple Myeloma and Why Is It So Difficult to Treat?

Multiple myeloma is the second most common blood cancer (hematologic cancer) in adults, and its incidence has been rising in recent years. According to the SEER database, 47,966 new cases were diagnosed between 2014 and 2018 in the United States alone.

The disease begins when plasma cells—a type of white blood cell responsible for producing antibodies—become malignant and multiply uncontrollably in the bone marrow. Over time, these cancer cells accumulate genetic changes: copy number modifications, secondary mutations, and epigenetic alterations. These changes create what doctors call intratumor heterogeneity, meaning that within a single patient, multiple distinct clones of cancer cells exist, each with its own resistance mechanisms. This is a major reason why multiple myeloma has been so hard to cure.

Standard treatments have improved survival significantly. Proteasome inhibitors (PIs), anti-CD38 monoclonal antibodies, and immunomodulatory drugs (IMiDs) are now used in various combinations. Patients who are eligible for autologous stem cell transplantation (ASCT)—a procedure that uses the patient's own stem cells—or CAR-T cell therapy often receive these combination treatments for three to six months as a "bridge" to prepare their bodies for the more intensive procedure.

The Unmet Need: Relapsed/Refractory Multiple Myeloma

Despite these advances, some patients become refractory, meaning their disease stops responding to treatment. This is especially challenging for patients who have been exposed to all three major drug classes: anti-CD38 antibodies, proteasome inhibitors, and immunomodulatory drugs. These "triple class exposed" patients face particularly poor outcomes. According to the LocoMMotion study, patients with relapsed/refractory multiple myeloma (RRMM) receiving standard-of-care therapy had only a 29.8% overall response rate and a median overall survival of just 12.4 months.

Fortunately, the treatment landscape is now being reshaped by two powerful immunotherapy approaches: bispecific antibodies that redirect the body's own T cells to attack myeloma cells, and CAR-T cell therapy, which involves genetically engineering a patient's T cells to recognize and destroy cancer cells. This review explores both strategies in depth and provides practical guidance on how they are being sequenced and administered in real-world clinical practice.

How Bispecific Antibodies Work

Bispecific antibodies are engineered proteins that act as a bridge between two different targets. One end of the antibody binds to a protein on the surface of the patient's immune T cells (usually CD3), while the other end binds to a protein on the surface of myeloma cells. This physical connection forces the T cell to engage with and kill the myeloma cell.

There are three key target proteins on myeloma cells that bispecific antibodies are designed to recognize:

  • BCMA (B-cell maturation antigen): A cell membrane receptor glycoprotein found almost exclusively on plasma blasts and plasma cells, making it an ideal therapeutic target. Its N-terminal section contains six motifs, classifying it as part of the tumor necrosis factor receptor superfamily 17 (TNFRSF17)/CD269. BCMA plays a vital role in immune function.
  • GPRC5D (G-protein-coupled receptor family C group 5 member D): A type C seven-pass transmembrane receptor protein that is expressed at levels at least 500-fold higher on malignant and normal plasma cells in the bone marrow compared to circulating plasma cells. Among normal tissues, only hair follicles express GPRC5D.
  • FcRH5 (Fc receptor-homolog 5): Another emerging target on myeloma cells.

These bispecific agents have been proven to induce deep and durable responses in heavily pre-treated patients, offering new hope where older treatments have failed.

Talquetamab (Talq): Targeting a New Marker on Myeloma Cells

Talquetamab (Talq) is a bispecific antibody directed against GPRC5D. It has been approved for patients with relapsed/refractory multiple myeloma who have progressed on at least four prior lines of therapy. Its approval was based on the pivotal MonumenTAL-1 trial, which demonstrated:

  • A 70% overall response rate (ORR)—meaning 7 out of 10 patients experienced significant tumor shrinkage
  • A median duration of response (DOR) of 10.2 months, showing that responses were meaningful and lasted nearly a year

However, Talquetamab has a distinctive side effect profile due to GPRC5D expression on hair follicles. Patients commonly experience:

  • Dysgeusia (taste changes): 60% of patients
  • Weight loss: 30% of patients
  • Skin changes: 70% of patients

Table 1 below summarizes the approved bispecific antibodies covered in this review, with their targets, trial names, response rates, and notable toxicities:

Table 1. Currently Approved Bispecific Antibodies with Trial Data

  • Talquetamab (Target: GPRC5D; Pivotal trial: MonumenTAL-1): ORR 70%, median DOR 10.2 months. Notable toxicities: cytokine release syndrome (CRS) in 78%, dysgeusia, skin/nail changes.
  • Teclistamab (Target: BCMA; Pivotal trial: MajesTEC-1): ORR 63%, median DOR 18.4 months. Notable toxicities: CRS in 72%, neurotoxicity, infections.
  • Elranatamab (Target: BCMA; Pivotal trial: MagnetisMM-3): ORR 61%, median DOR not reached by 14 months of follow-up. Notable toxicities: CRS in 58%, cytopenias, infections.
  • Linvoseltamab (Target: BCMA; Pivotal trial: LINKER-MM1): ORR 71%, median DOR data maturing. Notable toxicities: CRS, cytopenias, infections.

Talquetamab as a "Bridge" to CAR-T Therapy

A key question in clinical practice is how bispecific antibodies and CAR-T therapy should be sequenced. The authors of this review suggest using Talquetamab as a therapeutic bridge to BCMA CAR-T therapy. The rationale is that Talquetamab can achieve significant disease debulking (reducing the tumor burden) before the patient undergoes CAR-T cell collection and infusion, and it provides an opportunity for dual targeting—attacking the myeloma through a different antigen (GPRC5D) than the CAR-T cells will target (BCMA).

A retrospective multi-institutional study evaluated the safety and efficacy of this bridging strategy. The study included 134 patients, of whom:

  • 43% had extramedullary disease (myeloma outside the bone marrow)
  • 45% had high-risk cytogenetics (genetic abnormalities associated with aggressive disease)
  • 10% had prior BCMA therapy
  • Patients had received a median of 5 prior treatment lines

Among patients treated with Talquetamab as bridging therapy, 77% were treated every 2 weeks and 23% were treated every 4 weeks. Critically, 119 patients (89%) successfully proceeded to CAR-T cell therapy. The distribution of CAR-T therapies used included:

  • Idecabtagene vicleucel (Ide-cel): 18%
  • Ciltacabtagene autoleucel (Cilta-cel): 82%

The results were encouraging. In patients who received Talquetamab as a bridge to CAR-T:

  • 49% had a deep response (complete response or stringent complete response, meaning no detectable myeloma)
  • 46% had unchanged response (stable disease)
  • Median progression-free survival (PFS) was 13 months (interquartile range 10 to not estimable)
  • Median follow-up from the first Talquetamab dose was 7.5 months
  • Following CAR-T, the median follow-up was 4.9 months

The toxicities observed with this bridging approach are summarized in Table 2:

Table 2. Toxicities for Talquetamab and CAR-T

  • Cytokine release syndrome (CRS): Talquetamab 68% (grade 1–2 only; no grade ≥3 reported) vs. CAR-T 72%
  • Immune effector cell-associated neurotoxicity (ICANS): Talquetamab 10% vs. CAR-T 10%
  • Skin toxicities: Talquetamab 42%; not reported for CAR-T
  • Oral toxicities: Talquetamab 56%; not reported for CAR-T
  • Delayed neurotoxicity: CAR-T 1.5%
  • Infections: CAR-T 27%
  • Secondary malignancies: CAR-T 1.5%
  • New Guillain-Barré syndrome: 0% for both
  • Parkinsonian symptoms: 0% for both

Ultimately, 85% of patients proceeded to CAR-T therapy, achieving a complete or stringent complete response (CR/sCR) in 52%, a very good partial response (VGPR) in 71%, and an overall response rate (ORR) of 95%, with most patients deepening their response over time. In plain terms, this means that more than 9 out of every 10 patients who followed this sequential approach experienced significant benefit, and more than half achieved what appears to be complete elimination of detectable disease.

Teclistamab: The First BCMA-Targeting Bispecific

Teclistamab is the first bispecific antibody designed to redirect T cells by binding to CD3 on T-lymphocytes and BCMA on myeloma cells. It uses a weight-based dosing system that delivers sustained, significant responses in patients with relapsed/refractory multiple myeloma. The MajesTEC-1 trial reported a 63% overall response rate and an 18.4-month median duration of response.

Because of the risk of toxicities—particularly cytokine release syndrome—and the need for close monitoring, step-up dosing of Teclistamab is commonly done in the inpatient (hospital) setting. However, the authors examined whether this could be done safely in the outpatient (clinic) setting, which would be far more convenient for patients.

Can Teclistamab Be Given in the Outpatient Setting?

A retrospective study evaluated successful outpatient dose escalation (step-up dosing, or SUD) of Teclistamab from 2022 to 2023. The study included 57 patients, of whom 89.2% (n=57) initiated Teclistamab in the outpatient setting. Key findings included:

  • 54.2% of patients completed step-up dosing using the 3-day dose interval
  • 18 patients (31.6%) developed cytokine release syndrome including one patient with Grade 4 CRS
  • All patients who developed CRS required hospital admission
  • Tocilizumab (a medication used to treat CRS) was required in 6 patients, but it was not given prophylactically
  • The median CRS-related hospital stay was just 2 days

The authors note that these rates of CRS and healthcare utilization burden were low—actually lower than those reported in the pivotal MajesTEC-1 trial. However, they caution that this may be partly due to underreporting in the outpatient setting and the limitations of retrospective data review. Overall, the conclusion was that outpatient administration of Teclistamab appears feasible, offering patients a more convenient treatment option without compromising safety.

Should Age Prevent Teclistamab Treatment?

Because older patients are often excluded from clinical trials, there is uncertainty about whether they benefit equally from new treatments. A retrospective multicenter study specifically addressed this question by comparing two cohorts of patients with RRMM: those younger than 75 years and those older than 75 years, all of whom received standard-of-care Teclistamab. The study included 83 patients in the older cohort.

Key efficacy results:

  • The older group had a lower rate of high-risk cytogenetics (45%) compared to the younger group (58%)
  • The overall response rate was 62% in the older group versus 53% in the younger group—meaning older patients actually responded better

Key safety results:

  • ICANS: 19% in older group vs. 13% in younger group (not statistically significant)
  • CRS: 59% in older group vs. 52% in younger group (not statistically significant)
  • No grade 4 events were observed in the older group
  • Time to CRS onset and maximum CRS severity did not differ significantly between age groups
  • Time to ICANS onset was shorter in the older group (3 days) compared to the younger group (4 days), but this difference was not statistically significant
  • Infection rate was higher in the older group: 25% versus 10% in the younger group

These real-world results mirror those seen in the MajesTEC-1 trial's elderly subgroup, showing good efficacy without substantially increased toxicity in older patients. Based on these findings, the authors explicitly recommend that age should not preclude the use of Teclistamab treatment.

Elranatamab: A Humanized Bispecific Antibody

Elranatamab (PF-06863135) is a humanized bispecific antibody designed to target myeloma cells by simultaneously binding both CD3 receptors on T cells and BCMA on myeloma cells. Once bound, T cells are activated to induce a cytotoxic (cell-killing) T-cell response against the myeloma.

In the phase 2 MagnetisMM-3 trial, patients with relapsed or refractory multiple myeloma received subcutaneous (under-the-skin) Elranatamab once weekly after two step-up priming doses. The trial reached its primary endpoint with impressive results:

  • Confirmed objective response rate (ORR) of 61.0%
  • Complete response rate of 35%
  • Among responders, 80% achieved improved or sustained response for ≥6 months

At a median follow-up of 14.7 months, several key measures had not yet been reached, indicating lasting benefit:

  • Median duration of response: 71.5% of patients maintaining response at that time point
  • Progression-free survival: 50.9%
  • Overall survival: 56.7%

Frequently reported adverse events (any grade; grade 3–4) included:

  • Infections: 69.9% (any grade), 39.8% (grade 3–4)
  • Cytokine release syndrome: 57.7% (any grade), 0% (grade 3–4)
  • Anemia: 48.8% (any grade), 37.4% (grade 3–4)
  • Neutropenia (low white blood cell count): 48.8% (any grade), 48.8% (grade 3–4)

Notably, despite the frequent low-grade CRS, there were no grade 3 or 4 CRS events with Elranatamab, which is particularly reassuring for patient safety.

Emerging Agents: Linvoseltamab

The field continues to evolve rapidly. Linvoseltamab is a BCMA-targeting bispecific antibody that received accelerated approval from the U.S. Food and Drug Administration (FDA) in July 2025. This approval was based on promising results from the LINKER-MM1 trial:

  • ORR of 70.9%
  • Kaplan-Meier estimated median DOR of 29.4 months—the longest duration of response reported among the bispecific antibodies discussed here
  • Low-grade cytokine release syndrome was reported in a minority of patients

Longer-term follow-up data are still pending, which will help oncologists determine exactly how linvoseltamab fits into the treatment sequencing landscape for RRMM. As the authors note, the growing number of available agents creates both opportunities and challenges in choosing the right treatment at the right time for each patient.

CAR-T Cell Therapy: A Personalized Cellular Treatment

CAR-T therapy is fundamentally different from bispecific antibodies. Rather than being a manufactured protein given to the patient, CAR-T therapy involves collecting the patient's own T cells, genetically engineering them in a laboratory to recognize cancer cells, multiplying them, and infusing them back into the patient. These engineered "living drugs" then seek out and destroy myeloma cells.

The approval history of CAR-T agents for multiple myeloma shows rapid progress:

  • 2022: Ide-cel was approved for RRMM with progression on at least four prior lines of therapy
  • 2022: Cilta-cel was approved for the same indication
  • 2024: Ide-cel's approval was expanded to include patients with progression on two prior lines of therapy
  • 2024: Cilta-cel was expanded to include lenalidomide-refractory patients with progression on at least one prior line of therapy

This expansion to earlier lines of therapy reflects growing evidence of the transformative potential of these treatments.

Idecabtagene Vicleucel (Ide-cel)

Idecabtagene vicleucel (Ide-cel) is an autologous (a patient's own) T-cell therapy genetically engineered with a lentiviral vector to express a chimeric antigen receptor (CAR) that targets BCMA on myeloma cells. The receptor includes a murine (mouse-derived) extracellular single-chain variable fragment (scFv) specific for BCMA. When the anti-BCMA receptor binds to target cells, it triggers a signaling cascade through the CD3ζ and 4-1BB costimulatory domains, leading to CAR-T cell activation, proliferation, and production of cytokines against BCMA-expressing cells.

In the pivotal KarMMa-1 trial, 100 RRMM patients received one infusion of Ide-cel after lymphodepleting chemotherapy with cyclophosphamide and fludarabine. Results were impressive:

  • ORR of 72% (95% confidence interval: 62–81)
  • Stringent complete response (sCR) rate of 28% (95% CI: 19–38)
  • After a median follow-up of 10.7 months, the median duration of response was 11 months (95% CI: 10.3–11.4) in responders with at least a partial response
  • For patients who achieved stringent complete response, the median DOR was 19 months (95% CI: 11.4 months to not estimable)

In plain terms, nearly three-quarters of heavily pre-treated patients responded, and patients who achieved a complete response enjoyed a median duration of response of about a year and a half.

Ciltacabtagene Autoleucel (Cilta-cel)

Ciltacabtagene autoleucel (Cilta-cel) is a second-generation genetically engineered autologous CAR-T therapy that uses single-domain antibodies against two separate epitopes (binding sites) on the BCMA antigen. This "dual targeting" of BCMA is designed to enhance efficacy. Cilta-cel is the sixth CAR-T agent approved by the FDA for B-cell malignancies (following tisa-cel, axi-cel, brexu-cel, liso-cel, and ide-cel) and the second approved agent for multiple myeloma (after Ide-cel).

The phase 1 Legend-2 trial in China (described in Zhao et al., 2018) was a single-arm, open-label, multicenter study that initially evaluated Cilta-cel in 57 RRMM patients. The results demonstrated that a single Cilta-cel infusion produced a prompt, significant, and persistent response while maintaining an acceptable safety profile in heavily pre-treated patients:

  • ORR of 88%, including 68% complete responses, 5% VGPR, and 14% partial responses
  • 63% of patients achieved minimal residual disease (MRD) negativity at the 10⁻⁵ threshold (meaning fewer than 1 in 100,000 cancer cells remained)
  • Median time to first response: 1 month
  • At a median follow-up of 8 months: median progression-free survival was 15 months and median DOR was 14 months

By 2 years of follow-up, the results improved further: ORR was 97.9% and 82.5% of patients achieved stringent complete response. This means that long-term follow-up showed that virtually all treated patients responded, and more than 8 in 10 achieved a stringent complete response.

The pivotal CARTITUDE-1 trial confirmed these findings with an ORR of 97% (sCR 82.5%) and a median DOR of 14 months (see Table 3).

Table 3. Approved CAR-T with Trial Data

  • Idecabtagene vicleucel (Ide-cel) (Pivotal trial: KarMMa-1): ORR 72% (28% sCR), median DOR 11 months. Notable toxicities: CRS ~84%, neurotoxicity ~28%, cytopenias.
  • Ciltacabtagene autoleucel (Cilta-cel) (Pivotal trial: CARTITUDE-1): ORR 97% (sCR 82.5%), median DOR 14 months. Notable toxicities: CRS ~95%, neurotoxicity ~20%.

Cilta-cel vs. Ide-cel: Efficacy Versus Toxicity

A multicenter retrospective study directly compared safety outcomes and efficacy of Cilta-cel and Ide-cel in patients with RRMM who had been treated with at least 4 prior lines of therapy. This head-to-head comparison provided crucial insights:

Efficacy comparison:

  • ORR: Ide-cel 79% vs. Cilta-cel 89%
  • Best complete response: Ide-cel 47% vs. Cilta-cel 70%
  • Progression-free survival and overall survival: Both were superior with Cilta-cel

Safety comparison:

  • Patients treated with Cilta-cel experienced a statistically significant increase in grade ≥3 CRS compared to those treated with Ide-cel
  • Delayed neurotoxicity was statistically significantly higher with Cilta-cel
  • Infections were also statistically significantly higher in the Cilta-cel cohort

The authors summarize the trade-off clearly: Cilta-cel offers greater efficacy, but at the expense of greater toxicity. The limitations of this comparison include its retrospective design and the inherent biases of real-world data. Nonetheless, this information is invaluable for patients and oncologists weighing the risks and benefits of each option.

Clinical Implications: What This Means for Patients

The treatment landscape for relapsed/refractory multiple myeloma has been revolutionized by bispecific antibodies and CAR-T cell therapies, offering unprecedented efficacy for heavily pre-treated patients. Several key takeaway points emerge from this review:

  • Sequential therapy works. The successful use of Talquetamab as a bridge to CAR-T therapy—with 89% of patients able to proceed to CAR-T—demonstrates the power of combining different immunotherapy approaches. Targeting GPRC5D first, then BCMA with CAR-T, allows dual targeting and deeper responses.
  • Age should not be a barrier. The study of patients over 75 years old showed that older patients achieved a higher overall response rate (62% vs. 53%) than younger patients, with no grade 4 toxicity events. While infections were more common in older patients (25% vs. 10%), the overall safety profile supports using Teclistamab in this population.
  • Outpatient treatment is feasible. The retrospective outpatient Teclistamab study showed that most patients could complete step-up dosing with a 3-day interval, and CRS requiring hospitalization was manageable with a median hospital stay of just 2 days.
  • Newer agents are highly effective but with trade-offs. Cilta-cel shows superior efficacy to Ide-cel, but with higher rates of serious CRS, delayed neurotoxicity, and infections. These trade-offs require careful shared decision-making between patients and their oncology teams.

The recent expansion of approvals to earlier lines of therapy—Ide-cel now approved after two prior lines and Cilta-cel for lenalidomide-refractory patients after one prior line—reflects growing evidence that these treatments are most effective when used earlier in the disease course.

Limitations of This Review

It is important for patients to understand the limitations of the evidence presented in this review:

  • This is a review article, not a prospective clinical trial. It synthesizes data from multiple sources, including clinical trials and real-world retrospective studies.
  • Several key studies were retrospective, meaning they looked back at patient records and may include selection bias or underreporting of adverse events (such as the lower-than-expected CRS rates in the outpatient Teclistamab study).
  • The Talquetamab bridging study had a relatively short median follow-up (7.5 months from first dose and 4.9 months following CAR-T), so long-term durability of responses remains unknown.
  • Longer-term follow-up data for Linvoseltamab are still pending, so its full efficacy and safety profile has not yet been established.
  • The comparative study of Cilta-cel vs. Ide-cel was retrospective, not a randomized controlled trial, so unmeasured differences between patient groups could have influenced the results.
  • These therapies have significant toxicities, including cytokine release syndrome, neurotoxicity, infections, and secondary malignancies. Although most are manageable, they require treatment at specialized centers with experienced care teams.

Recommendations for Patients

  1. Discuss sequencing options with your specialist. If you are being evaluated for CAR-T therapy, ask whether a bispecific antibody such as Talquetamab could be used as a bridge to reduce disease burden before CAR-T infusion.
  2. Do not assume you are "too old" for newer therapies. Evidence from the Teclistamab studies suggests that patients over 75 can benefit substantially, though they may require closer monitoring for infections.
  3. Ask about outpatient treatment options. If you are starting Teclistamab, ask whether outpatient step-up dosing is available at your center—this approach appears feasible and may allow you to spend less time in the hospital. If you have concerns about CRS side effects, remember that when they occur, they are typically manageable.
  4. Understand the trade-off between efficacy and toxicity when choosing between CAR-T options. If your medical team offers a choice between Ide-cel and Cilta-cel, ask about your individual risk factors for CRS, neurotoxicity, and infections to make an informed decision.
  5. Pay attention to side effect monitoring. Taste changes, skin changes, weight loss (Talquetamab), infections, and cytopenias are common with these therapies. Report new symptoms early so your team can manage them proactively.

The current era represents a paradigm shift in the treatment of relapsed/refractory multiple myeloma. With deepening and more durable responses, these combination immunotherapy approaches hold the potential to transform multiple myeloma from a uniformly fatal disease into one with significantly improved survival outcomes and quality of life.

Frequently Asked Questions

What are bispecific antibodies and CAR-T cell therapy for multiple myeloma?

Both are immunotherapies that use your immune system to fight myeloma. Bispecific antibodies are engineered proteins that connect your T cells to myeloma cells, triggering their destruction. CAR-T therapy collects your own T cells, genetically modifies them to recognize cancer, and infuses them back as a living drug. Both are used when standard treatments stop working.

How effective is Talquetamab as a bridge to CAR-T therapy?

In a retrospective study of 134 patients, 119 patients (89%) successfully completed Talquetamab bridging and proceeded to CAR-T cell therapy. Among those, 95% achieved an overall response, 71% achieved a very good partial response or better, and 52% achieved a complete or stringent complete response. This sequential approach allowed dual targeting of different myeloma markers.

Can Teclistamab be given in an outpatient setting?

Yes, a retrospective study of 57 patients showed outpatient step-up dosing was feasible. About 54% completed dosing using a 3-day interval, and 31.6% developed cytokine release syndrome, all requiring hospital admission. The median CRS-related hospital stay was only 2 days. This offers a more convenient option without compromising safety.

Should age prevent older patients from receiving Teclistamab?

No. A retrospective multicenter study compared patients over 75 with younger patients. Overall response rate was 62% in older patients versus 53% in younger patients. No grade 4 toxicity occurred in older patients. Infections were more common (25% vs 10%), but the authors recommend that age alone should not preclude Teclistamab treatment.

What side effects does Talquetamab cause?

Talquetamab commonly causes cytokine release syndrome (78%), taste changes (60%), skin changes (70%), and weight loss (30%). These side effects are related to GPRC5D expression on hair follicles. Most are manageable with supportive care and monitoring. Always report new symptoms to your care team early.

What is the overall response rate for Elranatamab?

In the phase 2 MagnetisMM-3 trial, Elranatamab achieved a confirmed overall response rate of 61.0%, with 35% complete responses. Many responses were durable, with 71.5% of responders maintaining response at 14.7 months. Notably, there were no grade 3 or 4 cytokine release syndrome events, which is reassuring for safety.

When should a patient with relapsed/refractory multiple myeloma seek a second opinion on treatment with bispecific antibodies versus CAR-T therapy?

Seek a second opinion when choosing between bispecific antibodies and CAR-T therapy, or when planning their sequence. Talquetamab successfully bridges to CAR-T, with 89% of patients going on to CAR-T. Teclistamab is effective in patients over 75, and outpatient step-up dosing is feasible. Cilta-cel has higher response rates than Ide-cel but greater toxicity. Because these options differ in efficacy, side effects, and convenience, a second opinion can clarify which approach fits your disease burden and risk profile. Diagnostic Detectives Network provides independent expert second opinions.

Source Information

Original Article Title: Bispecific Antibodies and CAR-T cell Therapy in Multiple Myeloma

Authors: Margaret Locke, Amanda Lee, and Maria J Nieto, Department of Cancer, Northwell Health Cancer Institute & Donald and Barbara Zucker School of Medicine at Hofstra, Lake Success, NY, USA

Journal: Journal of Clinical Haematology, 2026; Volume 7, Issue 1, pages 13–18

Publication Dates: Received November 10, 2025; Accepted January 27, 2026

Citation: Locke M, Lee A, Nieto MJ. Bispecific Antibodies and CAR-T cell Therapy in Multiple Myeloma. J Clin Haematol. 2026;7(1):13–18.

Funding: The research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflict of Interest: The authors declared no conflicts of interest.

This patient-friendly article is based on peer-reviewed research. The original article is an open-access publication distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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