Dose adjustment methods and precautions for talquetamab-tgvs

Dose adjustments of talquetamab are generally based on tolerability and treatment response in patients with multiple myeloma (MM). This medication is available in two common dosing schedules: weekly and biweekly. The dose escalation and adjustment methods of the two programs are slightly different, but the core goal is to gradually increase the dose according to the patient's immune response and side effects to achieve the best therapeutic effect.

For a weekly dosing schedule, dose escalation of taquitumab generally follows the following steps: On the first day of treatment, patients start at a dose of 0.01 mg/kg. Next, the dose was increased to 0.06 mg/kg on the 4th day of treatment and to 0.4 mg/kg on the 7th day. In subsequent weekly treatments, the dose will be maintained at 0.4 mg/kg with each subcutaneous injection. It is worth noting that if the patient develops adverse reactions after the previous treatment, the dosing interval can be extended and can be postponed to a maximum of 7 days, but the interval between each dose must be at least 6 days.

For dosing every two weeks (biweekly regimen), dose escalation is also staged. The starting dose is 0.01 mg/kg on the first day, increased to 0.06 mg/kg on the 4th day, and 0.4 mg/kg on the 7th day. On day 10, the initial dose is adjusted to 0.8 mg/kg and maintained at this dose by subcutaneous injection every two weeks. For these two dosing regimens, if adverse reactions occur, doctors may appropriately extend the dosing interval and adjust the dose based on the patient's specific response.

In actual clinical applications, dose adjustment requires close monitoring of the patient's immune response and side effects. If patients experience more severe allergic reactions, rashes, or other immune-related side effects, dose escalation should be suspended and continued after symptoms subside. When the patient's physical condition permits, dose escalation should be carried out gradually to ensure the best therapeutic effect.

Reference materials:https://www.talveyhcp.com/