Impact of extramedullary plasmacytoma on outcomes in patients with relapsed refractory multiple myeloma treated with talquetamab: U.S. Myeloma Immunotherapy Consortium

@article{afrough2026impact,
  title = {{Impact of extramedullary plasmacytoma on outcomes in patients with relapsed refractory multiple myeloma treated with talquetamab: U.S. Myeloma Immunotherapy Consortium}},
  author = {Aimaz Afrough and Oren Pasvolsky and Andrew J. Portuguese and Saurabh Zanwar and Mahmoud R. Gaballa and Aishwarya Sannareddy and Danai Dima and Utkarsh Goel and Hossam M. Ali and Kelley Julian and Andre De Menezes Silva Corraes and Murali Janakiram and Scott Goldsmith and James A. Davis and Kimberly Green and Noa Biran and Lindsay Fogel and Eli Zolotov and Megan M. Herr and Hamza Hassan and Leyla Shune and Jeries Kort and Christina Ye and Susan Bal and Luciano J. Costa and Laura Joiner and Samer AL Hadidi and Adeel M. Khan and Shahzad Raza and Faiz Anwer and Jack Khouri and Rahul Banerjee and Raffaela Cassano Cassano and Surbhi Sidana and Masooma Shifa Rana and Lekha Mikkilineni and Hitomi Hosoya and Shebli Atrash and Christopher Ferreri and Cindy Varga and Douglas W. Sborov and Shonali Midha and Omar Nadeem and Ariel Grajales-Cruz and Rachid Baz and Brandon Blue and Ciara Freeman and Frederick L. Locke and Krina K. Patel and Yi Lin and Shaji K. Kumar and Doris K. Hansen and Larry D. Anderson Jr and Peter M. Voorhees and Omar Castaneda-Puglianini},
  journal = {Blood cancer journal},
  year = {2026},
  month = jul,
  doi = {10.1038/s41408-026-01565-0},
  url = {https://europepmc.org/article/PMC/PMC13691119},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Impact of extramedullary plasmacytoma on outcomes in patients with relapsed refractory multiple myeloma treated with talquetamab: U.S. Myeloma Immunotherapy Consortium
AU  - Aimaz Afrough
AU  - Oren Pasvolsky
AU  - Andrew J. Portuguese
AU  - Saurabh Zanwar
AU  - Mahmoud R. Gaballa
AU  - Aishwarya Sannareddy
AU  - Danai Dima
AU  - Utkarsh Goel
AU  - Hossam M. Ali
AU  - Kelley Julian
AU  - Andre De Menezes Silva Corraes
AU  - Murali Janakiram
AU  - Scott Goldsmith
AU  - James A. Davis
AU  - Kimberly Green
AU  - Noa Biran
AU  - Lindsay Fogel
AU  - Eli Zolotov
AU  - Megan M. Herr
AU  - Hamza Hassan
AU  - Leyla Shune
AU  - Jeries Kort
AU  - Christina Ye
AU  - Susan Bal
AU  - Luciano J. Costa
AU  - Laura Joiner
AU  - Samer AL Hadidi
AU  - Adeel M. Khan
AU  - Shahzad Raza
AU  - Faiz Anwer
AU  - Jack Khouri
AU  - Rahul Banerjee
AU  - Raffaela Cassano Cassano
AU  - Surbhi Sidana
AU  - Masooma Shifa Rana
AU  - Lekha Mikkilineni
AU  - Hitomi Hosoya
AU  - Shebli Atrash
AU  - Christopher Ferreri
AU  - Cindy Varga
AU  - Douglas W. Sborov
AU  - Shonali Midha
AU  - Omar Nadeem
AU  - Ariel Grajales-Cruz
AU  - Rachid Baz
AU  - Brandon Blue
AU  - Ciara Freeman
AU  - Frederick L. Locke
AU  - Krina K. Patel
AU  - Yi Lin
AU  - Shaji K. Kumar
AU  - Doris K. Hansen
AU  - Larry D. Anderson Jr
AU  - Peter M. Voorhees
AU  - Omar Castaneda-Puglianini
PY  - 2026
DA  - 2026/07/01
JO  - Blood cancer journal
DO  - 10.1038/s41408-026-01565-0
UR  - https://europepmc.org/article/PMC/PMC13691119
AB  - Talquetamab, a GPRC5D-targeting bispecific antibody, shows promising activity in relapsed-refractory multiple myeloma. However, real-world outcomes in patients with extramedullary disease (EMD) remain poorly described. We studied 360 patients treated with talquetamab at 15 U.S. centers by Dec 2024. Soft tissue plasmacytomas (STP) were classified as EMD (not contiguous with bone) or paraskeletal disease (PSD; contiguous with bone). If both were present, patients were assigned to the EMD category. Of those, 97 (27%) had EMD, 22 (6%) had PSD, and 241 (67%) had No-STP. Median follow-up was 12.8 months. Overall response rates were 68% in EMD, 63% in PSD, and 65% in No-STP (p = 0.8). Median progression-free survival was 4.3, 4.5, and 7.8 months, respectively (p = 0.009), and median overall survival was 10.3 months, 13.0 months, and not reached (p = 0.070). These findings demonstrate that EMD and PSD are associated with preserved response rates but shorter PFS and OS with talquetamab. While systemic markers of tumor burden and inflammation—particularly lactate dehydrogenase (LDH) and ferritin—emerged as independent predictors of inferior PFS, elevated LDH also retained independent prognostic significance for OS. While EMD was associated with shorter PFS and OS on univariate analysis, it did not retain independent prognostic significance on multivariable analysis, suggesting that inferior outcomes are driven by aggressive disease biology rather than by lesion anatomy alone. These findings are hypothesis-generating and require prospective validation. Talquetamab retains clinical utility in this high-risk population with EMD, though outcomes are suboptimal with a need for further refinement of treatment approaches.
SN  - 2044-5385
ER  -