SMC approves next-gen treatment talquetamab approved in Scotland
People living with myeloma in Scotland can now access the next-generation bispecific antibody, talquetamab (Talvey®).
The treatment targets myeloma in a new way compared to currently available bispecific antibodies and has been shown to deliver remission times of over 11 months.
Talquetamab can also be given fortnightly, which offers more flexibility and respite between doses.
Around 50 patients are expected to benefit from the new life-extending drug each year on the NHS in Scotland.
The Scottish Medicines Consortium (SMC) recommended talquetamab for myeloma patients who have had at least three previous treatments, including an immunomodulatory agent such as lenalidomide (Revlimid®), a proteosome inhibitor such as bortezomib (Velcade®) and an anti-CD38 antibody like daratumumab (Darzalex®).
Myeloma UK submitted data and evidence to SMC, along with clinicians and the pharmaceutical company, to make the case for talquetamab to be rolled out on the NHS.
Gabrielle King, Senior Policy Officer, said:
“This is fantastic news and we know it will make a huge difference to people with myeloma in Scotland. Talquetamab targets myeloma in a completely different way to currently available treatments. It is also more flexible, which means less time spent in hospital for patients and their families, and a better quality of life.
This is the culmination of months of hard work gathering and submitting evidence to SMC and it means that the treatment is now available to people across the UK. Until we have a cure, it is vital that everyone is given as many options as possible to keep their cancer at bay and to live better lives with myeloma.”
Talquetamab was licensed in the UK based on results from the phase 1/2 MonumenTAL-1 trial. According to the latest data, around 70% of patients on talquetamab responded to treatment, with almost 60% having a very good partial response, or better. The most common adverse events were cytokine release syndrome, taste changes, and infections. New data from the trial was shared as part of the appraisal and reported a median progression-free survival (PFS) of 11.2 months.
In the SMC appraisal, talquetamab was compared to teclistamab as the main comparator. The results from indirect comparison suggest that talquetamab can increase how long people live compared with teclistamab. The overall survival benefit was attributed to talquetamab’s unique targeting mechanism and reduction in the number of infections patients experience, compared with teclistamab.
Anne Head, from Pitlochry, was 66 when she was diagnosed with myeloma in 2019, after months of increasingly debilitating back pain.
Because of her history of joint problems, which saw her receive five knee replacements, her symptoms were initially put down to yet another orthopaedic issue, before being suddenly diagnosed with myeloma.
Over the next five years, Anne cycled through treatments, none of which were able to keep her myeloma at bay for long. When her cancer returned for the third time, she was told she had run out of options.
Thankfully, two months later, she was able to enrol in a clinical trial for talquetamab. Two years on, Anne is still in remission, and her myeloma is undetectable for the very first time since her diagnosis – even despite needing to take a break from the trial for four months last year due to septic arthritis.
“Sometimes I think how long will it work? But the fact that it has not reared its head makes me really hopeful. I spend the majority of my spare time doing things with my grandchildren, whether it be having them over for tea or going fishing. I really hope I’m here to see them starting senior school.
I’m still here and I’m still doing all the things that I enjoy. I’m doing a zipline in Wales with my son and my friend’s daughter in August. There is hope ahead and I’m full of positivity.”
Q&A
What does this decision mean for people with myeloma?
The approval means eligible myeloma patients across the UK now have access to talquetamab. It also means more patients could potentially have no detectable signs of myeloma in their blood and bone marrow following treatment, for longer.
What is talquetamab?
Talquetamab is a type of immunotherapy drug called a bispecific antibody.
It works by helping T cells (a type of immune cell) find and kill myeloma cells.
Talquetamab attaches to a protein found on the surface of myeloma cells called GPRC5D and a protein found on the surface of T cells called CD3, forming a link between myeloma cells and the T cell.
It is the only available myeloma treatment that targets myeloma in this way.
When will talquetamab be available on the NHS in Scotland?
A positive recommendation from the Scottish Medicines Consortium (SMC) means clinicians in Scotland can start prescribing the treatment to eligible patients. However, it may take some time for the treatment to become available, depending on the treatment itself and the capacity of hospitals to deliver it.
NHS boards across Scotland are expected to make the newly approved treatment, or an equivalent SMC-accepted medicine, available within 90 days of a positive decision from the SMC.
What about England, Wales and Northern Ireland?
Talquetamab should already be available to eligible patients in England, Wales and Northern Ireland following the positive recommendation from the National Institute for Health and Care Excellence last year.
Useful resources
- SMC Guidance: Talquetamab as monotherapy for the treatment of adults with relapsed and refractory myeloma
- MHRA: Talquetamab summary of product characteristics (SPC)
- MHRA: Talquetamab patient information leaflet (PIL)
- Myeloma Nurse Guide – Bispecific antibodies
- Digital Infosession: BCMA and GPRC5D antibodies in practice: Implementation and management for healthcare professionals
