Multidisciplinary approach to managing GPRC5D-related adverse events in relapsed or refractory multiple myeloma patients

The introduction of talquetamab, a G protein-coupled receptor family C group 5 member D (GPRC5D)-targeting bispecific antibody, represents a novel therapy for patients with relapsed/refractory multiple myeloma (RRMM). Despite its promising efficacy, talquetamab is associated with distinctive adverse events (AEs), such as oral (dysgeusia, dysphagia, dry mouth) and dermatologic AEs (rashes, other skin-related symptoms, nail toxicities). These recommendations aim to develop a multidisciplinary framework for managing GPRC5D-related AEs, tailored for a wide audience that includes hematologists, oncology nurses, dieticians, and patients. A comprehensive literature review was conducted to identify current evidence and guidelines on GPRC5D-related AEs. Clinical experience from 12 Belgian healthcare professionals (6 hematologists, 4 nurses, 2 dieticians) was integrated and discussed to inform the development of practical recommendations. Data were synthesized to develop practical recommendations for managing common talquetamab-related AEs. Key AEs included dysgeusia, dry mouth, dysphagia, skin toxicities, and nail toxicities. These AEs, though mostly low-grade, impacted patient quality of life and nutritional status. Management strategies focused on dose modifications, oral care, dermatologic support, and early dietician referral. Patient education and multidisciplinary collaboration were identified as essential components of optimal supportive care. This is the first expert consensus-based set of multidisciplinary recommendations in Belgium addressing GPRC5D-related AEs. It provides practical, role-specific recommendations to support talquetamab-treated patients, improve tolerability, and optimize treatment adherence and outcomes.