Home›Allergy & Immunology› Talquetamab monotherapy linked to 51% any-grade infection rate in relapsed/refractory myeloma
Talquetamab monotherapy linked to 51% any-grade infection rate in relapsed/refractory myelomaNew data shows infection risks for patients on talquetamab
Frontiers in MedicinePublished August 19, 2026DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Consider monitoring for infections in RRMM patients on talquetamab; rates are high but evidence is exploratory.
This systematic review and meta-analysis evaluated infection risk associated with talquetamab monotherapy and talquetamab-based combinations in patients with relapsed/refractory multiple myeloma (RRMM). The analysis included 735 patients for any-grade infections and 584 patients for grade ≥3 infections. The primary outcome was infection risk, with secondary outcomes including infection-related mortality, reported pathogens, and preventive strategies.
For talquetamab monotherapy, the pooled rate of any-grade infections was 51% (95% CI, 34%–67%), and the rate of grade ≥3 infections was 22% (95% CI, 17%–28%). Infection-related mortality ranged from 0% to 3.2%. The authors note that combination regimens may carry a higher infection burden, though specific data were not reported.
The meta-analysis is limited by a small number of available studies and substantial heterogeneity (I² = 94.2% for any-grade infections; I² = 59.6% for grade ≥3 infections). The authors describe the results as exploratory and hypothesis-generating, and they caution that the findings for monotherapy should be interpreted as such.
For clinicians, these findings underscore a clinically meaningful risk of infections with talquetamab monotherapy in RRMM. The association between talquetamab and infection risk is based on pooled observational data, not a randomized comparison, and the certainty of evidence is low. Preventive strategies and vigilant monitoring for infections are prudent, but the exploratory nature of these results warrants cautious interpretation.
How this fits prior evidence
This meta-analysis extends prior coverage on bispecific antibodies in relapsed/refractory multiple myeloma, which called for cautious interpretation of efficacy and safety due to low evidence certainty. It provides quantitative infection risk estimates for talquetamab, complementing earlier findings on CAR-T neurologic toxicities and VTE risk models. The high heterogeneity and exploratory nature align with prior cautions about low certainty in myeloma treatments.
Living with relapsed or refractory multiple myeloma is a heavy burden, and choosing the right treatment involves weighing benefits against potential side effects. New data looks specifically at how the drug talquetamab affects patients' risk of developing infections.
Researchers found that about 51% of patients taking talquetamab monotherapy experienced some form of infection. Among those who took the drug, roughly 22% experienced more serious infections graded as level 3 or higher. While these numbers show a clear link between the medication and infection risk, the data is still early. Because there were only a few studies available to review, the results are currently considered exploratory.
It is important to note that combination therapies might lead to an even higher burden of infections compared to using talquetamab alone. Because the study had high variability between different reports, these findings help doctors understand potential risks while they continue to gather more evidence.
What this means for you:
About 51% of patients on talquetamab monotherapy experienced some infection, with 22% facing serious cases.
Common questions
How common are infections for people taking talquetamab?
The data shows that 51% of patients treated with talquetamab monotherapy experienced some type of infection. This means more than half of the patients in the study had an infection at some point during their treatment.
Are these infections usually serious?
While many infections occur, about 22% of patients taking talquetamab monotherapy experienced a grade 3 or higher infection. These are considered more serious cases that require closer medical attention.
How certain is this information about talquetamab?
Because there were a limited number of studies available, these results are currently considered exploratory and hypothesis-generating. The high variation between different reports means the data is still being interpreted by experts.
BackgroundTalquetamab, a first-in-class G protein–coupled receptor family C group 5 member D (GPRC5D) × CD3 bispecific antibody, demonstrates substantial clinical activity in relapsed/refractory multiple myeloma (RRMM). However, immune dysfunction associated with advanced disease, extensive prior therapies, and bispecific antibody–mediated immune modulation may increase susceptibility to infections. This systematic review and meta-analysis aimed to characterize infection risk associated with talquetamab, with separate evaluation of monotherapy and combination therapy settings.MethodsPubMed, Embase, Web of Science Core Collection, and Cochrane Library databases were searched from inception to July 1, 2026. Studies reporting infection outcomes among RRMM patients treated with talquetamab-containing regimens were eligible. Outcomes included any-grade infections, grade ≥3 infections, infection-related mortality, reported pathogens, and preventive strategies when available. Because talquetamab monotherapy and combination regimens represent clinically distinct treatment strategies, quantitative analyses were restricted to monotherapy cohorts, whereas combination therapy studies were summarized descriptively. A random-effects model was used to estimate pooled infection incidence. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Series.ResultsSix studies were included in the qualitative synthesis, including four talquetamab monotherapy cohorts and two talquetamab-based combination therapy cohorts. Quantitative meta-analysis included four monotherapy cohorts comprising 735 patients for any-grade infections and three cohorts comprising 584 patients for grade ≥3 infections. The pooled incidence of any-grade infections was 51% (95% CI, 34%–67%; I² = 94.2%), while the pooled incidence of grade ≥3 infections was 22% (95% CI, 17%–28%; I² = 59.6%). Given the limited number of available studies and substantial heterogeneity, these pooled estimates should be interpreted as exploratory and hypothesis-generating. Combination therapy cohorts, including talquetamab plus teclistamab and talquetamab-based regimens from MonumenTAL-3, demonstrated substantial infection burdens and were characterized descriptively rather than quantitatively. Infection-related mortality ranged from 0% to 3.2%. Frequently reported infections included viral infections (particularly SARS-CoV-2 and cytomegalovirus), bacterial pneumonia, and opportunistic infections such as Pneumocystis jirovecii pneumonia.ConclusionsTalquetamab monotherapy in heavily pretreated RRMM patients is associated with a clinically meaningful risk of infections, including severe infections. The substantial heterogeneity observed across studies likely reflects differences in patient characteristics, prior therapies, treatment settings, infection definitions, and supportive care strategies. Combination bispecific antibody regimens may represent a potentially higher infection burden requiring enhanced infection surveillance and preventive approaches. Further prospective studies are warranted to better define infection risk factors and optimal prevention and management strategies during talquetamab therapy.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261357352, identifier CRD420261357352.
