MonumenTAL-3 Key Takeaways
Design - Phase 3 randomized trial (n=864): talquetamab (Talvey, GPRC5DxCD3 bispecific) + daratumumab +/- pomalidomide vs daratumumab-pomalidomide-dexamethasone (DPd) in relapsed/refractory multiple myeloma (NCT05455320; Janssen/J&J).
PFS (primary) - 24-month PFS 81.3% (Tal-DP) and 77.6% (Tal-D) vs 51.2% (DPd); HR 0.28 (Tal-DP) and 0.33 (Tal-D), both P<0.0001 (NEJM, EHA 2026 S100).
Overall survival - 24-month OS 89.2% (Tal-DP) and 87.9% (Tal-D) vs 79.1% (DPd); OS HR 0.47 (Tal-DP, P=0.0006) and 0.51 (Tal-D, P=0.0015).
Depth of response - ≥CR 71.1% / 68.9% vs 34.5%; MRD-negative ≥CR 52.3% / 46.3% vs 15.9%.
Safety - GPRC5D-related events common - taste changes (~73-75%) and weight loss (~38-46%), mostly grade 1-2; ataxia/balance disorders with talquetamab arms (mostly low grade); CRS mostly grade 1-2.
Regulatory / sponsor - Investigational combinations; talquetamab monotherapy approved after >=4 prior lines. Sponsor Johnson & Johnson.
Compiled and reviewed by the KOL Pulse research team, led by Brian Shields, Founder, KOL Pulse. Last updated July 21, 2026.
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𝕏About the MonumenTAL-3 Trial
MonumenTAL-3 is a Phase 3, randomized study evaluating talquetamab (a first-in-class GPRC5D×CD3 bispecific antibody) in combination with daratumumab, with or without pomalidomide (Tal-DP and Tal-D), versus the standard regimen of daratumumab, pomalidomide and dexamethasone (DPd) in patients with relapsed or refractory multiple myeloma. Results were presented at the 2026 EHA Congress (Abstract S100) with simultaneous publication in The New England Journal of Medicine — the first Phase 3 study to demonstrate superior progression-free survival with a GPRC5D bispecific combination in earlier-line myeloma. The talquetamab combinations are investigational and not FDA-approved (talquetamab monotherapy is approved for adults with RRMM after ≥4 prior lines of therapy).
Trial Methodology & Results
Study Design
Phase 3, open-label, randomized 1:1:1 to Tal-DP, Tal-D or DPd. Primary endpoint: PFS by independent review committee. (NEJM, S100)
Population
864 patients with RRMM and ≥1 prior line including lenalidomide and a proteasome inhibitor; 85.1% lenalidomide-refractory; 30.9% high-risk cytogenetics. (NEJM, S100)
Interventions
Talquetamab (GPRC5D bispecific) + daratumumab ± pomalidomide vs daratumumab + pomalidomide + dexamethasone (DPd).
Endpoints
Primary: PFS. Secondary: overall response, ≥complete response, MRD-negative ≥CR, overall survival, safety. (NEJM, S100)
Progression-Free Survival
Both talquetamab combinations significantly improved PFS versus DPd. 24-month PFS was 81.3% (Tal-DP) and 77.6% (Tal-D) versus 51.2% (DPd), with hazard ratios of 0.28 (Tal-DP) and 0.33 (Tal-D), both P<0.0001. (NEJM, S100)
24-mo PFS 81% vs 51% · HR 0.28Source: J&J / NEJM (EHA 2026 S100) →
Overall Survival
A clinically meaningful OS benefit was observed: 24-month OS was 89.2% (Tal-DP) and 87.9% (Tal-D) versus 79.1% (DPd), with OS hazard ratios of 0.47 (Tal-DP, P=0.0006) and 0.51 (Tal-D, P=0.0015). Response was deep: ≥CR rates were 71.1% / 68.9% vs 34.5%, and MRD-negative ≥CR 52.3% / 46.3% vs 15.9%. (NEJM, S100)
24-mo OS 89% vs 79% · death risk cut up to 53%Source: J&J / NEJM (EHA 2026 S100) →
Safety
Adverse events were consistent with each agent. GPRC5D-related events were common — taste changes (~73–75%) and decreased weight (~38–46%), most grade 1–2. Ataxia/balance disorders occurred with the talquetamab arms (Tal-DP 11.6% grade 1–2, 2.9% grade 3) and were primarily low grade. CRS was mostly grade 1–2. Grade 3–4 TEAEs and infections were higher with Tal-DP. (NEJM, S100)
Source: ClinicalTrials.gov · MonumenTAL-3 →Clinical Implications
⚠️ Investigational. MonumenTAL-3 is the first Phase 3 study to show a GPRC5D bispecific antibody combination outperforming standard DPd in earlier-line relapsed/refractory myeloma. KOLs flagged the practice-changing efficacy balanced against GPRC5D-specific toxicity (taste changes, weight loss, late-onset ataxia). The talquetamab combinations are not FDA-approved.
Key KOL Sentiments — MonumenTAL-3
MonumenTAL-3 FAQ
What is the MonumenTAL-3 trial?
MonumenTAL-3 (NCT05455320) is a Phase 3, Johnson & Johnson-sponsored randomized trial (n=864) that tests talquetamab (Talvey), a first-in-class GPRC5D x CD3 bispecific antibody, in combination with daratumumab - with or without pomalidomide - versus standard daratumumab-pomalidomide-dexamethasone (DPd) in relapsed/refractory multiple myeloma, moving the GPRC5D bispecific to an earlier line of therapy.
What did MonumenTAL-3 show?
Both talquetamab combinations significantly improved progression-free survival: 24-month PFS was 81.3% (talquetamab-daratumumab-pomalidomide) and 77.6% (talquetamab-daratumumab) versus 51.2% for DPd, with hazard ratios of 0.28 and 0.33 (both P<0.0001). A clinically meaningful overall-survival benefit was seen (24-month OS 89.2% / 87.9% vs 79.1%), with deep responses (MRD-negative complete response 52.3% / 46.3% vs 15.9%). Results were presented at EHA 2026 (S100) with simultaneous NEJM publication.
Are the MonumenTAL-3 combinations FDA approved?
No. The talquetamab-based combinations studied in MonumenTAL-3 are investigational and not FDA-approved. Talquetamab (Talvey) is separately FDA-approved as monotherapy for adults with relapsed/refractory multiple myeloma after at least four prior lines of therapy, and daratumumab and pomalidomide are individually approved in multiple myeloma.
What is the safety profile of talquetamab combinations?
Adverse events were consistent with each agent. GPRC5D-related events were common, including taste changes (about 73-75%) and weight loss (about 38-46%), most of which were grade 1-2. Ataxia and balance disorders occurred with the talquetamab arms and were primarily low grade, and cytokine release syndrome was mostly grade 1-2. Overall the profile reflects the combined toxicities of a GPRC5D bispecific added to a daratumumab backbone.
Why is MonumenTAL-3 significant for myeloma treatment?
MonumenTAL-3 is the first Phase 3 trial to move a GPRC5D-directed bispecific antibody into an earlier line of relapsed/refractory multiple myeloma, showing a large PFS and OS advantage over a standard daratumumab triplet. Featured KOLs, including Voorhees, Al Hadidi, Banerjee and Rajkumar, discuss how it could reshape sequencing of T-cell-redirecting therapies.




























