Methods: The phase 2 ongoing TALisman (NCT06500884) study has been previously described. Briefly, pts with RRMM receive experimental prophylaxis for 7 days before the first Tal step-up dose or Tal-only as a control. Co-primary endpoints are incidence of dysgeusia and severe dysgeusia, time to severe dysgeusia, and dysgeusia improvement at the end of 3 and 7 months per WETT.
Results: As of April 2026, 84.0% of 25 pts in the Tal-only cohort completed ≥3 cycles and 52.0% completed ≥6 cycles; 92.9% and 7.1% of 14 pts in the clonazepam (Tal+clon) cohort completed ≥3 and ≥6 cycles, respectively. Across cohorts, median age was 65.0 yrs; 59.0% were male. Adverse events led to dose modifications of Tal in 52.0% (Tal-only) and 64.3% (Tal+clon). By WETT, dysgeusia (any severity) occurred in 84.0% of pts with Tal-only and 92.9% with Tal+clon. Severe dysgeusia occurred in 56.0% and 85.7%, respectively. Median time to dysgeusia was 8 (Tal-only) and 4 days (Tal+clon); median time to severe dysgeusia was 75 and 8 days, respectively. The highest rates of dysgeusia/severe dysgeusia by WETT (Tal-only) occurred at cycle 3 (71.4%). The component WETT scores (Tal-only) with the highest mean change from baseline at timepoints through cycle 3 were sweet (–3.13), salty (–2.95), and sour (–2.18). Improvement in dysgeusia (any severity) was observed in 58.8% of pts with Tal-only and 58.3% with Tal+clon at the end of month 3, and in 66.7% (Tal-only) at the end of month 7. Further data on WETT taste components, patient-reported taste function, and oral health experience will be presented at the congress.
Conclusions: Dysgeusia by WETT improves as early as 3 months after Tal initiation, with 67% showing improvement after 7 months. Clonazepam prophylaxis did not improve incidence, onset, or resolution of dysgeusia, although low numbers limit definitive conclusions. The highest proportion of pts with dysgeusia/severe dysgeusia by WETT occurred during cycle 3, with the largest changes observed in the sweet, salty, and sour components of the taste profile. The innovative study design of TALisman enables investigation of additional prophylactic interventions for dysgeusia to help clarify expectations for pts, caregivers, and healthcare providers, and facilitate ongoing treatment and clinical benefit from Tal.
