Mitigating Teclistamab Toxicity: Prophylactic Tocilizumab and Timing of Immunoglobulin Replacement Therapy in a Nationwide Cohort - Report - MDSpire
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Reducing Toxicity Associated with Teclistamab: The Role of Prophylactic Tocilizumab and Timing for Immunoglobulin Replacement in a National Cohort Study

  • By

  • Astrid Hundebøll Torpe

  • Jonathan Thorsen

  • Gustav Mathiasen

  • Katrine Fladeland Iversen

  • Sarah Farmer

  • Thomas Lund

  • Charlotte Toftmann Hansen

  • Lene Kongsgaard Nielsen

  • Nicolai Grønne Dahlager Jørgensen

  • Maja Ølholm Vase

  • Elena Manuela Teodorescu

  • Morten Salomo

  • Christina Wennerström

  • Tobias S. Slørdahl

  • Agoston Gyula Szabo

  • May 26, 2026

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Clinical Report: Reducing Toxicity Associated with Teclistamab

Overview

This study evaluates the impact of prophylactic tocilizumab on cytokine-release syndrome (CRS) in patients receiving teclistamab for relapsed or refractory multiple myeloma. Results indicate a reduction in CRS incidence with prophylactic tocilizumab compared to standard care.

Background

Teclistamab is a bispecific antibody effective against relapsed or refractory multiple myeloma, but its use is complicated by a high incidence of cytokine-release syndrome (CRS) and infections.

Data Highlights

GroupCRS IncidenceGrade 2 CRSICANS
NoPPxToci (N=52)69%29%3/52
PPxToci (N=53)8%2%1/53

Key Findings

  • CRS occurred in 69% of the NoPPxToci group versus 8% in the PPxToci group (p = 0.001).
  • Grade 2 CRS was reported in 29% of the NoPPxToci group compared to 2% in the PPxToci group.
  • No Grade ≥ 3 CRS events were observed in either group.
  • Infections were reported in 79% of patients in the MajesTEC-1 study.

Clinical Implications

The use of prophylactic tocilizumab prior to the first step-up dose of teclistamab reduces the incidence of CRS.

Conclusion

Prophylactic tocilizumab may mitigate CRS in patients receiving teclistamab.

Related Resources & Content

  1. Blood Cancer Journal, 2023 -- Preventive Use of Tocilizumab to Mitigate Cytokine Release Syndrome (CRS) in Patients Receiving Teclistamab: Insights from a Single-Center Study
  2. Blood Cancer Journal, 2024 -- Teclistamab for the Treatment of Relapsed Refractory Multiple Myeloma: A Comprehensive Real-World Analysis Across Multiple Institutions
  3. Blood Cancer Journal, 2024 -- Enhancing Patient Outcomes with Bispecific Antibodies Targeting BCMA: Focus on Infection Risks
  4. Journal of Clinical Oncology -- Longer-term follow-up of patients receiving prophylactic tocilizumab for the reduction of cytokine release syndrome (CRS) in the phase 1/2 MajesTEC-1 study
  5. Frontiers in Immunology — Model-informed safety management of tocilizumab for pediatric sJIA: a PBPK approach for dose-escalation and vaccination timing
  6. FDA Label for Teclistamab
  7. Infection risk associated with teclistamab in relapsed/refractory multiple myeloma
  8. Longer-term follow-up of patients (pts) receiving prophylactic tocilizumab (toci) for the reduction of cytokine release syndrome (CRS) in the phase 1/2 MajesTEC-1 study of teclistamab in relapsed/refractory multiple myeloma (RRMM). | Journal of Clinical Oncology

Original Source(s)

Mitigating Teclistamab Toxicity: Prophylactic Tocilizumab and Timing of Immunoglobulin Replacement Therapy in a Nationwide Cohort

  • by Astrid Hundebøll Torpe, Jonathan Thorsen, Gustav Mathiasen, Katrine Fladeland Iversen, Sarah Farmer, Thomas Lund, Charlotte Toftmann Hansen, Lene Kongsgaard Nielsen, Nicolai Grønne Dahlager Jørgensen, Maja Ølholm Vase, Elena Manuela Teodorescu, Morten Salomo, Christina Wennerström, Tobias S. Slørdahl, Agoston Gyula Szabo

  • May 26, 2026

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