Real-world evaluation of teclistamab for the treatment of relapsed/refractory multiple myeloma (RRMM): an International Myeloma Working Group Study - Report - MDSpire
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Real-world evaluation of teclistamab for the treatment of relapsed/refractory multiple myeloma (RRMM): an International Myeloma Working Group Study
Real-World Outcomes of Teclistamab in Relapsed/Refractory Multiple Myeloma
Overview
This international retrospective study evaluated teclistamab in 210 patients with relapsed/refractory multiple myeloma treated outside clinical trials. The overall response rate was 67%, with responses deepening over time, including 21% achieving complete response. Safety findings were consistent with prior studies, with manageable cytokine release syndrome and infections.
Background
Teclistamab is the first approved BCMAxCD3 bispecific antibody for heavily pretreated relapsed/refractory multiple myeloma (RRMM). The pivotal MajesTEC-1 trial demonstrated an overall response rate (ORR) of 63% and median progression-free survival (PFS) of 11.4 months. However, real-world data are needed as clinical trial populations are often more fit and less heterogeneous. This study assessed teclistamab’s efficacy and safety in a diverse international cohort treated in routine clinical practice.
Data Highlights
Characteristic
Value
Number of patients
210
Median age (range)
67 (33–91) years
Patients ≥75 years
23%
High-risk cytogenetics
50%
Extramedullary disease
29%
Creatinine clearance ≤30 ml/min
12.4%
Median prior lines of therapy
6 (range 1–20)
Triple-class refractory
83%
Penta-drug refractory
44%
Overall response rate (ORR)
67%
Very good partial response (VGPR)
34%
Complete response (CR) or better
21%
Key Findings
67% ORR observed in a heavily pretreated, real-world RRMM population, including patients ineligible for MajesTEC-1 trial criteria.
Responses deepened over time, with 21% achieving complete response or better.
44% of patients were penta-drug refractory; 83% were triple-class refractory, reflecting a highly resistant cohort.
44% had prior BCMA-targeted therapy, including CAR T-cell, ADC, or bispecific antibodies.
Safety profile consistent with clinical trials: CRS mostly grade ≤2, manageable ICANS, and high infection rates requiring vigilance.
12.4% had significant renal impairment (CrCl ≤30 ml/min), demonstrating teclistamab use in patients with comorbidities.
Clinical Implications
Teclistamab demonstrates meaningful efficacy and a manageable safety profile in a broad, heavily pretreated RRMM population outside clinical trials, including patients with prior BCMA therapies and comorbidities. Clinicians should monitor for infections and immune-related adverse events but can consider teclistamab as a valuable option in routine practice. Real-world data support its use beyond strict trial eligibility criteria.
Conclusion
This large international real-world study confirms teclistamab’s effectiveness and tolerability in diverse RRMM patients, supporting its role as a key therapeutic option in heavily pretreated and high-risk populations. Continued monitoring and management of adverse events remain essential.
References
MajesTEC-1 Study -- Teclistamab in RRMM
Nooka et al. 2023 -- Long-term Follow-up of Teclistamab
IMWG Immunotherapy Working Group -- Real-World Teclistamab Study
by Carlyn Rose Tan, Sireesha Asoori, Chiung-Yu Huang, Larissa Brunaldi, Rakesh Popat, Efstathios Kastritis, Joaquin Martinez-Lopez, Radhika Bansal, Andre De Menezes Silva Corraes, Saurabh Chhabra, Ricardo Parrondo, Sikander Ailawadhi, Despina Fotiou, Meletios A. Dimopoulos, Kwee Yong, Catriona Mactier, Chris Lau, Magdalena Corona, Adolfo Jesús Sáez Marin, Hira Mian, Brian GM. Durie, Saad Z. Usmani, Thomas G. Martin, Yi Lin
