Impact of COVID-19 on outcomes with teclistamab in patients with relapsed/refractory multiple myeloma in the phase 1/2 MajesTEC-1 study - Scorecard - MDSpire
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Impact of COVID-19 on outcomes with teclistamab in patients with relapsed/refractory multiple myeloma in the phase 1/2 MajesTEC-1 study
Clinical Scorecard: Effects of COVID-19 on the Efficacy of Teclistamab in Individuals with Relapsed/Refractory Multiple Myeloma: Insights from the Phase 1/2 MajesTEC-1 Trial
At a Glance
Category
Detail
Condition
Relapsed/Refractory Multiple Myeloma (RRMM)
Key Mechanisms
Teclistamab is a BCMA × CD3 bispecific antibody targeting malignant plasma cells in RRMM
Target Population
Patients with RRMM, heavily pretreated, triple-class and penta-drug refractory
Care Setting
Clinical trial and specialized oncology care settings during the COVID-19 pandemic
Key Highlights
Patients with RRMM have high infection risk and immune dysfunction, exacerbated by COVID-19.
During MajesTEC-1, 29.1% of patients contracted COVID-19; 10.9% died from it, with some deaths related to teclistamab.
COVID-19 vaccination during treatment reduced infection risk and mortality; unvaccinated patients had earlier and higher mortality.
Guideline-Based Recommendations
Diagnosis
Diagnosis of RRMM per standard criteria prior to teclistamab treatment.
COVID-19 infection diagnosed and graded per institutional protocols.
Management
Infection management including immunoglobulin replacement and teclistamab interruption as needed.
Supportive therapies for COVID-19 such as glucocorticoids, antivirals (e.g., remdesivir), hyperimmune plasma, and tocilizumab.
Annual inactivated influenza and COVID-19 vaccinations (including boosters) recommended when available.
Monitoring & Follow-up
Close monitoring for infections during teclistamab treatment, especially COVID-19.
Censoring of COVID-19 deaths in survival analyses to assess treatment efficacy accurately.
Risks
High risk of severe COVID-19 infection and mortality in RRMM patients, especially unvaccinated.
165 patients with RRMM, median age 64, median 5 prior therapies, mostly triple-class refractory
Teclistamab demonstrated median PFS of 11.3 months and OS of 21.9 months; outcomes improved when COVID-19 deaths were censored. Vaccination during treatment correlated with reduced COVID-19 mortality.
Clinical Best Practices
Implement infection prevention strategies including vaccination prior to and during teclistamab treatment.
Manage COVID-19 infections promptly with supportive therapies and consider teclistamab dosing interruption.
Maintain active MM treatment despite pandemic-related healthcare disruptions to preserve disease control.
Use institutional protocols for infection management and adapt as new data emerge.
by Niels W. C. J. van de Donk, Nizar Bahlis, Luciano J. Costa, María-Victoria Mateos, Ajay K. Nooka, Aurore Perrot, Alfred L. Garfall, Pragya Thaman, Keqin Qi, Clarissa Uhlar, Katherine Chastain, Margaret Doyle, Saad Z. Usmani
