Dr Grajales-Cruz on Real-World Responses With Teclistamab in Pretreated R/R Multiple Myeloma

Ariel Grajales-Cruz, MD, assistant Member, Department of Malignant Hematology, Multiple Myeloma Section, Moffitt Cancer Center, discusses real-world safety and efficacy outcomes from treatment with the bispecific antibody teclistamab (Tecvayli) in heavily pretreated patients with relapsed/refractory multiple myeloma who progressed on aprior BCMA-directed therapy.

A retrospective, single-center study assessed the real-world efficacy of this standard-of-care therapy relative to results from the phase 1/2 MajesTEC-1 trial (NCT03145181; NCT04557098), Ariel Grajales-Cruz, MD begins. In this trial, teclistamab produced an objective response rate of 63%, he reports, and a median progression-free survival (PFS) of 11.3 months. Such findings supported the FDA approval of teclistamab in October 2022 in the treatment of patients with relapsed/refractory multiple myeloma who had received at least 4 previous lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody.

Results presented at the 2023 ASH Annual Meetingdemonstrated a favorable overall response rate of 63% with teclistamab in heavily pretreated patients in clinic, with a complete response rate of 36%, Grajales-Cruz states. These response rates were comparable to that of patients in the MajesTEC-1 trial, who were not previously exposed to prior BCMA therapy, he emphasizes. No new safety signals were identified.

Unlike the MajesTEC-1 trial, this real-world cohort comprised of more heavily pretreated patients, Grajales-Cruz reports, adding that 36 individuals had been treated with BCMA-directed therapies, including CAR T-cell therapy, antibody-drug conjugates, or other bispecific antibodies. The study also enrolled approximately 45% of patients with high-risk features as well as frailer patients with an ECOG performance status of 2 or greater, Grajales-Cruz states. Despite including a more difficult-to-treat patient population, the study demonstrated results with teclistamab that align closely with outcomes observed in the original MajesTEC-1 trial, Grajales-Cruz says. This underscores the robustness and effectiveness of teclistamab across diverse patient profiles, he concludes.