Teclistamab in Early Relapse Multiple Myeloma

Jill Burke, NP, and Tanika Pittman, APRN, discuss practical considerations for incorporating teclistamab plus daratumumab into the management of patients with multiple myeloma experiencing early relapse, with particular emphasis on patient preparation, safety infrastructure, and APP-led education. Jill describes an outpatient step-up dosing program and emphasizes assessing caregiver readiness before treatment, including ensuring that caregivers understand the potential for cytokine release syndrome (CRS) and when urgent evaluation may be necessary. Both faculty highlight infection risk and the importance of establishing clear communication pathways so patients know when and how to contact the oncology team. Tanika describes the value of structured education materials, symptom and vital-sign monitoring, and coordinated outpatient workflows to support patients receiving step-up dosing outside the infusion clinic. The discussion emphasizes that the clinical benefits of teclistamab plus daratumumab must be accompanied by deliberate safety planning, infection prevention, monitoring, and caregiver engagement. The faculty also discuss retreatment with an anti-CD38-containing regimen as a potential consideration for selected patients with multiple myeloma, particularly those who previously experienced a meaningful and durable response and are not truly refractory to the prior anti-CD38 therapy.