Teclistamab Induces Deep and Durable Responses in Triple–Class-Exposed Relapsed/Refractory MM

Teclistamab, a T-cell-redirecting bispecific antibody that targets both CD3 expressed on the surface of T cells and B-cell maturation antigen expressed on the surface of myeloma cells, induced a high rate of deep and durable response in patients with triple–class-exposed relapsed or refractory multiple myeloma (MM), according to a study published in The New England Journal of Medicine. 

The phase 1-2 study enrolled 165 patients who had relapsed or refractory MM after at least 3 therapy lines, including triple-class exposure to an immunomodulatory drug, a proteasome inhibitor, and an anti-CD38 antibody. Overall, 77.8% of patients were triple-class refractory and the median lines of prior therapy was 5.

Patients received a weekly subcutaneous injection of teclistamab at a dose of 1.5 mg per kilogram of body weight after receiving step-up doses of 0.06 mg and 0.3 mg per kilogram. The primary end point was overall response, defined as partial response or better.

With a median follow-up of 14.1 months, the overall response rate was 63%, with 65 (39.4%) patients having a complete response or better. A total of 44 (26.7%) patients were found to have no minimal residual disease (MRD); the MRD-negativity rate among the patients with a complete response or better was 46%. The median duration of response was 18.4 months (95% confidence interval [CI], 14.9 to not estimable). The median duration of progression-free survival was 11.3 months (95% CI, 8.8 to 17.1). 

The most common adverse events were cytokine release syndrome (72.1%), neutropenia (70.9%), anemia in (52.1%), and thrombocytopenia in (40%). Infections occurred in 76.4% of patients. In addition, neurotoxic events occurred in 24 (14.5%) patients, including immune effector cell–associated neurotoxicity syndrome in 5 (3%) patients (all grade 1 or 2). 

“Teclistamab resulted in a high rate of deep and durable response in patients with triple-class–exposed relapsed or refractory [MM],” the study authors wrote. “The high rate of deep and durable responses in this population indicates the potential for teclistamab to provide substantial clinical benefit to a broader population of patients.”

Source:

Moreau P, Garfall A, van de Donk, NWCJ, et al. Teclistamab in Relapsed or Refractory Multiple Myeloma. N Engl J Med. Published online June 5, 2022. doi:10.1056/NEJMoa2203478.