Teclistamab in Multiple Myeloma with One to Three Previous Lines of Therapy

Author(s): Cyrille Touzeau, M.D., Ph.D.¹; Roberto Mina, M.D.^2,3; Hang Quach, M.D.⁴; Vania Hungria, M.D., Ph.D.⁵; Divaya Bhutani, M.D.⁶; Wenming Chen, M.D.⁷; Swarup Kumar, M.D.⁸; Chakra Chaulagain, M.D.⁹; Meletios Athanasios Dimopoulos, M.D.^10,11; Nizar J. Bahlis, M.D.¹²; Senem Maral, M.D.¹³; Niels W.C.J. van de Donk, M.D., Ph.D.¹⁴; Jayr Schmidt Filho, M.D.¹⁵; Khalid Saja, M.B., Ch.B.¹⁶; Raphael Teipel, M.D.¹⁷; Miki Ando, M.D.¹⁸; Wilfried Roeloffzen, M.D., Ph.D.¹⁹; Ombretta Annibali, M.D., Ph.D.²⁰; Bradley Augustson, M.B., B.S.²¹; Cirino Botta, M.D., Ph.D.²²; Michel Delforge, M.D., Ph.D.²³; Emmanuelle Bourgeois, M.D.²⁴; Gabriele Buda, M.D., Ph.D.²⁵; Marek Hus, M.D., Ph.D.²⁶; Aurore Perrot, M.D., Ph.D.²⁷; Meir Preis, M.D., Ph.D.^28,29; Meral Beksac, M.D.³⁰; Ludek Pour, M.D.³¹; Sarah Farmer, M.D., Ph.D.³²; Marta Nunes, M.D.³³; Albert Oriol, M.D., Ph.D.³⁴; Thomas Melchardt, M.D., Ph.D.³⁵; Yu Hu, M.D.^36,37,38; Max Flogegård, M.D.³⁹; Dai Wang, Ph.D.⁴⁰; Lixia Pei, Ph.D.⁴⁰; Susan Wroblewski, Ph.D.⁴¹; Ingrid M. Ariës, Ph.D.⁴²; Natalia A. Quijano Cardé, Ph.D.⁴¹; Tatiana Perova, Ph.D.⁴¹; Tertia de Jager, Ph.D.⁴³; Tzu-Min Yeh, M.S.⁴⁰; Veronique Vanquickelberghe, Ph.D.⁴⁴; Priya Shah, M.B., B.S.⁴⁵; Katherine Chastain, M.D.⁴⁰; Rachel Kobos, M.D.⁴⁰; Robin Carson, M.D.⁴¹; Ola Landgren, M.D., Ph.D.⁴⁶; the MajesTEC-9 Trial Investigators*;

Source: DOI: 10.1056/NEJMoa2603870

Dr. Anjan Patel's Thoughts

It comes as no surprise that bispecific agents are moving up into earlier lines of therapy in multiple myeloma. Here, in the setting of early relapsed, anti-CD38 and –imid exposed patients, single agent teclistimab showed an 18mo progression-free survival benefit over PFd/Kd.

BACKGROUND

The efficacy of teclistamab, a bispecific antibody targeting B-cell maturation antigen and CD3, as early-line monotherapy in relapsed or refractory multiple myeloma is unclear.

METHODS

We randomly assigned patients with relapsed or refractory multiple myeloma who had previously received one, two, or three lines of therapy, including an anti-CD38 monoclonal antibody and lenalidomide, to receive teclistamab or the investigator’s choice of pomalidomide, bortezomib, and dexamethasone (PVd) or carfilzomib and dexamethasone (Kd). Antimicrobial prophylaxis and immune globulin replacement were recommended. The primary end point was progression-free survival as assessed by an independent review committee. Research Summary Teclistamab in Previously Treated Multiple Myeloma

RESULTS

A total of 296 patients were assigned to teclistamab and 297 to PVd or Kd. the interim analysis (median follow-up, 17.3 months), teclistamab significantly improved progression-free survival as compared with PVd or Kd (estimated 18-month progression-free survival, 69.8% vs. 26.9%; hazard ratio for disease progression or death, 0.29; 95% confidence interval [CI], 0.23 to 0.38; P

CONCLUSIONS

Among patients with multiple myeloma and one to three previous lines of therapy, teclistamab significantly improved progression-free and overall survival as compared with PVd or Kd. Infections of grade 3 or 4 were common. (Funded by Johnson & Johnson; MajesTEC-9 ClinicalTrials.gov number, NCT05572515.) Quick Take Teclistamab in Previously Treated Multiple Myeloma 2m 44s

Author Affiliations

¹Department of Hematology, University Hospital of Nantes, Nantes, France; ²Division of Hematology, Department of Molecular Biotechnology and Health Sciences, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy; ³Winship Cancer Institute, Emory University, Atlanta; ⁴University of Melbourne, St. Vincent’s Hospital Melbourne, Melbourne, VIC, Australia; ⁵Clinica São Germano, São Paulo; ⁶Columbia University Medical Center, New York; ⁷Department of Hematology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing; ⁸Division of Hematology and Oncology, Neag Comprehensive Cancer Center, UConn Health, Farmington, CT; ⁹Department of Hematology and Oncology, Myeloma and Amyloidosis Program, Cleveland Clinic Florida, Weston; ¹⁰Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens; ¹¹Department of Medicine, Korea University, Seoul, South Korea; ¹²Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada; ¹³Department of Hematology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey; ¹⁴Department of Hematology, Amsterdam University Medical Center, Cancer Center Amsterdam Vrije Universiteit Amsterdam, Amsterdam; ¹⁵Department of Hematology, A.C. Camargo Cancer Center, São Paulo; ¹⁶Hematology Department, Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom; ¹⁷Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, Dresden, Germany; ¹⁸Department of Hematology, Juntendo University School of Medicine, Tokyo; ¹⁹Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; ²⁰Policlinico Universitario Campus Bio-Medico, Dipartimento di Medicina e Chirurgia Università Campus Bio-Medico, Rome; ²¹Department of Hematology, Sir Charles Gairdner Hospital, Perth, WA, Australia; ²²Hematology Unit, “P. Giaccone” University Hospital and Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; ²³Department of Hematology, University Hospital Leuven, Leuven, Belgium; ²⁴Groupement des Hôpitaux de l’Institut Catholique de Lille, Lille, France; ²⁵Department of Clinical and Experimental Medicine, Hematology, University of Pisa, Pisa, Italy; ²⁶Medical University of Lublin, Lublin, Poland; ²⁷Université de Toulouse, Centre Hospitalier Universitaire, Service d’Hematologie, Institut Universitaire du Cancer de Toulouse–Oncopole, Cancer Research Center of Toulouse, Toulouse, France; ²⁸Institute of Hematology, Lady Davis Carmel Medical Center, Haifa, Israel; ²⁹University of Haifa, School of Medicine, Haifa, Israel; ³⁰Department of Hematology, İstinye University, Ankara Liv Hospital, Ankara, Turkey; ³¹Department of Internal Medicine, Hematology and Oncology, Faculty of Medicine, University Hospital Brno, Masaryk University, Brno, Czech Republic; ³²Department of Hematology, Vejle Hospital, Vejle, Denmark; ³³Department of Hematology, Unidade Local de Saúde de Gaia e Espinho, Vila Nova de Gaia, Portugal; ³⁴Institut Català d’Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Spain; ³⁵Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectiology, and Rheumatology, Cancer Research Laboratory of the Department of Internal Medicine III, Paracelsus Medical University, Salzburg, Austria; ³⁶Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; ³⁷Key Laboratory of Biological Targeted Therapy, Ministry of Education, Huazhong University of Science and Technology, Wuhan, China; ³⁸Hubei Clinical and Research Center of Thrombosis and Hemostasis, Wuhan, China; ³⁹Department of Internal Medicine, Falun General Hospital, Falun, Sweden; ⁴⁰Johnson & Johnson, Raritan, NJ; ⁴¹Johnson & Johnson, Spring House, PA; ⁴²Johnson & Johnson, Leiden, the Netherlands; ⁴³Johnson & Johnson, Neuss, Germany; ⁴⁴Johnson & Johnson, Beerse, Belgium; ⁴⁵Johnson & Johnson, High Wycombe, United Kingdom; ⁴⁶Sylvester Myeloma Institute, Sylvester Comprehensive Cancer Center, University of Miami, Miami

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