Real-World Experience with Teclistamab for Relapsed/Refractory Multiple Myeloma from the US Myeloma Immunotherapy Consortium
Beatrice M. Razzo, Shonali Midha, Andrew J. Portuguese, Ariel Grajales‐Cruz, Andre De Menezes Silva Corraes, Patrick Costello, Yuxin Liu, Adam S. Sperling, Omar Nadeem, Danai Dima, Rahul Banerjee, Andrew J. Cowan, Aimaz Afrough, Larry D. Anderson, Alex Lieberman-Cribbin, Gurbakhash Kaur, Anmol Goyal, Shebli Atrash, Christopher J. Ferreri, Peter M. Voorhees, Oren Pasvolsky, Hans C. Lee, Krina K. Patel, Kelley Julian, Peter A. Forsberg, Megan M. Herr, Saurabh Chhabra, Ricardo Parrondo, Yi Lin, Anna Chen, Sandra P. Susanibar-Adaniya, Jack Khouri, Shahzad Raza, Faiz Anwer, Mariola Vazquez‐Martinez, Omar Castañeda Puglianini, Douglas W. Sborov, James A. Davis, Adriana Rossi, Leyla Shune, Jenny Bhurtel, Wei‐Ting Hwang, Doris K. Hansen, Surbhi Sidana, Alfred L. Garfall, Shambavi Richard
Abstract
Teclistamab is an anti-CD3-/B-cell maturation antigen (BCMA) bispecific antibody approved for use in relapsed/refractory multiple myeloma. We undertook a retrospective study of post-approval, real-world outcomes with teclistamab in the US Multiple Myeloma Immunotherapy Consortium. Among 509 patients, 89% would have been ineligible for the MajesTEC-1 trial, primarily due to prior BCMA-directed therapy, cytopenias, or diminished performance status. Cytokine release syndrome occurred in 54% (1.4% grade ≥3) and immune effector cell-associated neurotoxicity syndrome in 11% (2.2% grade ≥3), with no fatal events. Infections occurred in 42% and contributed to death in 5%. Partial response (PR) or better was achieved in 53% and very good PR or better in 45%. With 10.1 months of median follow-up, the estimated median progression-free survival (PFS) was 5.8 months and 12-month overall survival was 61%. Independent predictors of less than very good PR and shorter PFS included BCMA-directed chimeric antigen receptor T-cell therapy in the previous 9 months, high disease burden, lymphopenia, and elevated ferritin. SIGNIFICANCE: T cell-engaging bispecific antibodies such as teclistamab represent an important new treatment modality for multiple myeloma and other blood cancers. This study evaluates the real-world safety and efficacy of teclistamab, including its activity in populations not represented in the initial phase I/II study, and identifies clinical variables associated with treatment response. See related commentary by Zweegman et al., p. 542.