Bispecific Antibody Treatment Leads to ‘Deep and Durable’ Responses in R/R MM

Treatment with teclistamab, a T-cell–redirecting bispecific antibody, led to a “high rate of deep and durable response” in patients with triple-class-exposed relapsed or refractory (R/R) multiple myeloma (MM), according to investigators of a recent phase I/II study.

Philippe Moreau, MD, of the University Hospital of Nantes, France, and colleagues, conducted the study and published its results in the New England Journal of Medicine.

The researchers enrolled 165 patients who had R/R MM after at least three lines of therapy, including an immunomodulatory drug, a proteasome inhibitor, and an anti-CD38 antibody. Most patients (77.6%) had triple-class refractory disease. The study’s primary endpoint was the overall response rate.

The overall response rate was 63% at a median follow up of 14.1 months, with 39.4% of patients having a complete response or better.

There were 44 patients (26.7%) who had no minimal residual disease (MRD). The MRD-negativity rate was 46% in patients with a complete response or better.

The median duration of response was 18.4 months (95% CI, 14.9 to not estimable). The median duration of progression-free survival was 11.3 months (95% CI, 8.8 to 17.1).

Infections were reported in 76.4% of patients, cytokine release syndrome was reported in 72.1% of patients, neutropenia was reported in 70.9% of patients, anemia was reported in 52.1% of patients and thrombocytopenia was reported in 40% of patients. The researchers reported neurotoxic events in 14.5% of patients, including immune effector cell-associated neurotoxicity syndrome in 3% of patients.

“Teclistamab resulted in a high rate of deep and durable response in patients with triple-class–exposed relapsed or refractory multiple myeloma,” Dr. Moreau and colleagues concluded. “Cytopenias and infections were common; toxic effects that were consistent with T-cell redirection were mostly grade 1 or 2.”

Moreau P, Garfall AL, van de Donk NWCJ, et al. Teclistamab in relapsed or refractory multiple myeloma. N Engl J Med. 2022;387(6):495-505. doi:10.1056/NEJMoa2203478