Teclistamab Combination Shows Higher Response Rate in Multiple Myeloma

Emma Searle, PhD, consultant hematologist at the Christie Hospital NHS Foundation Trust, and honorary senior lecturer at the University of Manchester, discusses results of the MajestTEC-2 trial (NCT04722146) combining teclistamab (Tecvayli) with daratumumab (Darzalex) and lenalidomide (Revlimid) for patients with multiple myeloma presented at the 2022 American Society of Hematology Annual Meeting and Exposition (ASH).

Searle says that the bispecific T-cell engager teclistamab showed a strong overall response rate (ORR) of 63.0% as a monotherapy in the MajesTEC-1 trial (NCT03145181, NCT04557098). The multicohort phase 1b MajestTEC-2 trial contained a cohort of 32 patients who received teclistamab with daratumumab and lenalidomide in patients who had received between 1 and 3 lines of prior therapy, including a proteasome inhibitor and immunomodulatory drug.

At a median follow-up of 8.4 months, the ORR for the combination across 2 dosing groups of teclistamab (0.72 mg/kg or 1.5 mg/kg with step-up dosing), was 93.5%, including 54.8% who had a complete response (CR) or better. Looking at the lower dosing group at a median follow-up of 11 months, the ORR was 100% with all 13 evaluable patients responding to treatment. Searle says this is a powerful regimen for patients with multiple myeloma.

The randomized phase 3 MajesTEC-7 trial (NCT05552222) will compare this regimen with daratumumab, lenalidomide, and dexamethasone in patients with newly diagnosed transplant-ineligible multiple myeloma.

TRANSCRIPTION:

0:08 | What we've learned about teclistamab, when you [look at] cohort E from MajesTEC-2 trial is that when you use teclistamab in combination with daratumumab and lenalidomide, you certainly see higher responses than we saw when we used this in monotherapy. In the monotherapy trial, the ORR was 63%, and the ORR in this combination across both dosing groups was 94%, so it was very high. We saw deep remissions, so 55% of patients had achieved CR or better at the points that we analyzed the data ahead of ASH. If I look at the patients at the lower teclistamab dosing where the data is slightly more mature, we had a median follow-up of 11 months as opposed to 8.4 [months] across the whole study. In general, the response rate was 100%, so these are powerful anti-myeloma combinations.