The Efficacy and Safety of Teclistamab Among Patients With Relapsed or Refractory MM

Key Takeaways:

• Teclistamab is associated with improved survival outcomes: Among patients with relapsed or refractory (RR) multiple myeloma (MM), teclistamab demonstrated significantly better progression-free survival (PFS) and overall survival (OS).
• Teclistamab is associated with slightly higher toxicity: Patients who received teclistamab had higher rates of high-grade adverse events (AEs) and infection.
• Prolonged survival vs quality of life: The study’s findings illustrate the factors that influence treatment decision-making for physicians and patients.

Researchers conducted a study to assess the effectiveness of teclistamab, a bispecific antibody that targets B-cell maturation antigen, in treating patients with RRMM.

Patients with 1 to 3 prior lines of therapy were randomly assigned either teclistamab or pomalidomide, bortezomib, and dexamethasone (PVd) or carfilzomib and dexamethasone (Kd). The teclistamab cohort had 296 patients, and 297 patients were treated with either PVd or Kd.

Efficacy of Teclistamab vs PVd and Kd

Teclistamab was associated with higher PFS than PVd and Kd. At an 18-month follow-up, patients receiving teclistamab had a PFS of 69.8% while patients receiving either PVd or Kd had a PFS of 26.9%.

The teclistamab cohort had a significantly higher percentage of patients who achieved a complete response (CR) or better than the PVd and Kd cohorts, 65.9% vs 16.8%, respectively.

OS was also higher in the teclistamab cohort than the PVd and Kd cohorts, 79.2% vs 68.6%, respectively.

Safety of Teclistamab vs PVd and Kd

While teclistamab demonstrated higher efficacy than PVd and Kd, it was also associated with higher toxicity.

The teclistamab cohort had more reports of AEs than the PVd and KD cohort, 84.9% vs 76.3%, respectively. Additionally, nearly twice as many patients receiving teclistamab experienced a grade 5 AE compared to PVd and Kd patients, 6.5% vs 3.5%, respectively.

Among teclistamab patients, 66% experienced cytokine release syndrome (CRS), and 4.1% experienced immune effector cell–associated neurotoxicity syndrome (ICANS).

In the teclistamab cohort, 41.6% experienced a grade 3 or 4 infection compared to 29% in the PVd and Kd cohort.

Implications for Oncology Care

The authors noted, “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.”

Teclistamab demonstrated improved effectiveness in treating RRMM, but with slightly higher toxicity. These findings indicate the balance care providers must consider between delaying disease progression and maintaining quality of life.

Reference

Touzeau C, Mina R, Quach H, et al. Teclistamab in multiple myeloma with one to three previous lines of therapy. N Engl J Med. 2026;395(5):440-453. doi:10.1056/NEJMoa2603870