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Outcomes of teclistamab in patients with relapsed/refractory multiple myeloma with prior exposure to BCMA-directed therapy: a multicenter study from the U.S. Multiple Myeloma Immunotherapy Consortium.

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Outcomes of teclistamab in patients with relapsed/refractory multiple myeloma with prior exposure to BCMA-directed therapy: a multicenter study from the U.S. Multiple Myeloma Immunotherapy Consortium. Blood cancer journal Dima, D., Vazquez-Martinez, M. A., Davis, J. A., Goel, U., Afrough, A., Sannareddy, A., Pasvolsky, O., Razzo, B., Banerjee, R., Khouri, J., Grajales-Cruz, A., Lieberman-Cribbin, A., Rana, M. S., Julian, K., DeJarnette, S., Portuguese, A. J., Gaballa, M. R., De Avila, G., Susaniba Adaniya, S., Raza, S., Herr, M. M., Ouchveridze, E., Richards, T., Hosoya, H., Mikkilineni, L., Kaur, G., Castaneda Puglianini, O., Rossi, A., Lin, Y., Atrash, S., Sborov, D., Shain, K. H., Voorhees, P. M., Richard, S., Garfall, A. L., Hansen, D. K., Sidana, S., Patel, K. K., Cowan, A. J., Anderson, L. D., Lee, H. C., Anwer, F., Ferreri, C. J., Shune, L. 2025; 15 (1): 111

Abstract

Data describing outcomes of teclistamab in multiple myeloma patients with prior exposure to BCMA-directed therapy (BCMA-DT) are limited. The goal of this multicenter retrospective analysis was to report the efficacy and safety of standard-of-care teclistamab in patients with prior BCMA-DT. A total of 385 patients were included, of whom 193 (50%) had received prior BCMA-DT, including 47 (24%) patients with prior antibody-drug conjugate (ADC)-only, 99 (51%) with chimeric antigen receptor T-cell therapy (CAR T)-only, 36 (19%) with both ADC and CAR T, 6 (3%) with bispecific antibody-only, and 5 (3%) with other combinations. Most safety parameters between cohorts were comparable. The prior BCMA-DT cohort had a lower overall response rate (ORR: 48.7% versus 61.5%; p?=?0.012), and median progression-free survival (PFS: 4.6 versus 8.2 months; p?=?0.017) compared to the cohort without prior BCMA-DT. However, in multivariable analysis, despite a clear trend, ultimately receipt of a prior BCMA-DT was not independently associated with ORR or PFS (p?=?0.057 and p?=?0.1, respectively). No significant differences in PFS were noted when stratifying patients by number of prior BCMA-DTs, types of all prior BCMA-DTs received, type of most recent prior BCMA-DT, or depth of response to most recent BCMA-DT. Using the maximally selected rank statistics method, the optimal cut-off for time from the last BCMA-DT exposure to teclistamab initiation was identified as 8.7 months. Patients with >8.7 months between their last exposure to prior BCMA-DT and teclistamab initiation had a significantly improved median PFS with teclistamab (8.1 months, 95% CI: 4.6-11.7) compared to patients with <8.7 months (2.5 months, 95% CI: 1.1-5.7), p?=?0.001. Altogether, our findings support the use of teclistamab as a viable treatment option in patients previously exposed to BCMA-DT.

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