Teritusumab may induce responses in relapsed/refractory multiple myeloma

Relapsed or refractory multiple myeloma (MM) who previously received B cell maturation agent (BCMA) targeted therapy, based on published studies Patients may benefit from teritusumab (Teclistamab-cqyv) which also targets BCMA. However, problems with grade 3 or worse cytopenias and infections remain with this therapeutic intervention. Treatment advances including immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies targeting CD38 have improved progression-free survival in patients with multiple myeloma. However, the risk of relapsed or refractory disease remains, necessitating new interventions.

Over the past few years, BCMA has emerged as a therapeutic target, including in patients exposed to 3 standard regimens in this patient population. For the ongoing Phase 1/2 MajesTEC-1 study (ClinicalTrials.gov identifiers: NCT03145181 and NCT04557098), investigators are studying the safety and efficacy of teritolumab in patients with relapsed or refractory multiple myeloma, regardless of whether they have received BCMA-targeted therapy.

Overall, as ofAugust 2023, a total of 40 patients have participated in the trial and received treatment. In this cohort, the median age at baseline was 63.5 years, 62.5% of patients were male, 33.3% had high-risk cytogenetics, 100% had level III exposure, and 100% had received prior BCMA-targeted therapy (37.5% of which were chimeric antigen receptor [CAR] T-cell therapy). The median number of prior lines of treatment was 6 (range 3-14).

These results provide clinicians with important data on the potential clinical benefit of teritusumab in patients with [relapsed or refractory] multiple myeloma. The median follow-up time was 28 months. At this time, all enrolled patients were receiving weekly teritusumab treatment at 1.5 mg/kg. Preliminary analysis showed that the overall response rate was 52.5%, with 30% of patients achieving complete remission or better; the median duration of response was 14.8 months. The median progression-free survival was 4.5 months; the median overall survival was 15.5 months.

Common treatment-emergent adverse events include infection (70%), 32.5% of patients developed grade 3 or 4 infections, and 10% developed grade 5 infections. Grade 5 acute kidney injury, one case each of cardiac arrest, heart failure, and coronary artery dissection were also observed. A total of 65% of patients experienced grade 3 or 4 neutropenia, and 42.5% of patients experienced grade 3 or 4 lymphopenia.

These results provide clinicians with important data on the potential clinical benefit of teritusumab following prior anti-BCMA therapy, as prior exposure to such treatments becomes more common among patients with relapsed or refractory multiple myeloma, the study authors wrote in the report.

Reference materials:https://www.hematologyadvisor.com/news/multiple-myeloma-teclistamab-induce-response-treatment-risk/