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ASH 2020: Intravenous and Subcutaneous Teclistamab for Resistant Multiple Myeloma

By: Julia Fiederlein
Posted: Wednesday, December 23, 2020

In an early-phase trial, the B-cell maturation antigen (BCMA)- and CD3-targeted bispecific antibody teclistamab seemed to confer deep and durable responses with both intravenous and subcutaneous administration in patients with relapsed or refractory multiple myeloma, according to Alfred L. Garfall, MD, of the University of Pennsylvania, Philadelphia, and colleagues. The results, which were presented during the virtual edition of the 2020 American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 180), support the planned phase II monotherapy trial.

“Teclistamab takes a similar approach to cellular therapies, which genetically engineer a patient’s T cells to find and destroy cancer cells,” explained Dr. Garfall in a press release. A total of 84 and 44 patients were administered intravenous (0.3–720 µg/kg weekly) and subcutaneous (80–3,000 µg/kg weekly) teclistamab, respectively.

Anemia (55%), neutropenia (55%), thrombocytopenia (41%), leukopenia (26%), cytokine-release syndrome (53%), pyrexia (28%), diarrhea (24%), cough (23%), fatigue (23%), nausea (22%), back pain (20%), and headaches (20%) were the most frequently reported adverse events in the overall study population. Treatment-related adverse events of grade 3 or higher were observed in 39% of patients; neutropenia (23%) and anemia (9%) were the most common. Cytokine-release syndrome also occurred with both intravenous (55%) and subcutaneous (50%) administration.

The highest and most active dose levels were 270 and 720 µg/kg with intravenous teclistamab and 720 and 1,500 µg/kg with subcutaneous teclistamab. After combining these four dose levels, the investigators reported an objective response rate of 63.8%; this included 24 patients with a very good partial response or better and 9 with a complete response or better. A recommended phase II dose of 1,500 µg/kg of subcutaneous teclistamab was established; a total of three partial responses, one very good partial response, and two stringent complete responses were observed at this dose level.

Disclosure: For full disclosures of the study authors, visit ash.confex.com.



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