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Prashant Kapoor, MD, FACP


Early Results With Bispecific T-Cell Engager in High-Risk Smoldering Myeloma

By: Amanda E. Ruffino, BA
Posted: Tuesday, January 23, 2024

Omar Nadeem, MD, of Dana-Farber Cancer Institute, Boston, and colleagues compared the bispecific T-cell engager teclistamab-cqyv with standard lenalidomide and dexamethasone in high-risk smoldering multiple myeloma. In this small study, this agent yielded responses in 100% of evaluable patients to date, with reportedly manageable hematologic and nonhematologic toxicities. The investigators presented their findings from the phase II Immuno-PRISM platform study at the 2023 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 206).

In a cohort of 19 patients with high-risk smoldering multiple myeloma, with a median age of 59 years, teclistamab demonstrated no dose-limiting toxicities in the safety run-in, prompting the randomized trial. This novel agent yielded a 100% overall response rate, with 42% complete responses, 25% very good partial responses, and 33% partial responses. Of note, all evaluable patients achieved measurable residual disease (MRD) negativity. The average time to MRD negativity was 4.25 cycles, and no disease progression on treatment was observed. In contrast, those given lenalidomide and dexamethasone had a lower overall response rate of 66%, with no complete responses. Stem cell collection was reported to be successful in all eligible patients.

With teclistamab, the investigators reported no cases of immune effector cell–associated neurotoxicity syndrome. Cytokine-release syndrome occurred in 75% of patients, mainly grade 1, with two cases of grade 2 requiring tocilizumab; all cases resolved.

Disclosures: For the study authors’ full disclosures, visit

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