Dr Raab on Continued Investigation of Teclistamab Plus Daratumumab-Based Induction in Myeloma

"Phase 3 trials are planned or already underway for this newly diagnosed setting, [investigating] highly effective T-cell engagers in a setting where the T cells are treatment naive."

Marc S. Raab, MD, a professor of medicine and clinical director of the Heidelberg Myeloma Center in the Department of Medicine V at Heidelberg University Hospital, CCU Molecular Hematology/Oncology, German Cancer Research Center, discusses next steps for the investigation of teclistamab-cqyv (Tecvayli) in combination with daratumumab (Darzalex)–based induction regimens for the treatment of patients with newly diagnosed multiple myeloma based on results from the phase 2 MajesTEC-5 trial (NCT05695508).

During the 22nd Annual International Myeloma Society (IMS) Meeting and Exposition, findings from MajesTEC-5 showed that an overall response rate of 100% was achieved in all patients who received teclistamab every week in combination with daratumumab and lenalidomide (Revlimid; Tec-DR; n = 10), Tec-DR with teclistamab every 4 weeks ( n = 20) or teclistamab plus daratumumab, bortezomib (Velcade), and lenalidomide (n = 19). Beyond these high response rates, the depth of response was particularly notable. All patients with available samples had MRD negativity that was reached as early as after cycle 3, and was confirmed after cycle 6 using flow cytometry at a sensitivity of 10−5

Although MajesTEC-5 is a phase 2 study and does not yet change routine clinical practice, Raab stated that it opens a "clear avenue" for subsequent research. He added that phase 3 trials are currently being planned or are already underway in the newly diagnosed setting. The motivation for utilizing highly effective T-cell engagers in this initial stage of treatment is that the T cells are treatment naive, suggesting that therapy is likely most effective and most active in this stage, Raab concluded.