Dr Raab on the Rationale for Adding Teclistamab to Daratumumab-Based Induction in NDMM

"Although standard quadruplet induction regimens achieve high response rates, there remains room for improvement, as evidenced by the MRD negativity rate observed in studies like PERSEUS.”

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, discussed the rationale for adding teclistamab-cqyv (Tecvayli) to standard daratumumab (Darzalex)–based induction regimens for the treatment of patients with newly diagnosed multiple myeloma.

The current standard-of-care (SOC) induction regimen for patients with newly diagnosed, transplant-eligible multiple myeloma is the quadruplet combination of daratumumab (Darzalex), bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (Dara-VRd), Raab began. This regimen is known to achieve high response rates and long durations of response, he noted.

Despite the effectiveness of Dara-VRd, Raab noted that there remains "still room for improvement" in patient outcomes. As an example, the phase 3 PERSEUS study (NCT03710603), which evaluated Dara-VRd in this patient population, showed that the rate of minimal residual disease (MRD) negativity, even after transplant and consolidation, was 75.2%. This finding implies that nearly a quarter of patients still had detectable disease, prompting the search for more effective induction strategies, Raab explained.

The phase 2 MajesTEC-5 trial (NCT05695508) was designed to evaluate the safety and efficacy of enhancing the SOC by adding a bispecific antibody, specifically teclistamab-cqyv (Tecvayli), to regimens containing daratumumab, lenalidomide, dexamethasone and/or bortezomib in a phase 2 setting, he stated. By targeting BCMA with teclistamab early in the treatment pathway, researchers hoped to improve upon the high response rates achieved by Dara-VRd, Raab concluded.