Dr Raab on Updated Findings With Teclistamab-Based Induction in Newly Diagnosed Multiple Myeloma

“We found that the response rates not only deepened over time, but almost reached a 100% CR [rate] across all cohorts.”

Marc S. Raab, MD, PhD, a professor of medicine and clinical director of the Heidelberg Myeloma Center and the Department of Medicine V at the Heidelberg University Hospital, discussed updated findings from the phase 2 GMMG-HD10/DSMM-XX MajesTEC-5 (NCT05695508) study evaluating teclistamab-cqyv (Tecvayli)–based induction therapy in patients with newly diagnosed multiple myeloma.

The updated dataset presented at the 22nd International Myeloma Society Annual Meeting included all 3 study cohorts, totaling 49 patients, all of whom completed 6 cycles of induction therapy. Across treatment arms, teclistamab/daratumumab (Darzalex)–based induction therapy produced deep and consistent responses, with an overall response rate (ORR) of 100% observed in all cohorts. In arm A (teclistamab weekly plus daratumumab; n = 10), all patients achieved a complete response (CR) or better. In arm A1 (teclistamab every 4 weeks plus daratumumab; n = 20), 95% of patients achieved a CR or better.

In arm B (teclistamab every 4 weeks plus daratumumab, bortezomib [Velcade], and lenalidomide [Revlimid]; n = 19), 73.7% of patients achieved a CR or better, 94.7% of patients achieved a very good partial response (VGPR) or better, and 5.3% of patients achieved a PR. Notably, several patients in arm B with a VGPR at the end of induction subsequently converted to a CR following autologous stem cell transplant. Collectively, all 49 patients responded to treatment by the end of induction.

Minimal residual disease (MRD) negativity was a key outcome of the study. Raab noted that MRD negativity by flow cytometry at a sensitivity of 10⁻⁵ was achieved in all MRD-evaluable patients, some as early as cycle 3, and MRD negativity was confirmed for all evaluable patients by cycle 6. Next-generation sequencing at a sensitivity of 10⁻⁶ confirmed MRD negativity in all 46 patients with available samples, yielding a 100% MRD-negative rate among tested patients and a 98.0% rate overall in the study population, Raab concluded.