Dr Raza on Unmet Needs in R/R Myeloma With Extramedullary Disease

"This highlights one of the unmet needs: to explore therapeutic options and determine what type of therapies would be ideal. This study is trying to answer the question of whether we can improve survival for these patients with [the combination]."

Shahzad Raza, MD, a hematologist/oncologist at the Cleveland Clinic, discussed challenges associated with the management of relapsed/refractory multiple myeloma with extramedullary disease (EMD), and how this provided the rationale for the phase 1b/2 RedirecTT-1 study (NCT04586426).

Raza began by emphasizing the unique nature of RedirecTT-1, noting that while myeloma studies typically classify patients by refractory status, lines of therapy, and measurable disease, no prior quality studies have specifically focused on EMD, where myeloma is present outside the bone marrow niche in areas like the liver or kidney, he expanded. This study is pioneering in addressing this critical gap, Raza asserted. Furthermore, RedirecTT-1 introduces unique criteria for defining EMD, clearly distinguishing it from paraskeletal diseases, he added. A significant inclusion criterion for this study is the enrollment of patients with unmeasurable, oligosecretory, or nonsecretory disease, a population often excluded from previous clinical trials, Raza noted.

The prognosis for patients with EMD generally remains poor, underscoring the urgent need to identify more effective therapeutic strategies, Raza continued. RedirecTT-1 aims to explore potential therapeutic options and determine the ideal types of therapies to improve survival for these patients. He explained that the study seeks to answer whether the combination of talquetamab (Talvey) and teclistamab (Tecvayli) can enhance survival outcomes in this challenging patient population. This study represents a dedicated effort to address a historically overlooked and difficult-to-treat aspect of multiple myeloma, Raza concluded.