EHA 2025 Insights: Real-World Data Updates On Teclistamab and Talquetamab In Advanced R/R MM

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Real-world evidence studies for bispecific antibodies provide crucial data beyond clinical trial populations, with approximately 70% of real-world patients being ineligible for the original registration trials. The Real-TEC study data demonstrated a 60% overall response rate with teclistamab, consistent with clinical trial results. Subgroup analyses revealed important sequencing insights: prior chimeric antigen receptor T therapy did not significantly impact outcomes when adequate time had elapsed, whereas prior antibody-drug conjugate exposure appeared to reduce efficacy, possibly due to timing proximity.

Comparative effectiveness research requires synthetic control arms due to the single-arm nature of bispecific approval trials. The LocoMMotion and MONUMENT (-1, -2, -3) studies enrolled similar patient populations from 2019 to 2023, creating historical control data sets. Through propensity score matching, researchers established that the expected median overall survival for standard of care in this population was 4.6 months compared with 15 months with bispecific therapy—representing a quadrupling of survival benefit.

Real-world practice patterns show significant deviation from clinical trial protocols, with over half of patients spacing out treatments beyond prescribed schedules. This spacing occurs not due to toxicity but to patient preference after achieving desired responses, without apparent negative impact on efficacy. These findings highlight the need for ongoing real-world data collection to understand optimal dosing strategies, long-term efficacy in high-risk subgroups, and the potential for finite duration therapy approaches across different bispecific agents.