Multiple Myeloma Progression Still Slowed With Reduced Tecvayli Dosing

A reduced dosing schedule of Tecvayli (teclistamab) continued to slow the progression of relapsed or refractory multiple myeloma among patients who switched to a lower dosing frequency due to treatment response or for safety reasons, researchers have found.

Research presented during the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting included data from 32 patients who went from weekly treatment to receiving Tecvayli every other week. There was a median follow-up of 6.4 months.

Study Highlights:

  • A reduced dosing schedule of Tecvayli (teclistamab) was effective in slowing the progression of relapsed/refractory multiple myeloma in some patients.
  • Patients who received the lower dosage of Tecvayli did so because they initially responded well to treatment or experienced safety concerns with the higher dosage.
  • Despite receiving a lower dose, the study reports a promising response rate. Among the 32 patients who switched to every-other-week dosing, 90% still responded to treatment after a median follow-up of 6.4 months.
  • Overall, among 77 patients with evaluable responses, 61% responded to treatment, with 43% achieving a very good partial response or better.

The six-month progression-free survival rate (percentage of patients who are alive without their disease spreading or worsening) was 90%, with 28 of 32 patients still responding and undergoing treatment. Otherwise, three patients had experienced disease progression and one had died from infection with active multiple myeloma, researchers reported.

READ MORE: FDA Approves Dosing Reduction of Tecvayli in Relapsed, Refractory Myeloma

The results are from a retrospective observational study of 86 patients with relapsed or refractory multiple myeloma who began treatment with Tecvayli at Memorial Sloan Kettering Cancer Center in New York between Nov. 29, 2022 (when it first became commercially available at the center) and March 1, 2024. Patients had a median age of 71 years, 51% were female, 76% were White and patients had received a median of six prior lines of therapy.

Among 77 patients with evaluable responses, the overall response rate (the percentage of patients who responded partially or completely to treatment) was 61%, with 43% achieving a very good partial response (90% or more reduction in a myeloma-associated protein in the blood) or better. The median time to first response was 1.3 months and, at a median follow-up of 9.5 months, the six-month progression-free survival rate was 52.4%. The median duration of response has not yet been reached, meaning that more than half of patients were still responding to treatment.

Researchers also evaluated early initiators who were treated by March 31, 2023, and recent initiators who were treated after that date.

Early initiators, researchers noted, were more heavily pre-treated, having received eight prior lines of therapy versus five received by recent initiators and 21 (62%) having received prior BCMA therapy, compared with 11 (21%) recent initiators who received prior BCMA therapy.

Early initiators experienced a 67% overall response rate, while recent initiators had a 57% overall response rate. Six-month progression-free survival rates were 53.3% and 52.3%, respectively and six-month duration of response rates were 70% and 82.1%, respectively.

“A higher proportion of early initiators had prior BCMA-directed therapy and more prior lines of therapy but both cohorts yielded consistently high treatment response rates,” stated Dr. Carlyn Rose Tan, myeloma specialist with Memorial Sloan Kettering Cancer Center, in a presentation of the data.

READ MORE: Tecvayli Effective in BCMA-Pretreated R/R Multiple Myeloma

This real-world (not in a clinical trial setting) analysis, researchers noted, displayed an overall response rate comparable to that of the MajesTEC-1 clinical trial which led to the 2022 approval by the Food and Drug Administration of Tecvayli for the treatment of adults with pretreated relapsed or refractory multiple myeloma.

Tecvayli, as defined by the National Cancer Institute, functions by binding to the CD3 protein on healthy immune cells (part of the immune system) and to the BCMA protein on myeloma cells, bringing the two cells near each other to help the T cells kill the myeloma cells.

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