Continuous vs fixed-duration teclistamab dosing strategies in RRMM: Real-world evidence

Results from a multicenter retrospective study comparing continuous vs fixed-duration teclistamab in patients with relapsed/refractory multiple myeloma (RRMM) were recently published by Snyder et al. in Cancers. Eligible patients received step-up dosing followed by weekly administration of teclistamab (N = 88). Patients who achieved a very good partial response or better (≥VGPR) and discontinued therapy due to deep response, toxicity, or preference were assigned to the fixed-duration cohort (n = 16), while the continuous cohort included patients who continued treatment per standard practice (n = 72). Outcomes included complete response (CR) rate, progression-free survival (PFS), and adverse events (AEs).

Key data: The fixed-duration cohort achieved a higher rate of CR compared with the continuous cohort (69% vs 44%) with a shorter median time to best response (1 month vs 2 months). The median PFS was 16 months in the continuous cohort compared with 13 months in the fixed-duration cohort (hazard ratio [HR], 1.7; p = 0.20). The 12-month PFS rates were similar in the continuous vs fixed-duration cohort (65% vs 66%). Infections were more frequent in the fixed-duration cohort compared with the continuous cohort (any grade, 75% vs 59%; Grade ≥3, 69% vs 22%, respectively; p < 0.001). 

Key learning: Fixed-duration teclistamab after VGPR appears to be feasible in selected patients with RRMM, with comparable early survival outcomes to continuous treatment. Infection burden remained elevated and requires close monitoring.