Talquetamab plus teclistamab shows promise in multiple myeloma

For patients with relapsed or refractory multiple myeloma, talquetamab plus teclistamab shows response in a high percentage of patients and a higher incidence of grade 3 or 4 infections than with either therapy alone, according to a study published in the New England Journal of Medicine.

Yael C. Cohen, MD, from the Tel Aviv Sourasky Medical Center in Israel, and colleagues conducted a phase 1b-2 study of talquetamab plus teclistamab in patients with relapsed or refractory multiple myeloma. Five dose levels were investigated in a dose-escalation study in phase 1. The recommended phase 2 regimen was talquetamab at a dose of 0.8 mg/kg body weight plus teclistamab at a dose of 3.0 mg/kg every other week. The primary objective of the study was to evaluate adverse events and dose-limiting toxic effects.

Ninety-four patients received treatment; 44 used the recommended phase 2 regime. Patients were followed for a median of 20.3 months. The researchers found that three patients had dose-limiting toxic effects (including one with grade 4 thrombocytopenia, who received the recommended phase 2 regimen). The most common adverse events across all dose levels were cytokine release syndrome, neutropenia, taste changes, and nonrash skin events.

Ninety-six percent of patients had grade 3 or 4 adverse events, most often hematologic events. Sixty-four percent of patients had grade 3 or 4 infections. A response occurred in 80% of the patients with the recommended phase 2 regimen and in 78% across all dose levels. The likelihood of patients continuing in response at 18 months was 86 and 77% with the recommended phase 2 regimen and across all dose levels, respectively.

“On the basis of these results, this dual-targeting, off-the-shelf combination therapy warrants further investigation in patients with relapsed or refractory multiple myeloma,” the authors write.

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