The Effects of a Combination of Teclistamab, Subcutaneous Daratumumab, and Lenalidomide in Myeloma
Dr. Emma Searle presents the results of Cohort E of MajesTEC-2 studying the effects of Teclistamab in combination with subcutaneous Daratumumab and Lenalidomide in patients with multiple myeloma
Abstract title:
Teclistamab in Combination with Subcutaneous Daratumumab and Lenalidomide in Patients with Multiple Myeloma: Results from One Cohort of MajesTEC-2, a Phase1b, Multicohort Study
Purpose of the trial:
Teclistamab (tec) is an off-the-shelf, B-cell maturation antigen (BCMA) × CD3 bispecific antibody that redirects CD3+ T cells to mediate T-cell activation and subsequent lysis of BCMA-expressing multiple myeloma (MM) cells. The combination of daratumumab (dara) and lenalidomide (len) plus dexamethasone is approved for the treatment of MM. Both dara and len have immunomodulatory effects that may enhance the function of tec, potentially resulting in enhanced antimyeloma activity in a broader population of patients. We present initial safety and efficacy data for patients with MM who received tec in combination with dara and len (tec-dara-len) in a phase 1b multicohort study (MajesTEC-2; NCT04722146).
Video summary:
Patients were eligible for tec-dara-len if they had received 1–3 prior lines of therapy (LOT), including a proteasome inhibitor and immunomodulatory drug. In this cohort, patients received weekly doses of tec (0.72 or 1.5 mg/kg with step-up dosing) plus the approved schedules of dara 1800 mg + len 25 mg. Responses were investigator assessed per International Myeloma Working Group criteria and adverse events (AEs) by CTCAE v5.0, except for cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which were graded per ASTCT guidelines.
Conclusions:
Tec-dara-len was well tolerated, with a safety profile consistent with tec or dara-len individually. Promising ORR supports the potential for this combination to have enhanced early disease control through the addition of tec. These data warrant further investigation. The randomized phase 3 MajesTEC-7 study will compare tec-dara-len vs the combination of dara, len, and dexamethasone in patients with NDMM ineligible or not intended for autologous stem cell transplant as initial treatment.
Trial information:
ASH 2022: Abstract #160
Authors:
Emma Searle, Hang Quach, Sandy W. Wong, MD, Luciano J. Megala Costa, MD, PhD, Cyrille Hulin, Wojciech Janowski, Jesus Berdeja, MD, Sébastien Anguille, Jeffrey V. Matous, MD, Cyrille Touzeau, Anne-Sophie Michallet, MD, PhD, Marla Husnik, Deeksha Vishwamitra, Zhuolu Niu, Julie Larsen, Lingling Chen, Jenna D. Goldberg, Rakesh Popat and Andrew Spencer
