ASH 2024 | How newer bispecifics, including teclistamab & talquetamab, may influence myeloma treatment

Teclistamab and talquetamab are antibodies which are bispecific and they target BCMA and GPRC5D. Teclistamab and elranatamab, which are two BCMA bispecific antibodies, are now available in clinical practice in the UK for patients who are relapsed/refractory and got to fourth or fifth line setting. But what’s of interest is really the use of teclistamab and talquetamab in the newly diagnosed setting. And there is an ongoing MajesTEC trial which is looking at this combination with daratumumab and lenalidomide, with teclistamab or talquetamab, and comparing that with daratumumab, lenalidomide, and dexamethasone. This is exciting because very high response rates have been seen when you combine teclistamab or talquetamab to daratumumab and lenalidomide. So the key question is whether very high response rates will be achieved and whether this would mean that patients have a significantly improved progression-free survival and overall survival in the transplant-ineligible myeloma patients. There’s also data being presented in this meeting of use of teclistamab as maintenance after transplant, comparing teclistamab versus teclistamab and lenalidomide. And the early data does show that very high proportion of patients are going into remission, but there is some expected toxicity that we’re seeing in this particular trial. And therefore, those have to be mitigated in the subsequent trial designs of both teclistamab and elranatamab as maintenance post-transplant.

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