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New Drug for Multiple Myeloma Yields Positive Results in Clinical Trial

New Drug for Multiple Myeloma Yields Positive Results in Clinical Trial content piece image
Credit: The National Cancer Institute.
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A new study published in The New England Journal of Medicine outlines positive findings from a Phase I/II trial of a new drug – teclistamab – for treating multiple myeloma (MM).

New treatments needed for multiple myeloma

The clinical trial, led by researchers at Winship Cancer Institute at Emory University, recruited patients with MM whose disease had reoccurred or was treatment resistant.

What is multiple myeloma?

A type of blood cancer, MM affects a type of white blood cell known as plasma cells, found in bone marrow. When cancerous plasma cells accumulate within the bone marrow, they overcrowd the healthy cells, producing abnormal proteins rather than helpful antibodies.

For over 50% of MM patients, the disease is incurable and nearly 100% of patients will relapse post-treatment, requiring further therapeutic intervention. Novel treatment modalities are desperately sought to help treat patients and improve their quality of life.

Teclistamab is a drug that targets a specific receptor on the surface of immune cells, and an antigen expressed on the surface of myeloma cells, engaging elimination of the cancer cell via the immune system. It is an example of a bispecific antibody therapy.

Participants were recruited across nine countries for the clinical trial, which occurred between March 2020 and August 2021. In total, 165 participants were allocated to receive teclistamab, having a weekly dose of the drug administered subcutaneously.

After 14.1 months of treatment, 104 patients had responded to the drug. Within that cohort, 65 had a “complete or better response” and forty-four patients did not have any measurable residual disease. At 18.4 months, half the participants experienced responses, and half survived 11.3 months without their disease progressing. Based on the total follow-up period, estimated survival time was 18.3 months.

The study's principal investigator at Winship, Dr. Ajay K. Nooka, MD, MPH, FACP, medical director of Winship's Data and Technology Applications Shared Resource and associate professor in the department of hematology and medical oncology at Emory University School of Medicine, said: “The MajesTEC-1 study update suggests patients with relapsed or refractory multiple myeloma receiving teclistamab achieved a deep response that was also durable.”

Side effects of teclistamab

Of the side effects reported, the most commonly occurring adverse event (AE) was cytokine release syndrome, a reaction where the body releases excess cytokines, causing high fevers, a reduction in blood pressure and sometimes sepsis-like symptoms. This side effect was observed in 72% of patients during the priming or first dose component of the trial.

The research team are now exploring the benefits of using this therapy as an earlier line of treatment in multiple myeloma patients, and in combination with other therapies.

"These longer-term data," says Nooka, "notably the overall response rate and progression-free survival, are encouraging in this heavily pretreated patient population whose treatment history left them with fewer options. New therapies are critically needed for these patients, and this therapy shows real promise."

Reference: Moreau P, Garfall AL, van de Donk NWCJ, et al. Teclistamab in relapsed or refractory multiple myeloma. N Engl J Med. 2022. doi: 10.1056/NEJMoa2203478.

This article is a rework of a press release issued by the Winship Cancer Institute at Emory University. Material has been edited for length and content.