IMWG Update: Long-Term Follow-Up, Teclistamab in Relapsed/Refractory Myeloma

My name is Carleen Tan. I'm an assistant attending a Memorial Sloan Kettering Cancer Center. I mostly focus on treating multiple myeloma and other related plasma cell disorders. I'm going to be presenting on our poster that is looking at long-term follow-up data and outcomes in patients who were treated with Ticlystumab for relapsed refractory multiple myeloma through the IMWG Immunotherapy Committee Working Group database. So we have a very large database, an international database involving five countries collecting data on patients who have received certain immunotherapy agents. In this poster, we'll be looking specifically at Ticlystumab and looking at safety and outcomes of patients after a follow-up of more than 12 months. So we have long-term follow-up data on these patients. The median follow-up time in our study was 16 months and included 223 patients. Like I said, it was from five different countries, nine centers in the world. And we found that the overall response rate was pretty similar to what was shown in the pivotal Majestic 1 study that led to the approval of Ticlystumab for relapsed refractory myeloma. It was in the high 60% range. We also did see that the progression-free survival, so the time that patients stayed in remission from Ticlystumab was a little bit shorter than what was reported in the clinical trial. But that was probably most likely because the patients in the real-world setting, unfortunately, wouldn't have met the criteria for the clinical trial. So 77% of the patients in our real-world study would not have met the Majestic 1 criteria, eligibility criteria. We did include patients who had had prior BCMA-directed therapy. And in those 94 patients, they fortunately, 50-plus percent of those patients still were able to achieve a response on Ticlystumab, which is encouraging. So with the Majestic 1 study, they didn't allow for patients that had had prior BCMA-directed therapy because Ticlystumab targets BCMA. They required that patients had to have good performance status, zero to one. Because it's the real world, we included patients who were more frail, may have had more comorbidities, had lower blood counts. There were strict criteria for that in the Majestic 1 study, as well as strict criteria for kidney function. So there were patients that had kidney, chronic kidney disease, creatinine clearance less than 30 in our group of patients. All these patients had to have received Ticlystumab outside of a clinical trial. I think it's still encouraging that patients who had had prior BCMA-directed treatment still able to have a response, although a little bit lower than BCMA-naive patients. The people that had antibody drug conjugates, like Bilantumab, actually had pretty high response rates. And the patients that had CAR-T had a little bit lower response rates. But I think we need more studies to see how to sequence these treatments now that there are many BCMA-directed agents in the market and some might be coming back, hopefully soon.