Prophylactic Tocilizumab to Prevent CRS During Bispecific Step-up Dosing | Astrid Torpe, MD

My name is Astrid Hunnibull-Torpe. I'm a medical doctor and PhD student from the University Hospital of Copenhagen in Denmark. And here at ASH 2025, I have presented our work on the use of prophylactic tricelysumab during teclistumab step-up dosing. So teclistumab is a bispecific antibody effective against relapsed and refractory multiple myeloma. And a common class effect of therapy with teclistumab is cytokine release syndrome, which usually happens during the days of step-up dosing. And usually the treatment for CRS can be a tricelysumab, which is an interleukin 6 receptor inhibitor. But tricelysumab may also be used as CRS prophylactis. So in our study, we investigated the use of prophylactic tricelysumab before the first teclistumab step-up dose to evaluate the safety and efficacy by focusing mainly on CRS rates and the efficacy of the teclistumab treatment and adverse events. So what we found was that giving a single dose of prophylactic tricelysumab just prior to the first teclistumab step-up dose dramatically reduced the incidence of CRS from 69.2% down to just 7.5. And importantly, we found that the more severe CRS, grade 2 CRS, was reduced from 29% in the population that did not get prophylactic tricelysumab down to just 2%. Another important finding of this study was that the effectiveness of teclistumab therapy was just as effective as in the MAJESTIC-1 trial, even though our cohort was of real-world patient with high prevalence of extramedullary disease and high prevalence of high-risk cytogenetics by FISH. So the main findings of our study is that a single prophylactic measure can substantially reduce toxicity during step-up dosing without affecting the efficacy of the teclistumab therapy. We believe that our data support that prophylactic tricelysumab can be a safe and practical path towards doing step-up dosing as outpatient. If our videos have helped you in any way and you're able to, please consider making a donation to help us continue this important work. Your gift will go three times as far when we reach $500,000 by the end of the year. Every contribution, big or small, makes a difference, and we're deeply grateful for your support.