New research presented at the 23rd International Myeloma Society (IMS) Annual Meeting suggests that most people treated with teclistamab plus daratumumab may one day have a life expectancy close to that of people their age without myeloma. The finding comes from a statistical model, not from patients followed for decades, so it is an estimate that still needs to be confirmed. Still, it offers a hopeful look at where myeloma care may be heading.
Dr. Niels van de Donk, a professor of Hematology at the Amsterdam University Medical Center, presented the analysis on behalf of the research team in September 2026 in Glasgow, Scotland.
Using data from MajesTEC-3 to project survival
The model used data from MajesTEC-3 (NCT05083169), a phase 3 clinical trial. A phase 3 trial is a large study that compares a new treatment against a current standard treatment.
The trial tested two medicines given together for relapsed or refractory multiple myeloma. Relapsed means the myeloma came back after treatment. Refractory means it stopped responding to a treatment.:
Teclistamab (Tecvayli, Johnson & Johnson): Teclistamab is a bispecific antibody. This is a lab-made protein that grabs onto two targets at once. One end attaches to B-cell maturation antigen (BCMA), a protein found on myeloma cells. The other end attaches to CD3, a protein on T cells. T cells are immune cells that can kill cancer. By pulling the two together, teclistamab helps the immune system find and destroy myeloma cells.
Daratumumab (Darzalex Faspro, Johnson & Johnson): Daratumumab is a monoclonal antibody that targets CD38, another protein found on myeloma cells.
Researchers often call this combination "tec-dara."
In March 2026, the U.S. Food and Drug Administration (FDA) approved teclistamab with daratumumab for adults with relapsed or refractory multiple myeloma who have had at least one prior line of therapy, including a proteasome inhibitor and an immunomodulatory drug. Relapsed means the myeloma came back after treatment. Refractory means it stopped responding to a treatment.
What did the MajesTEC-3 study already show?
There were 587 adults enrolled in MajesTEC-3. They had relapsed or refractory multiple myeloma and had received one to three prior lines of therapy, including lenalidomide and a proteasome inhibitor. They had not received BCMA-targeted treatment before, and their myeloma was not refractory to anti-CD38 antibodies such as daratumumab.
Earlier results, published in the New England Journal of Medicine, showed a large benefit for teclistamab plus daratumumab. After a median follow-up of about three years (34.5 months):
Progression-free survival (PFS): the length of time patients live without their myeloma getting worse. At three years, 83.4% of patients on teclistamab plus daratumumab were alive without progression, compared with 29.7% of patients on standard treatment.
Overall survival (OS): the length of time patients live, whatever the cause of death. At three years, 83.3% of patients on teclistamab plus daratumumab were alive, compared with 65.0% on standard treatment.
Teclistamab plus daratumumab lowered the risk of progression or death by 83% and the risk of death by 54% compared with standard treatment.
Something else stood out. On a survival graph, the teclistamab plus daratumumab lines flattened out after about six months. This flat stretch is called a plateau. It means that after the first few months, very few additional patients relapsed or died. Of patients who were alive and progression free at six months, 90% were still alive and progression free at about three years. A plateau like this can be a sign that a group of patients has reached long-term disease control.
What is a mixture cure model?
Three years of data cannot tell us how patients will do over 20 years. To estimate that, researchers used a tool called a relative survival mixture cure model (MCM). An MCM is a statistical method that assumes the patients in a study fall into two groups:
A "cured" group, whose risk of dying is the same as that of people without myeloma
An "uncured" group, who still carry an extra risk of dying from myeloma or its treatment
The model works in four steps:
It starts with the survival data actually seen in the trial.
It builds a comparison group from population life tables, which are records of how long people typically live. Each trial patient was matched with people of the same age, sex and country in the general population, using 2023 United Nations data.
It compares the two to separate out the risk of death that comes from myeloma or its treatment. This is called relative survival.
It estimates the share of patients who have no extra risk of death from myeloma or treatment. This share is called the statistical cure fraction.
What does "functional cure" mean in this study?
This is an important point. In this research, a functional cure does not mean the myeloma is gone from the body. It means a patient's risk of dying is no higher than that of a similar person without myeloma, and that the patient remains in long-term remission.
The researchers were clear that a functional or statistical cure is not the same as a biological or clinical cure. Some myeloma cells may still be present. Patients in the trial also continued receiving treatment.
What did the MCM model find?
The researchers tested seven different statistical models to see which one best matched the real trial data. The best fit, called an exponential model, closely matched the survival seen during the roughly four years covered by the trial.
For teclistamab plus daratumumab:
The model estimated that about 87% of patients (86.6%) have no extra long-term risk of death compared with the general population.
The researchers were 95% confident that the true number falls between 81% and 91%. This range is called a confidence interval. A narrow range like this suggests the estimate is fairly stable.
Results were similar across the different models tested, ranging from 84.4% to 86.8%.
When the researchers ran the same analysis using progression-free survival instead of overall survival, they got almost the same answer (86.7%).
For standard treatment (DPd/DVd):
The best-fit model estimated a statistical cure fraction of 0%. The survival curve kept falling over time instead of leveling off.
The estimates for this group were very uncertain, with a confidence interval of 0% to 53%. The researchers said a cure model may not be a good fit for this group at all.
How long might patients on tec-dara live?
Using the model to look 20 to 25 years ahead, the researchers estimated median overall survival. The median is the midpoint: half of patients are expected to live longer than this, and half shorter.
General population matched by age, sex and country: 21.1 years
Teclistamab plus daratumumab: 18.5 years*
DPd/DVd: 4.9 years
In other words, the model projects that people treated with teclistamab plus daratumumab may live nearly four times longer than those on standard treatment, and close to as long as their peers without myeloma. When asked, Dr. van de Donk said the estimated median progression-free survival with teclistamab plus daratumumab was also about 18 years.
*This is based on updated data presented at IMS.
What questions were raised after the talk?
Audience members asked several thoughtful questions after the presentation.
Does the model hold up for different types of patients? Dr. van de Donk said the team looked at younger and older patients, as well as patients with standard-risk and high-risk disease based on genetic testing. High-risk myeloma is myeloma with certain genetic changes, called cytogenetic abnormalities, that tend to make it more aggressive. He said that in each group, estimated survival was very close to that of the matched general population.
Could treatments after relapse skew the results? Overall survival can be affected by the treatments patients receive after their myeloma comes back. Dr. van de Donk explained that this is one reason the team repeated the analysis with progression-free survival, which is not affected by later treatments. That analysis gave nearly identical cure fractions.
Can the myeloma become resistant to teclistamab? Myeloma cells can sometimes change the BCMA target so that BCMA-directed drugs no longer work. Dr. van de Donk said his team had not seen BCMA changes of this kind with teclistamab so far. He suggested that the treatment may shrink the myeloma so deeply early on that very few cancer cells remain to develop resistance.
How does this fit with other options at first relapse? Dr. van de Donk noted that chimeric antigen receptor T-cell therapy (CAR-T) has the advantage of being a one-time infusion. CAR-T uses a patient's own T cells, changed in a lab to attack myeloma. He said teclistamab plus daratumumab worked well even in patients with high-risk genetics or early relapse, and that these patients likely benefit from continuous treatment. He added that researchers should study whether some patients might be able to stop treatment after a certain amount of time.
What are the limits of this research?
This analysis offers encouraging news, but it is important to read it carefully.
It is a projection. The model extends about three years of real data out over decades. The actual long-term outcomes are not yet known.
More follow-up is needed. MajesTEC-3 is still ongoing. The researchers said their estimates will need to be confirmed as more years of data come in.
It is not a cure in the usual sense. A statistical cure describes survival risk, not whether myeloma cells have been fully cleared from the body.
The treatment has side effects. In the main trial, serious side effects occurred in 70.7% of patients on teclistamab plus daratumumab and in 62.4% of patients on standard treatment. Cytokine release syndrome (CRS), an immune reaction that can cause fever and low blood pressure, occurred in about 60% of patients on teclistamab plus daratumumab. All CRS cases were mild to moderate. Infections were also a common concern.
What does this mean for patients?
For many years, relapsed myeloma has been seen as a disease that returns again and again. This model suggests that for a large share of patients, newer immune-based treatments like teclistamab plus daratumumab may change that picture. If longer follow-up confirms the model, this combination may help redefine what patients can expect after relapse.
Every person's myeloma is different. Your age, overall health, genetic risk, past treatments, and personal goals all matter when choosing a treatment. If you have relapsed myeloma, or are wondering what options may be available if your myeloma comes back, talk with your care team about whether teclistamab plus daratumumab or another treatment may be right for you. Always check with your care team before starting, changing, or stopping any treatment.
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Sources
Van Effelterre TP, Buyukkaramikli N, Slavcev M, et al. Projecting Functional Cure in Patients With Relapsed/Refractory Multiple Myeloma (RRMM) in the MajesTEC-3 Study of Teclistamab-Daratumumab (Tec-Dara) Using a Mixture Cure Model. Presented by N.W.C.J. van de Donk at the 23rd International Myeloma Society Annual Meeting and Exposition; September 23–26, 2026; Glasgow, Scotland. [Link to abstract: TO ADD]
Costa LJ, Bahlis NJ, Perrot A, et al. Teclistamab plus Daratumumab in Relapsed or Refractory Multiple Myeloma. N Engl J Med. 2026;394(8):739-752. https://doi.org/10.1056/NEJMoa2514663.
MajesTEC-3 trial record, ClinicalTrials.gov. https://clinicaltrials.gov/study/NCT05083169
Felizzi F, et al. Mixture Cure Models in Oncology: A Tutorial and Practical Guidance. PharmacoEconomics Open. 2021;5(2):143-155. https://pubmed.ncbi.nlm.nih.gov/33638063/
The ASCO Post. FDA Approves Teclistamab and Daratumumab For Relapsed or Refractory Multiple Myeloma. March 25, 2026. https://ascopost.com/issues/march-25-2026/fda-approves-teclistamab-and-daratumumab-for-relapsed-or-refractory-multiple-myeloma/
HealthTree for Multiple Myeloma. Myeloma FDA Approval: Teclistamab with Daratumumab. March 6, 2026. https://healthtree.org/myeloma/community/articles/26-fda-approves-teclistamab-daratumumab-myeloma
