As Dr. Yael Cohen presented her team's clinical trial results at ASCO 2023, the hope in the air was palpable. Veteran myeloma specialists hosting the session listened with wide eyes and enormous smiles as what would seem like a simple Phase 1 Trial resulted in ground-breaking myeloma advances.
This was the first time two bi-specifics had been combined in treatment against a hematological malignancy.
Interesting things to note about this specific trial:
You can listen to Dr. Cohen's summary of the trial and its powerful results or read the written synopsis below:
Is the combination of teclistimab and talquetamab safe for patients?
This was a Phase I (1) clinical trial, meaning that its primary purpose was to evaluate the safety profile of the combination. However, the secondary objectives of the trial included preliminary anticancer activity of each arm of the study.
Ninety-three (93) patients were enrolled.
The requirements included measurable myeloma, relapsed/refractory myeloma or intolerant to the last line of therapy, and they had to have been exposed to a proteasome inhibitor (such as bortezomib/VELCADE), immunomodulatory drug (such as lenalidomide/REVLIMID), and anti-CD38 therapy (such as daratumumab/DARZALEX).
It began on December 15, 2020, and the median (range) duration of follow-up was 14.4 months. Phase 1 should conclude on November 16, 2023.
The study has entered phase 2, and the estimated completion date is March 24, 2024.
The regimen proved to be a safe option for myeloma patients. No unexpected side effects were reported as a result of combining the new drugs. As expected, there were incidences of cytokine release syndrome consistent with other immunotherapies, but they were treatable, and all CRS events were resolved at data cutoff.
Infections were common and mostly low grade.
Across all dosing levels, the overall response rate (ORR) was 86.6%, but in the dosing arm of teclistimab 3.0 mg/kg + Tal 0.8 mg/kg, the overall response rate was 96.3%.
At the data cutoff, 61% of patients remained on the treatment.
An overall response rate (ORR) of 83% was achieved in patients with extramedullary disease (as seen below). There will be an extramedullary disease cohort opening based on these promising results, with overall safety and efficacy supportive of future explanation in larger studies.
Bispecific therapy creates promising opportunities for myeloma patients. But there are many of them! Combining them for a more effective purpose is a worthwhile opportunity when trying to achieve deep and lasting responses, especially in tough-to-treat myeloma, like extramedullary disease. It will be important to keep our eye on Phase II (2) and Phase III (3) of this trial moving forward. There is a lot of hope on the myeloma horizon!
We want to thank the following researchers and specialists who made this trial possible, along with the clinical trial participants and their supportive caregivers.
Yael C Cohen, Daniel Morillo, Moshe E Gatt, Michael Sebag, Kihyun Kim, Chang-Ki Min, Albert Oriol, Enrique M Ocio, Sung-Soo Yoon, Maria-Victoria Mateos, Michael Chu, Paula Rodríguez-Otero, Irit Avivi, Yue Guo, Maria Krevvata, Michelle R. Peterson, Melissa Jo Beelen, Jill Vanak, Arnob Banerjee, Hila Magen
As Dr. Yael Cohen presented her team's clinical trial results at ASCO 2023, the hope in the air was palpable. Veteran myeloma specialists hosting the session listened with wide eyes and enormous smiles as what would seem like a simple Phase 1 Trial resulted in ground-breaking myeloma advances.
This was the first time two bi-specifics had been combined in treatment against a hematological malignancy.
Interesting things to note about this specific trial:
You can listen to Dr. Cohen's summary of the trial and its powerful results or read the written synopsis below:
Is the combination of teclistimab and talquetamab safe for patients?
This was a Phase I (1) clinical trial, meaning that its primary purpose was to evaluate the safety profile of the combination. However, the secondary objectives of the trial included preliminary anticancer activity of each arm of the study.
Ninety-three (93) patients were enrolled.
The requirements included measurable myeloma, relapsed/refractory myeloma or intolerant to the last line of therapy, and they had to have been exposed to a proteasome inhibitor (such as bortezomib/VELCADE), immunomodulatory drug (such as lenalidomide/REVLIMID), and anti-CD38 therapy (such as daratumumab/DARZALEX).
It began on December 15, 2020, and the median (range) duration of follow-up was 14.4 months. Phase 1 should conclude on November 16, 2023.
The study has entered phase 2, and the estimated completion date is March 24, 2024.
The regimen proved to be a safe option for myeloma patients. No unexpected side effects were reported as a result of combining the new drugs. As expected, there were incidences of cytokine release syndrome consistent with other immunotherapies, but they were treatable, and all CRS events were resolved at data cutoff.
Infections were common and mostly low grade.
Across all dosing levels, the overall response rate (ORR) was 86.6%, but in the dosing arm of teclistimab 3.0 mg/kg + Tal 0.8 mg/kg, the overall response rate was 96.3%.
At the data cutoff, 61% of patients remained on the treatment.
An overall response rate (ORR) of 83% was achieved in patients with extramedullary disease (as seen below). There will be an extramedullary disease cohort opening based on these promising results, with overall safety and efficacy supportive of future explanation in larger studies.
Bispecific therapy creates promising opportunities for myeloma patients. But there are many of them! Combining them for a more effective purpose is a worthwhile opportunity when trying to achieve deep and lasting responses, especially in tough-to-treat myeloma, like extramedullary disease. It will be important to keep our eye on Phase II (2) and Phase III (3) of this trial moving forward. There is a lot of hope on the myeloma horizon!
We want to thank the following researchers and specialists who made this trial possible, along with the clinical trial participants and their supportive caregivers.
Yael C Cohen, Daniel Morillo, Moshe E Gatt, Michael Sebag, Kihyun Kim, Chang-Ki Min, Albert Oriol, Enrique M Ocio, Sung-Soo Yoon, Maria-Victoria Mateos, Michael Chu, Paula Rodríguez-Otero, Irit Avivi, Yue Guo, Maria Krevvata, Michelle R. Peterson, Melissa Jo Beelen, Jill Vanak, Arnob Banerjee, Hila Magen
about the author
Eduardo Franco
Eduardo Franco is an International Medical Graduate who Joined HealthTree in 2020 as part of The Patient Experience team. He reads the patient’s medical records and compares them with the information reported by patients on Healthtree so we can have the most exact information on our platform. He is a martial arts practitioner, drummer and avid reader.