Real world evidence with teclistamab for RRMM patients | Bea Razzo, MD | IMS 2024

Hi everyone, I'm Dr. Bea Rauzo, recently graduated fellow from the University of Pennsylvania, joining faculty at Thomas Jefferson University as a myeloma specialist. And I've had the pleasure of working with many colleagues throughout the United States who are part of the Multiple Myeloma Immunotherapy Consortium. It's been a very cool endeavor to really be able to follow our patients in a pooled group and to see how they do in the real world. And so our focus, as is that of many other groups, is to really know how our patients are doing with a lot of these new immunotherapy drugs for multiple myeloma in the real world outside of these highly controlled and highly selected patient groups that are part of the clinical trials that led to the approval of these different drugs. So in this study in particular, we looked at patients with relapsed refractory multiple myeloma who were getting Ticlystumab. And Ticlystumab was approved now about two years ago following a study called Machestic 1. The first initial large group that led to its approval were patients who had never received any other form of drug that targets BCMA. So those are some CAR T cells like IDA cell and CILTA cell or the other drug called Bilanumab. And patients who got Ticlystumab on this trial did very well with it. So we wanted to know how our patients get in the real world doing. So we looked at 385 patients who are treated throughout 14 institutions in the US. And those actually had a combination of patients who had or had not previously had different forms of drug targeting BCMA. The patients in our cohort were a little bit older, more frail than patients who participated in the trial. So that's pretty typical as trial requirements can be pretty stringent. But despite some of these differences, patients did very well. And the number of patients who respond to Ticlystumab was quite similar. And the safety of Ticlystumab was also very similar to when they got it on the trial. And so the results for that are encouraging. We have a lot of other follow up questions that are very pertinent to our field. And so this database helps answer some of those. For example, do patients who have gotten CAR T or Bilanumab, do they do as well? And in this data that we presented, as well as some other studies, patients have lower rates of response. So about 10% to 15% fewer patients will go on to respond, will have an effect of Ticlystumab. But on the other hand, actually about 50% of patients, even if they've had other CAR T or Bilanumab, still have a very good response to it. And so this kind of shows the duality of our field right now, where we want to know, OK, well, are patients going to do as well? How do we arrange the order of these different forms of therapies? And so we know that, yes, there will be fewer responses, but the responses are still likely to occur in at least 50% of patients. So this is not an answer to our questions of what sequence should we give these new immunotherapies in. But it is an encouraging kind of indicator in the real world that these remain very efficacious options that we are fortunate to be able to offer to our patients.