Real World Teclistamab Results for Relapsed Refractory Myeloma Patients | Meera Mohan, MD | ASH 2023

Good morning. I'm Meera Mohan. I'm one of the clinical faculty at the Medical College of Wisconsin. So we will be presenting our work on the real world data on the checklist map in patients with the laparotrophic fracture multiple myeloma. So the checklist map as we know is the first in class BCMA-Bispace-V antibody that was recently approved for laparotrophic fracture multiple myeloma in the fifth line. So our real world data is important because clinical trials are very strict inclusion and exclusion criteria. Patients with rapid relapsing myeloma or patients who have suboptimal organ functions are typically excluded from clinical trials and that's where real world studies such as ours comes into play. So in this real world experience we have about 110 patients who've got the checklist map. So unlike the clinical trial this is a very heavily pre-treated patient population. That means they've got a median of six prior lines of therapy. Almost all patients have had a triple class refractory disease. That means they have got an imid-BI and CD30 monoclonal antibody and the disease is refractory to that. In our study 35% of our patients got a prior BCMA-Directed therapy. This is unique because the pivotal clinical trial that led to the approval of the checklist map did not include this study population. Our follow-up is about 3.5 months but we see an overall response rate of 62% with 50% of our patients achieving a VGPR or better. Complete remission rates were about 20%. In this study we also looked into safety signals, the incidence and grades of CRS and ICANNs. Overall CRS which is cytokine release syndrome commonly seen for this class of agents was seen in 56% of patients and ICANNs in about 11% of patients. So there were no real new safety signals. We were also interested in understanding the infections with this class of agents in the real world setting. So what is unique in our studies is that we have implemented infection prophylaxis measures. Nearly all patients are on herpes zoster prophylaxis but 57% of our patients received a primary PGP prophylaxis and 46% of our patients were also on primary IVIG prophylaxis meaning they had IVIG prophylaxis irrespective of the IgG levels or history of prior infection. In this contest we still note that the cumulative incidence of all grade infections and high grade infection was pretty high. We also note here that primary use of IVIG supplements led to a reduction in high grade infection and that is really the takeaway message in this abstract. The real world study here shows that teclistomab in a heavily pretreated patient population which is real world population showed an impressive overall response rate. Infection remains high. However, our primary IVIG prophylaxis led to reduction in all grades of infection. Thank you.