At the 65th American Society of Hematology (ASH) Annual Meeting in San Diego, California, Carlyn Rose Tan, MD, Memorial Sloan Kettering Cancer Center, New York, New York, and colleagues presented data that demonstrated that prior exposure to a T-cell redirection therapy (TCRT) was associated with a significantly lower incidence of cytokine release syndrome (CRS) during the teclistamab step-up dosing phase among patients with relapsed/refractory multiple myeloma. 

“This observation will allow for optimization of CRS prophylactic strategies for R/R MM patients receiving [teclistamab] treatment,” Tan and colleagues noted. 

Transcript:

My name is Carlyn Tan. I'm an assistant attending [physician] at Memorial Sloan Kettering Cancer Center. I'm here attending the annual ASH conference. We have completed a retrospective study using a Premier Healthcare database, which is a charge master database, looking at the early initiators of teclistamab for relapse[d]/refractory multiple myeloma, and to evaluate patient characteristics, the step-up dosing process, as well as the incidents in management of [cytokine release syndrome] (CRS).

For these early initiators, we included 113 patients in our study, which is one of the larger teclistamab cohorts in the real-world setting, and we found that these early initiators were diverse, they were elderly and had significant comorbidities. The median age was 65, and about 43% of patients were over the age of 70. The patients, although they were elderly and had significant comorbidities, were able to complete their step-up dosing phase during a single inpatient hospitalization.

We did find that these early initiators were typically treated in urban areas, in large academic centers. There were 88 patients who completed the step-up dosing phase that we were able to capture that had dose strength of teclistamab given during their hospitalization. We found that the median length of stay was about 8.6 days, and most patients received the step-up dosing during a 3-day or a 2-day interval. The CRS incidents [were] lower than what was reported in the MajesTEC-1 study. Using the ICD-10 code, there was 23% CRS [and] using the Keating algorithm, we found 47% CRS incidents.

Source:

Hamadeh I, Shekarkhand T, Rueda C, et al. Patterns of cytokine release syndrome with teclistamab in relapsed/refractory multiple myeloma with or without prior T-cell redirection therapy. Presented at the ASH 65th Annual Meeting & Exposition; December 9-12 2023; San Diego, California. Abstract 1961