Elranatamab vs Teclistamab Treatment Among Patients With Triple-Class Exposed/Refractory Multiple Myeloma

Findings from an Unanchored Matching-Adjusted Indirect Comparison

According to findings from an unanchored matching-adjusted indirect comparison (MAIC) published in Leukemia & Lymphoma, elranatamab, a humanized IgG2A B-cell maturation antigen (BCMA)-directed bispecific antibody, exhibited significantly better response and survival outcomes among patients with triple-class exposed/refractory multiple myeloma (TCE/R MM), compared with teclistamab, a humanized IgG Fc BCMA-directed bispecific antibody. 

Triple-class refractory/exposed MM encompasses patients who have received at least 1 proteasome inhibitor, 1 immunomodulatory drug, and 1 anti-CD38 monoclonal antibody. These patients “commonly experience relapse or treatment refractoriness. Consequently, these heavily pretreated patients have a particularly poor prognosis,” explained Isha Mol, a Cytel, Inc., Rotterdam, The Netherlands, and coauthors. In previous years, both teclistamab and elranatamab had been approved by the United States Food and Drug Administration (US FDA) to treat this specific group of patients. 

In this analysis, Mol et al aimed to directly compare the effectiveness of elranatamab versus teclistamab through MAIC, since the absence of studies directly comparing treatments for TCE/R MM “presents a challenge in making informed decisions regarding value assessment and treatment selection,” as Mol et al described. End points included objective response rate (ORR), complete response (CR) rate, duration of response, profession-free survival (PFS), and overall survival (OS).

The study authors used MajesTEC-1 trial (NCT03145181) and MagnetisMM-3 trial (NCT04649359), on which FDA approvals for teclistamab and elranatamab were based, for this comparison. Key baseline characteristics were adjusted so that the 2 trials were comparable. 

Results indicated that elranatamab showed significantly better ORR and PFS compared to teclistamab. Additionally, elranatamab exhibited numerically better CR, duration of response, and OS. 

Mol et al concluded, “These results suggest that elranatamab is an efficacious option for treating patients with TCE/R MM.” 

Source: 

Mol I, Hu Y, LeBlanc TW, et al. A matching-adjusted indirect comparison of the efficacy of elranatamab versus teclistamab in patients with triple-class exposed/refractory multiple myeloma. Leuk & Lymph. Published online: February 12, 2024. doi: 10.1080/10428194.2024.2313628