Patients with relapsed multiple myeloma treated with Johnson & Johnson's teclistamab lived significantly longer and remained in remission far longer than those receiving standard therapies in a late-stage trial.
Nearly 70% of patients receiving teclistamab, sold under the brand name Tecvayli, had no disease progression after 18 months, compared with about 27% of patients receiving standard treatments, researchers reported at ASCO and in The New England Journal of Medicine.
Nearly two-thirds of patients treated with Tecvayli in the trial achieved complete remission, compared to roughly 17% of patients in the standard treatment group, the researchers said.
The control group received standard myeloma combination regimens of either Bristol Myers' Pomalyst (pomalidomide), Velcade (bortezomib) and the steroid dexamethasone, or Amgen's Kyprolis (carfilzomib) and dexamethasone.
Tecvayli belongs to a newer class of dual-action drugs known as bispecific antibodies. They work by linking immune T cells to a protein found on myeloma cells, allowing the immune system to recognize and attack the cancer directly.
“We are seeing very deep responses and long clinical benefit from these therapies. This is part of a much bigger transformation happening in myeloma care,” study investigator Dr. C. Ola Landgren of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine said in a statement.
The nearly 600 trial participants from 24 countries had multiple myeloma that recurred after one-to-three prior treatments.
“Patients with relapsed or refractory multiple myeloma... face poor outcomes and limited effective treatment options," said study leader Dr. Roberto Mina of the Winship Cancer Institute of Emory University in Atlanta.
"These results established teclistamab-based therapy as a new standard of care for (these) patients,” Mina said.
Researchers are now studying whether bispecific antibodies should be given even earlier in the disease course.
An NEJM editorial published with the study said it represents “a pivotal step forward.”
Still, it noted, “an increasingly crowded therapeutic landscape” of myeloma treatments means “treatment selection will probably depend more on patient characteristics, access, and sequencing than on intrinsic differences in efficacy."
Separately at the ASCO meeting, Bristol Myers reported that its experimental pill mezigdomide, from a class of drugs called cereblon E3 ligase modulator agents, delayed disease progression in a late-stage trial of multiple myeloma patients whose illness had relapsed or not responded to other treatments.
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