Older, Younger Patients With MM Show Similar Outcomes With Teclistamab

A poster presented at the 2023 American Society of Hematology Annual Meeting and Exposition showed the real-world toxicity profile and outcomes following treatment with teclistamab to be similar among patients above the age of 70 compared with younger patients.¹

“This is the first and largest multicenter, retrospective analysis characterizing a real-world cohort of patients who received teclistamab. Based on our results, older age—defined as age more than 70 years—did not appear to affect response outcomes or progression-free survival,” lead author Danai Dima, MD, of the Taussig Cancer Institute, Cleveland Clinic, explained in a video presentation of the poster.

Multiple myeloma blood testing | Image credit: luchschenF - stock.adobe.com

Teclistamab, a novel B-cell maturation antigen (BCMA)-directed bispecific antibody, is approved for relapsed or refractory multiple myeloma (RRMM) after at least 4 prior lines of therapy.² 

In the study, 5 academic centers within the US Myeloma Innovations Research Collaborative contributed data on 102 patients with RRMM who were treated with teclistamab before July 1, 2023. Of these patients, 32% (n = 33) were aged 70 or older, with a median age of 75 (range, 71-87) years. In the older cohort, 58% of patients had high-risk cytogenetics and 39% had extramedullary disease before treatment with teclistamab.

Overall, patients were heavily pretreated, with a median of 6 prior lines of treatment, and older patients were more likely to have worse performance status vs younger patients (45% vs 26% with an Eastern Cooperative Oncology Group performance status ≥ 2; P = 0.05). At a median follow-up of 3.2 months for the entire cohort, older and younger patients showed comparable overall response rates (ORR) and complete response rate or better (≥ CR) based on International Myeloma Working Group criteria.

Older patients showed an ORR of 70% compared with 61% among younger patients (P = .37). Among older patients, ≥ CR was 30% compared with 28% for younger patients (P = .8). Median estimated progression-free survival (PFS) was 5.4 vs 3.8 months in the older and younger cohorts, respectively (P = .61). Rates of cytokine release syndrome (CRS) were also similar. at 67% and 64% among older and younger patients, respectively (P = .7), and the same was true for immune effector cell–associated neurotoxicity syndrome (21% vs 11%; P = .17).

While grade 3 or 4 thrombocytopenia within the first 90 days of treatment was more common among older patients (27% vs 12%; P = .05), the authors noted that infection rates were similar between older and younger patients (33% and 26%; P = .46), as were hospital readmission rates (36% vs 23%; P = .16).

“For the most part, the safety profile appeared similar. However, patients older than 70 years were more likely to develop grade 3 and 4 thrombocytopenia," Dima said. "Importantly, the infection rates were not significantly different between the 2 groups, further supporting the broad use of teclistamab in older patients with relapsed/refractory multiple myeloma.”

References

1. Dima D, Sannareddy A, Ahmed N, et al. Toxicity and efficacy outcomes of teclistamab in patients with relapsed-refractory multiple myeloma (RRMM) above the age of 70 years: a multicenter study. Presented at: 65th American Society of Hematology Annual Meeting and Exposition; December 9-12, 2023; San Diego, CA. Poster 3330. https://ash.confex.com/ash/2023/webprogram/Paper180458.html

2. Tecvayli. Prescribing information. FDA; 2022. Accessed December 19, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/761291s000lbl.pdf