Al-Ola Abdallah, Associate Professor and Plasma Cell Disorder Program Director of the Division of HMCT at the University of Kansas Medical Center, shared a post on X about a paper he co-authored with colleagues, published in Cancers:
“The Future of BiTEs, especially in combination therapy trials, should be focused on fixed duration.
Teclistamab Dosing Strategies in Multiple Myeloma: Continuous versus Fixed-Duration Therapy:
Study Snapshot
- Multicenter, real-world retrospective analysis (n=88)
- Compared continuous (n=72) versus fixed-duration (n=16) teclistamab in relapsed/refractory Multiple Myeloma
- Goal: Evaluate if stopping after deep response compromises outcomes.
Core Finding Fixed-duration strategy appears feasible for select patients 12-mo PFS ~same: 65% (continuous) vs. 66% (fixed) BUT: Severe infection risk much higher in fixed-duration group (69% vs. 22%)
Patient Differences Matter Fixed-duration pts were older (median 73y vs. 69y) More prior BCMA-therapy refractory (56% vs. 29%) Similar rates of high-risk cytogenetics (~43%) Heavily pretreated: median 5 prior lines.
Response & Survival Fixed-duration pts stopped after ≥VGPR Median PFS: 16 mo (continuous) vs. 13 mo (fixed) OS trend favored continuous therapy (HR 2.79; p=0.048) ~38% of fixed-duration pts stayed treatment-free >12 mo.
Safety Watch CRS/ICANS rates similar (no grade ≥3 in fixed group) Infections = major issue:
- Any grade: 75% vs. 59%
- Grade ≥3: 69% vs. 22% (p<0.001) Reflects lasting immune suppression post-teclistamab.
Clinical Implications Fixed-duration may reduce treatment burden & improve QoL But immune recovery lags behind drug cessation Careful patient selection essential:
→ Deep, sustained responders only
→ Avoid in high-risk or aggressive biology.
Future Directions Prospective, randomized trials needed to:
- Define ideal candidates
- Set optimal duration pre-stop
- Identify immune reconstitution markers
- Balance efficacy vs. infection risk.
8/Bottom Line: Fixed-duration teclistamab = promising, but not ready for routine use. Maintain vigilance for infections & personalize discontinuation decisions.”
Title: Teclistamab Dosing Strategies in Relapsed/Refractory Myeloma: A Real-World Comparison of Weekly and Biweekly Versus Fixed Intervals
Authors: Jordan Snyder, Shebli Atrash, Barry Paul, Abdullah Mohammad Khan, Alma Habib, Hira Shaikh, Christopher Strouse, Omar Alkharabsheh, Anita Mazloom, Nausheen Ahmed, Zahra Mahmoudjafari, Muhammad Umair Mushtaq, Anas Zayad, Joseph McGuirk, Yun Kyoung Tiger, Mansi R. Shah, Al-Ola Abdallah
Read The Full Article in Cancers.
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