Teclistamab Transforms Early Myeloma Care: Roberto Mina, MD

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New topline data from the phase 3 MajesTEC-9 trial (NCT05572515) have bolstered the reputation of teclistamab-cqyv (Tecvayli; Johnson & Johnson/Janssen) as a transformative treatment for patients battling relapsed/refractory multiple myeloma.1 Teclistamab is a first-in-class bispecific T-cell engager that binds to B-cell maturation antigen (BCMA), a key antigen expressed on these cancerous cells, creating a highly effective platform for cellular destruction.

While teclistamab originally received FDA accelerated approval in October 2022 for adult patients who had received at least 4 prior lines of therapy,2 the MajesTEC-9 results suggest its utility much earlier in the treatment journey. This trial compared teclistamab monotherapy against standard-of-care regimens, such as pomalidomide, bortezomib, and dexamethasone or carfilzomib and dexamethasone.

The importance of this study lies in the specific patient population enrolled. Participants had received 1 to 3 prior lines of therapy and were required to have been exposed to an anti-CD38 monoclonal antibody and lenalidomide. In the current landscape of myeloma care, these agents are pivotal for newly diagnosed patients. However, many patients become refractory to them by their first relapse. In MajesTEC-9, 85% of patients were refractory to anti-CD38 therapy, and 79% were refractory to lenalidomide.

The trial results were striking, demonstrating a 71% reduced risk of disease progression or death and a 40% reduced risk of death compared with standard-of-care treatments.1 In this interview with The American Journal of Managed Care® (AJMC®), Roberto Mina, MD, an associate professor at the Winship Cancer Institute of Emory University, emphasizes the clinical impact of these findings.

Beyond its efficacy, he highlights the logistical advantages of teclistamab. The chief advantage is that bispecific antibodies like teclistamab are noted for being easier to administer, unlike more complex immunotherapies such as chimeric antigen receptor T-cell therapy.

“We know at the time of the relapse, most of these patients will be, and their disease will be, resistant to either or both drugs,” he explains. “This makes the treatment choice of a salvage regimen as early as a second line, or first relapse, quite challenging, and so MajesTEC-9 and teclistamab really tackles this issue.”

References

1. Shaw ML. MajesTEC-9 Data add to accolades for teclistamab in multiple myeloma. AJMC. January 15, 2026. Accessed January 23, 2026. https://www.ajmc.com/view/majestec-9-data-add-to-accolades-for-teclistamab-in-multiple-myeloma
2. Mattina C. FDA approves first bispecific antibody, teclistamab, for R/R multiple myeloma. AJMC. October 26, 2022. Accessed January 23, 2026. https://www.ajmc.com/view/fda-approves-first-bispecific-antibody-teclistamab-for-r-r-multiple-myeloma