(218) Safety Outcomes of Teclistamab Accelerated Dose Escalation

Poster Abstract: Background
Multiple myeloma is a disease defined by the uncontrolled growth of plasma cells. Treatment for relapse and refractory myeloma is an evolving field with recent novel therapies emerging to fill an unmet need for this patient population.

Teclistamab, a bispecific T-cell engaging antibody, is indicated for the treatment of refractory or relapsed multiple myeloma after at least four lines of therapy. Teclistamab targets both CD3 on T-cells and B-cell maturation antigen (BCMA) on myeloma cells. Teclistamab is associated with boxed warnings for life threatening or fatal cytokine release syndrome (CRS) and neurologic toxicity, including immune effector cell-associated neurotoxicity (ICANS) requiring Risk Evaluation and Mitigation Strategy (REMS) medication monitoring. To mitigate these risks, teclistamab is initiated using step-up doses administered two to four days apart until the maintenance dose is reached. The University of California Davis (UCD) medical center has standardized a two-day separation between step-up doses in an effort to streamline patient care.

Objective
To assess safety events associated with accelerated dose escalation of teclistamab at UCD medical center.

Methods
This was a retrospective, single-center, chart review study. Data was extracted from the electronic medical system (EMS) using a data analytics tool, encompassing all patients who received teclistamab within the past year. The primary endpoint was the overall incidence of CRS and ICANS. Secondary endpoints include hospital length of stay, cost analysis, and other safety parameters such as hematological toxicities (neutropenia, anemia, thrombocytopenia) and infection rates.

Results
Data to be presented at the Hematology/Oncology Pharmacy Association (HOPA) annual meeting in April 2024.

Conclusion
To be discussed at the Hematology/Oncology Pharmacy Association (HOPA) annual meeting in April 2024.

References (must also be included in final poster): Cowan AJ, Green DJ, Kwok M, et al. Diagnosis and Management of Multiple Myeloma: A Review. JAMA. 2022;327(5):464-477. doi:10.1001/jama.2022.0003

Bhatt P, Kloock C, Comenzo R. Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse. Curr Oncol. 2023;30(2):2322-2347. Published 2023 Feb 15. doi:10.3390/curroncol30020179

Albagoush SA, Shumway C, Azevedo AM. Multiple Myeloma. [Updated 2023 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534764/

Moreau P, Garfall AL, van de Donk NWCJ, et al. Teclistamab in Relapsed or Refractory Multiple Myeloma. N Engl J Med. 2022;387(6):495-505. doi:10.1056/NEJMoa2203478