Teclistamab

• Teclistamab is a bispecific T-cell engager antibody used in the treatment of relapsed or refractory multiple myeloma.
• Its mechanism of action involves redirecting the body’s own T-cells to target and eliminate multiple myeloma cells.
• It binds to CD3 on T-cells and B-cell maturation antigen (BCMA) on myeloma cells, forming an immunological synapse.
• Common side effects include cytokine release syndrome (CRS), neurological toxicity, and infections.
• Teclistamab offers a new therapeutic option for patients with advanced multiple myeloma who have exhausted other treatments.

What is Teclistamab?

Teclistamab is a novel bispecific T-cell engager antibody approved for the treatment of adult patients with relapsed or refractory multiple myeloma. This medication is designed to bridge T-cells and multiple myeloma cells, facilitating the immune system’s ability to recognize and destroy cancer cells. Its development marks a crucial step forward for patients who have undergone multiple prior lines of therapy and continue to experience disease progression.

Multiple myeloma is a cancer of plasma cells, a type of white blood cell found in the bone marrow. It is the second most common blood cancer, with an estimated 35,730 new cases diagnosed in the United States in 2024, according to the American Cancer Society. For patients whose disease has returned or not responded to previous treatments, new therapeutic options like Teclistamab are vital.

Mechanism of Action and Use in Multiple Myeloma

The teclistamab mechanism of action is highly targeted and innovative. It functions by simultaneously binding to two different targets: the CD3 receptor on the surface of T-cells and the B-cell maturation antigen (BCMA) found on multiple myeloma cells. By bringing these two cell types into close proximity, Teclistamab effectively creates an immunological synapse, activating the T-cells to release cytotoxic proteins that kill the BCMA-expressing myeloma cells.

This dual-targeting approach makes Teclistamab a potent teclistamab multiple myeloma treatment, particularly for patients with relapsed or refractory disease. Clinical trials have demonstrated significant response rates in heavily pretreated patients, offering a new avenue for disease control. It is typically administered subcutaneously and requires careful monitoring, especially during the initial doses, due to the potential for immune-related adverse events.

Teclistamab Side Effects

Like all potent therapies, Teclistamab is associated with a range of potential adverse effects. Understanding these teclistamab side effects is crucial for patient management and safety. The most common and significant side effects include Cytokine Release Syndrome (CRS) and neurological toxicity, which can range from mild to severe.

CRS is a systemic inflammatory response that can occur when T-cells are activated and release a large number of cytokines. Symptoms can include fever, chills, hypotension, hypoxia, and organ dysfunction. Neurological toxicity, often referred to as Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS), can manifest as headache, confusion, tremor, or even seizures. Both CRS and ICANS are typically managed with supportive care and, in some cases, specific medications like corticosteroids or tocilizumab.

Other common side effects observed in patients receiving Teclistamab include:

• Infections (e.g., upper respiratory tract infections, pneumonia)
• Cytopenias (e.g., neutropenia, anemia, thrombocytopenia)
• Fatigue
• Nausea and diarrhea
• Musculoskeletal pain
• Injection site reactions

Patients receiving Teclistamab are closely monitored for these side effects, particularly during the initial weeks of treatment, to ensure timely intervention and management. The benefits of Teclistamab in treating advanced multiple myeloma are generally considered to outweigh these potential risks for eligible patients.