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For patients on commercial teclistamab who achieve a response, are there patient-specific or response-specific parameters that would prompt you to de-escalate therapy from once per week?

For example - minimum number of months of therapy, driving distance to clinic, at least a CR with or without MRD negativity?
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What dose and frequency of teclistamab do you use after achieving at least a PR from treatment for patients with relapsed/refractory multiple myeloma?

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3 Answers
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Medical Oncology · University of Chicago
Answered on · Updated on

I think it’s safe to say we really lack good evidence to guide us.

However, we must balance the risk of persistent immunosuppression with teclistamab and its efficacy.
The only piece of data I am aware of in this regard comes from ASCO 2023 in an abstract by @Dr. First Last.

In the MajesTEC-1 study,...

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Medical Oncology · Winship Cancer Institute of Emory University
Answered on

I reviewed the investigator brochure for all the FDA-approved bispecific antibodies, and saw very little pharmacokinetic (PK) or pharmacodynamic (PD) data.

Hence, for patients that achieve a ≥VGPR after 1 month of weekly treatment, it's appealing to switch to monthly dosing for BCMA-directed bispec...

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Mednet Member
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Medical Oncology · University of Wisconsin
Answered on

We have started to de-escalate quickly, particularly for our elderly patients, who are having more difficulty tolerating teclistamab. Once the patients achieve at least a PR (which seems to be apparent within 2 cycles), we have been moving to q 2 weeks and even monthly, with what appears to be bette...

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