Bispecific antibodies (BsAbs) such as teclistamab can be effective in treating patients with relapsed or refractory multiple myeloma (RRMM). However, response rates are lower in patients with a high tumour burden and/ or extramedullary disease. There is some evidence to suggest that tumour debulking using chemotherapy and/or radiotherapy, and immune modulation involving T-cell stimulation, can restore responsiveness to BsAbs. This paper presents the case of a patient with teclistamab-refractory multiple myeloma who regained responsiveness following tumour reduction and immune modulation.

Teclistamab is a fully immune-based bispecific antibody monotherapy targeting CD3 and B-cell maturation antigen. It is approved for the treatment of adults with relapsed or refractory multiple myeloma (RRMM) who have already undergone multiple prior treatment regimens. The aim of this study was to evaluate the efficacy and safety of teclistamab as early-line monotherapy in patients with RRMM.

Despite major advances in chimeric antigen receptor T-cell (CAR-T) therapies for treating multiple myeloma, such as those targeting B-cell maturation antigen (BCMA) and GPRC5D (G-protein-coupled receptor, class C, group 5, member D) antigen, most patients eventually relapse. There is evidence that concurrent administration of MCARH125 (a BCMA-targeted CAR-T) and MCARH109 (a GPRC5D-targeted CAR-T) leads to deeper and more durable responses. The aim of this study was to evaluate the efficacy and safety of this approach in patients with relapsed or refractory multiple myeloma.

Talquetamab is a bispecific antibody that targets GPRC5D (G-protein-coupled receptor, class C, group 5, member D) on myeloma cells and CD3 on T cells. It is licensed for use in relapsed or refractory multiple myeloma (RRMM) after four or more prior lines of therapy. The aim of this study was to evaluate the efficacy of two talquetamabcontaining regimens – talquetamab plus daratumumab (Tal-D) and talquetamab plus daratumumab and pomalidomide (Tal-DP) – as earlier-line therapy in RRMM.