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. 2025 Jul 22;9(14):3408-3417.
doi: 10.1182/bloodadvances.2025016059.

Teclistamab for patients with heavily pretreated relapsed/refractory multiple myeloma and renal impairment

Danai Dima  1   2 , Aimaz Afrough  3 , Utkarsh Goel  1 , Ariel F Grajales-Cruz  4 , Jack Khouri  1 , Kelley Julian  5 , Oren Pasvolsky  6 , Rahul Banerjee  1 , Beatrice Razzo  7 , Christopher J Ferreri  8 , Mariola A Vazquez-Martinez  4 , James A Davis  9 , Aishwarya Sannareddy  3 , Omar Castaneda  4 , Shahzad Raza  2 , Andrew J Portuguese  1 , Mahmoud R Gaballa  6 , Masooma S Rana  10 , Alex Lieberman-Cribbin  11 , Shaun DeJarnette  12 , Rebecca Gonzalez  4 , Anna Chen  7 , Megan M Herr  13 , Lekha Mikkilineni  10 , Hitomi Hosoya  10 , Evguenia Ouchveridze  12 , Gurbakhash Kaur  3 , Adriana Rossi  11 , Leyla Shune  12 , Faiz Anwer  2 , Yi Lin  14 , Shambavi Richard  11 , Douglas W Sborov  5 , Rachid C Baz  4 , Alfred L Garfall  7 , Hans C Lee  6 , Larry D Anderson Jr  3 , Andrew J Cowan  1 , Krina K Patel  6 , Peter M Voorhees  8 , Surbhi Sidana  10 , Doris K Hansen  4 , Shebli Atrash  8 , Sandra P Susanibar-Adaniya  7
Affiliations

Teclistamab for patients with heavily pretreated relapsed/refractory multiple myeloma and renal impairment

Danai Dima et al. Blood Adv. .

Abstract

Outcomes of bispecific antibodies in patients with renal impairment (RI) are not well characterized, given the exclusion of these patients from clinical trials. Herein, we evaluated patients with relapsed/refractory multiple myeloma and RI treated with standard-of-care teclistamab. RI was defined as creatinine clearance (CrCl) <40 mL/min. CrCl <30 mL/min or dialysis dependence was defined as severe RI. Of the 384 included patients, 81 (21%) had RI, including 45 (18%) with severe RI, and 18 (5%) on dialysis. Patients with RI were more likely to be older (median age, 71 vs 67 years; P = .002) and have a higher median number of previous lines of therapy (7 vs 6; P = .04). Rates and severity of cytokine release syndrome (51% vs 59%; grade ≥3: 1.2% vs 1%) and immune effector cell-associated neurotoxicity syndrome (16% vs 13%; grade ≥3: 2.5% vs 2.6%) were similar in patients with and without RI, respectively. Patients with RI had higher baseline and day 30 post-teclistamab grade ≥3 anemia and grade ≥3 thrombocytopenia. Renal function did not worsen after teclistamab initiation in most patients with RI outside of the context of disease progression. Overall response rate (52% vs 56%; P = .61) and survival outcomes (median progression-free survival, 4.6 vs 6.5 months; P = .62) were comparable in patients with and without RI, respectively, after a median follow-up of 9.9 months. No differences in overall survival or non-relapse mortality were noted. Our findings suggest that treatment with teclistamab is feasible in patients with RI, including those on dialysis, with a similar safety and efficacy profile to patients without RI.

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Conflict of interest statement

Conflict-of-interest disclosure: R.B. reports consulting for Adaptive Biotechnologies, Bristol Myers Squibb (BMS), Caribou Biosciences, Genentech, Janssen, Karyopharm, Legend Biotech, Pfizer, Sanofi, and SparkCures; and receiving research support from AbbVie, BMS, Janssen, Novartis, Pack Health, Prothena, and Sanofi. D.D. reports consulting for Karyopharm. G.K. reports consulting for BMS, Arcellx, Sanofi, Janssen, Cellectar, Pfizer, and Kedrion; and receiving research support from BMS, Janssen, and AbbVie. S.S. reports receiving research support from Magenta Therapeutics, BMS, Allogene, Janssen, Novartis, and AbbVie; and serving on the advisory board/providing consultancy for BMS, Janssen, Sanofi, Oncopeptides, Takeda, Regeneron, AbbVie, Pfizer, BioLineRx, Legend, and Kite. J.A.D. reports providing consultancy for BMS and Janssen; and serving on the speaker’s bureau for Janssen. S. Richard reports receiving honoraria from Janssen, BMS, Genentech, Karyopharm Therapeutics, and MJH Life Sciences; serving on the steering committees of Gracell Therapeutics and BMS; receiving research support from Janssen, BMS, C4 Therapeutics, Gracell Therapeutics, and Heidelberg Pharma; and consulting for Genentech, Janssen, BMS, and Karyopharm Therapeutics. L.S. reports consulting for BMS. J.K. reports consulting for GPCR Therapeutics, Janssen, Prothena, and Legend Biotech; and receiving research support from Prothena, Ascentage, Janssen, Karyopharm, and GPCR Therapeutics. H.C.L. reports consulting for BMS, Pfizer, Janssen, Regeneron, GlaxoSmithKline (GSK), Sanofi, AbbVie, Takeda Pharmaceuticals, Allogene Therapeutics, Menarini, and Alexion Pharmaceuticals; and receiving research funding from Amgen, BMS, Janssen, GSK, Regeneron, and Takeda Pharmaceuticals. K.K.P. reports consulting for BMS, Janssen, AstraZeneca, Legend Biotech, Kite, Genentech, AbbVie, Sanofi, Caribou, Takeda, Regeneron, Poseida, Novartis, and Oricell. D.K.H. reports receiving research funding from BMS, Janssen, Karyopharm, Kite Pharma, and Adaptive Biotechnologies; and serving in a consulting or advisory role for BMS, Janssen, Legend Biotech, Pfizer, Kite Pharma, AstraZeneca, and Karyopharm. A.A. reports receiving research funding from AbbVie, Adaptive Biotechnologies, K36 Therapeutics, Johnson & Johnson, and Regeneron Pharmaceuticals; and serving in an advisory role for Karyopharm, BMS, Sanofi, Johnson & Johnson, and Pfizer. C.J.F. reports consulting for Janssen; receiving research support from Janssen and Regeneron; and ownership of publicly traded stock in Affimed. Y.L. reports consulting for Janssen, Legend, Celgene, Sanofi, BMS, Pfizer, Regeneron, Genentech, NexImmune, and Caribou; and receiving research funding from Janssen, Celgene, and BMS. A.J.C. reports consulting for AbbVie, Adaptive Biotechnologies, BMS, HopeAI, Janssen, Sebia, and Sanofi; and receiving research funding from AbbVie, Adaptive Biotechnologies, Caelum, Harpoon, Nektar, BMS, Janssen, Sanofi, OpnaBio, IgM Biosciences, and Regeneron. L.D.A. Jr reports consulting for Janssen, Celgene, BMS, Amgen, GSK, AbbVie, BeiGene, Cellectar, Sanofi, and Prothena; and receiving research support from BMS, Celgene, GSK, Janssen, and AbbVie. A.L.G. reports research funding from Johnson & Johnson, Novartis, Tmunity, and CRISPR Therapeutics; consulting for Johnson & Johnson, Gracell, BMS, GSK, Regeneron, AbbVie, and Smart Immune; and serving on data and safety monitoring board for Johnson & Johnson. S.P.S.-A. reports providing consultancy for Sanofi. H.H. reports consulting for Janssen; and speaker bureaus for Janssen and Karyopharm. F.A. reports serving as an adviser and speaker for BMS, Celgene, and Caribou Biosciences; and receiving research funding from Allogene Therapeutic, Celgene, GSK, BMS, and Caribou Biosciences. S. Raza reports serving on the advisory board of Pfizer, Prothena Biosciences, and Kite Pharma; and receiving research funding from Poseida, Therapeutics, Nexcella Inc, and Janssen. A.R. reports providing consultancy for Adaptive, BMS, Janssen, Karyopharm, and Sanofi. S.A. reports receiving research funding from GSK, Amgen, and Karyopharm; and honoraria from Janssen. D.W.S. reports consulting for Sanofi, Janssen, Pfizer, BMS, GSK, Legend Biotech, Bioline, AstraZeneca, Arcellx, Opna Bio, and AbbVie. R.C.B. reports receiving research funding from AbbVie, BMS, Celgene, Karyopharm Therapeutics, Regeneron, and Janssen; and serving on the advisory board of Cellectar, Janssen, and Pfizer. A.F.G.-C. reports serving on the advisory board for Cellectar Biosciences, Janssen, and Pfizer; receiving honoraria from Cellectar Biosciences, Janssen, Sanofi, Amgen, and Pfizer; and receiving research funding from Cellectar Biosciences. O.C. reports providing consultancy for Janssen, BMS, and Legend Biotech; and receiving honoraria from BMS for speaker bureau. P.M.V. reports providing consultancy for AbbVie, AstraZeneca, BMS, Karyopharm, Lava Therapeutics, Sanofi, Regeneron, Janssen, and GSK; and receiving research funding from AbbVie, GSK, Janssen, and Regeneron. L.M. reports serving on the advisory board of Legend Biotech and BioLineRx. M.R.G. reports serving on the advisory board of BMS and Arcellx. K.J. reports serving as advisory board consultant for Janssen, Pfizer, and BioLineRx. The remaining authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
ORR and depth of response outcomes. PR, partial response; VGPR, very good partial response.
Figure 2.
Figure 2.
Survival outcomes. (A) PFS and (B) OS with teclistamab therapy among patients with and without RI.
Figure 3.
Figure 3.
Survival outcomes. (A) PFS and (B) OS with teclistamab therapy among patients with and without severe RI.
See this image and copyright information in PMC

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