Teclistamab Plus Daratumumab: MajesTEC-3 Data, Patient Selection, and the Evolving Role of Bispecifics in RRMM

In this episode, 'Teclistamab Plus Daratumumab: MajesTEC-3 Data, Patient Selection, and the Evolving Role of Bispecifics in RRMM,' the panelists explore the following questions:

1. Bispecific antibodies have emerged as an important option in the relapsed/refractory setting. How are you thinking about bispecific-based combinations in the second-line space specifically, and for which patients do you see them as most appropriate at this stage of therapy?
2. Teclistamab has recently received FDA approval in combination with daratumumab hyaluronidase-fihj for patients with relapse/refractory multiple myeloma (RRMM). What were key takeaways from the MajesTEC-3 trial that supported its approval?

The panelists examined how bispecific antibodies are being positioned in the second-line relapsed or refractory setting, with the discussion centering on a practical patient selection framework that begins with an assessment of CAR-T eligibility and patient interest, before moving to bispecific selection based on whether the patient may eventually be a CAR-T candidate, in which case a non-BCMA bispecific such as a GPRC5D-targeting agent would be preferred to preserve the BCMA target for future use. The panelists also highlighted the landmark MajesTEC-3 data for teclistamab plus daratumumab, with particular emphasis on the trial's hazard ratio of 0.17, noting that this result meaningfully challenges the assumption that CAR-T should be the automatic default second-line choice, particularly for patients who lack the social support, caregiver availability, or logistical capacity to pursue CAR-T therapy. The discussion further underscored the practical advantages of the teclistamab plus daratumumab regimen for eligible patients, including its outpatient administration potential and its straightforward dosing schedule that requires patients to come in for two injections followed by IVIg before returning home.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, 'Bispecific Sequencing, CRS Risk, and CELMoDs: Navigating the Evolving Second-Line RRMM Landscape,' features the panelists advancing their conversation on multiple myeloma and focusing on how CRS risk profiles factor into the choice between BCMA- and GPRC5D-targeting bispecific agents, how antigen preservation informs sequencing decisions after CAR-T, and where the emerging class of CELMoDs may ultimately fit into the second-line treatment algorithm.