Defining the Role of Bispecifics in Relapsed Waldenström Macroglobulinemia

In an interview with CancerNetwork®, at the 2026 Society of Hematologic Oncology (SOHO) Annual Meeting, Meletios A. Dimopoulos, MD, discussed the emerging role of bispecific antibodies in relapsed Waldenström macroglobulinemia. Treatment for Waldenström macroglobulinemia has historically centered on Bruton’s tyrosine kinase (BTK) inhibitors and chemoimmunotherapy. More recently, investigators have begun exploring T-cell–engaging bispecific antibodies in this setting. One example is teclistamab-cqyv (Tecvayli), a BCMA x CD3 bispecific antibody developed in multiple myeloma.

A report describing teclistamab use in patients with relapsed/refractory Waldenström macroglobulinemia was published early online in Haematologica in July 2026.¹ Separately, a single-arm phase 2 trial (NCT07791498) is evaluating subcutaneous teclistamab, given for up to 9 cycles, in an estimated 24 patients with relapsed or refractory disease.² According to Dimopoulos, the approach is of interest mainly for a minority of patients with aggressive disease at presentation or relapse, considering most patients’ disease can be controlled for many years with existing therapies.

Dimopoulos is professor and chairman of the Department of Clinical Therapeutics at the National and Kapodistrian University of Athens School of Medicine in Greece.

Transcript:

CancerNetwork: Bispecific antibodies like teclistamab are now being explored in relapsed Waldenström macroglobulinemia, an area historically dominated by BTK inhibition and chemoimmunotherapy. How significant a shift is that for a disease that has not seen this kind of option before?

Dimopoulos: First of all, we have to clarify that Waldenström macroglobulinemia is a relatively indolent disorder with a much better prognosis than that of myeloma. In most patients, the disease can be controlled for many years with BTK inhibitors, chemoimmunotherapy, or other agents. There are occasional patients with quite aggressive disease at presentation or at the time of relapse who represent an unmet need. For these particular patients, there are some exploratory evaluations of the role of bispecific monoclonal antibodies that have been developed from those used in other low-grade lymphomas. I believe that, yes, it is of interest, but of course, it is not a treatment that the majority of patients with Waldenström macroglobulinemia may require during the course of their disease.

References

1. Kascak M, Muronova L, Venglar O, et al. Teclistamab in relapsed/refractory Waldenström macroglobulinemia. Haematologica. Published online July 16, 2026. doi:10.3324/haematol.2026.301159
2. Teclistamab in Waldenstrom’s macroglobulinemia. ClinicalTrials.gov. Updated September 1, 2026. Accessed September 23, 2026. https://tinyurl.com/bde4khc4