MAJESTEC-3 Evaluates Teclistamab Plus Daratumumab in Relapsed/Refractory Multiple Myeloma

Dr. Harsh Parmar presents results from the phase 3 MAJESTEC-3 trial evaluating the combination of teclistamab and daratumumab versus standard daratumumab-based regimens in patients with relapsed/refractory multiple myeloma (R/R MM) who had received one to three prior lines of therapy. He reviews the study design, eligibility criteria, and key efficacy outcomes, demonstrating substantial improvements in progression-free survival, overall response rate, depth of response, minimal residual disease negativity, and overall survival with the teclistamab-based regimen. Dr. Parmar also discusses the safety profile, highlighting rates of neutropenia, infections, cytokine release syndrome, and neurotoxicity, while emphasizing that cytokine release syndrome events were generally low grade and manageable with appropriate supportive care. The presentation concludes with practical considerations for infection prophylaxis, including intravenous immunoglobulin and antimicrobial prophylaxis, as well as the benefits of response-adapted dosing strategies to improve tolerability while maintaining the clinical efficacy of teclistamab-based therapy in relapsed/refractory multiple myeloma.