Teclistamab Improves Outcomes in Relapsed Multiple Myeloma

By: Jennifer Welsh | May 29, 2026 | 8 min. read |

Summary

On teclistamab, nearly two-thirds of multiple myeloma patients achieved complete remission, and many had no detectable myeloma cells on highly sensitive tests.
The practice-changing study supports earlier use of immune-based therapies such as teclistamab for multiple myeloma.
Researchers say the future of myeloma treatment is moving toward chemotherapy-free, precision-based immunotherapy approaches.

For decades, physicians treating multiple myeloma expected each relapse to be more difficult to control than the last. A new generation of immunotherapies is now beginning to change that outlook and may redefine the future of treatment for patients worldwide.

Patients who once survived only a few years after diagnosis are now increasingly living for decades. That longer survival has often required patients to cycle through many lines of therapy, including chemotherapy, stem cell transplantation and multiple immune-based treatments as the disease returned again and again.

Now, a major international study shows that patients with relapsed multiple myeloma treated with teclistamab lived longer and remained in remission significantly longer than patients receiving standard therapies. The findings were published in The New England Journal of Medicine and presented at the American Society of Clinical Oncology (ASCO) Annual Meeting.

The study was led by an international team of investigators, with C. Ola Landgren, M.D., Ph.D., serving as senior author and working closely with the lead author and collaborators around the world to conduct the trial and advance next-generation immune therapies for myeloma.

Sylvester Comprehensive Cancer Center physician-scientist C. Ola Landgren in his white coat. — Dr. C. Ola Landgren

“Now we have chemotherapy-free immunotherapy options for patients whose myeloma has relapsed for the first time,” said Dr. Landgren, chief of the Sylvester Myeloma Institute at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine. “We are seeing very deep responses and long clinical benefit from these therapies. This is part of a much bigger transformation happening in myeloma care.”

A New Era of Myeloma Care

When Dr. Landgren, co-Leader of the Translational and Clinical Oncology Program, the Paul J. DiMare Endowed Chair in Immunotherapy and a professor in the Myeloma Division at the Miller School, began his medical training more than 30 years ago, treatment for multiple myeloma relied almost entirely on chemotherapy. Today, the field has shifted toward immune-based therapies designed to help the body’s immune system identify and attack cancer cells more precisely and effectively.

Researchers are also moving these therapies earlier in the disease course instead of reserving them for later stages after multiple treatments have failed. Teclistamab is part of a newer class of drugs known as bispecific antibodies. The therapy works by linking T cells, a type of immune cell, to BCMA, a protein found on myeloma cells, allowing the immune system to recognize and attack the cancer directly.

Landscape infographic in University of Miami orange and green illustrating a treatment pathway for relapsed or refractory multiple myeloma, showing that about 70% of patients receiving teclistamab remained progression-free at 18 months compared with about 27% receiving standard therapy, with additional visual elements highlighting longer symptom control, slower disease worsening, and high remission rates.

The phase 3 clinical trial, called MajesTEC-9, enrolled 593 patients across 24 countries. All participants had multiple myeloma that had returned after one to three prior treatments. About three-quarters had already taken and stopped responding to standard therapies, including immune-modulating drugs such as daratumumab and lenalidomide, leaving them with limited treatment options in routine practice.

Even among patients who had failed other therapies, teclistamab improved outcomes. Patients lived longer, stayed in remission longer and, in some cases, saw their cancer reduced to extremely low or undetectable levels known as minimal residual disease negativity.

Nearly 70% of patients treated with teclistamab had not experienced disease progression after 18 months, compared with about 27% of patients receiving standard therapies. Patients treated with teclistamab also reported longer symptom control and slower worsening over time.

For many patients, teclistamab did more than slow disease progression. Nearly two-thirds achieved complete remission, meaning physicians could no longer detect signs of myeloma using standard tests. In many cases, even highly sensitive minimal residual disease tests could not find remaining cancer cells.

“To see that this drug is so efficacious and so safe across patients from all these locations worldwide is a very strong signal,” Dr. Landgren said. “To see that in patients who have been exposed and refractory to commonly used myeloma treatments is very important.”

Supportive Care Plays a Critical Role

Teclistamab activates immune cells, which can also affect normal immune defenses. As a result, patients receiving the therapy face a higher risk of infection, particularly during the first six months of treatment. Physicians manage that risk through close monitoring and preventive care.

We are working toward treatments that can either eliminate the disease entirely or control it for very long periods while minimizing the burden on patients and preserving quality of life.
Dr. C. Ola Landgren

“Most things in life that bring something good also have some potential downside,” Dr. Landgren said. “If you get the right supportive care, the medicine is going to be very safe and very efficacious.”

Patients receiving teclistamab often take antiviral and antibiotic medications to help prevent infections. Care teams regularly monitor antibody levels, and patients may receive immunoglobulin infusions if levels drop too low.

Earlier Treatment May Improve Outcomes

Researchers are now studying whether bispecific antibodies such as teclistamab could benefit patients even earlier in the disease course.

“For me, the goal is to develop curative strategies,” Dr. Landgren said. “We are working toward treatments that can either eliminate the disease entirely or control it for very long periods while minimizing the burden on patients and preserving quality of life.”

Clinical trials at the Sylvester Myeloma Institute are evaluating these therapies in patients with newly diagnosed multiple myeloma and in those with high-risk smoldering myeloma, a precancerous condition that can progress to active disease. Researchers are also studying whether these treatments could eventually serve as alternatives to stem cell transplantation.

Florida has the largest population of people living with multiple myeloma of any state in the United States. Miami, the state’s largest international city, is emerging as a global center for myeloma treatment, research and drug development. Fueled by innovation and international collaboration, the Sylvester Myeloma Institute is helping shape the next generation of precision medicine and immune-based cancer therapies.

“We don’t want anyone to have multiple myeloma. If someone is diagnosed with multiple myeloma, we are always here to help, and we will always offer access to the latest and most effective therapies,” Dr. Landgren said. “At Sylvester Myeloma Institute, we focus on excellence of care, innovation, collaboration and building the future of myeloma treatments.”