Teclistamab Significantly Lengthens Remissions and Survival in Relapsed Myeloma Trial

The MajesTEC-9 data point to a shift toward earlier use of bispecific immunotherapy by showing deeper, longer remissions that come with an infection risk that can be managed with prophylaxis and monitoring.

Overview

The phase III MajesTEC-9 trial, reported May 29 in the New England Journal of Medicine and presented at ASCO, found about 70% of patients on teclistamab had no disease progression at 18 months versus roughly 27% on standard therapy.
Nearly two-thirds of patients given teclistamab achieved complete remission, and many reached minimal residual disease (MRD) negativity, meaning highly sensitive tests could not detect remaining cancer cells.
Teclistamab is a BCMA–CD3 bispecific antibody that brings a patient’s T cells into direct contact with myeloma cells to trigger targeted killing, a mechanism that explains both its strong anti‑tumor effect and its immune-related risks.
The trial enrolled 593 patients across 24 countries who had relapsed after one to three prior treatments, including many who were refractory to drugs like lenalidomide and daratumumab; the study was sponsored by Johnson & Johnson.
Investigators said the benefits support testing bispecifics earlier in care and wider use if regulators and longer follow‑up confirm safety, while clinicians will need to prevent and monitor infections with antiviral/antibiotic prophylaxis and immunoglobulin checks.