Overview of Teclistamab:
Teclistamab is a human bispecific monoclonal antibody to the B cell maturation antigen (BCMA) and the CD3 cell surface antigen, which is supplied under the brand name Tecvayli. It is used in the treatment of refractory or relapsing multiple myeloma (MM). This medicine binds to B cell maturation antigen which is prominently expressed on the surface of B and myeloma cells. Teclistamab also binds to CD3 which is expressed on enabled T cells and thus brings them into contact with the bound B cell maturation antigen expressing myeloma cells. This two-fold engagement of myeloma cells causes their rapid destruction. As an outcome of its shown efficacy in a proportion of treated patients with refractory multiple myeloma in early phase trials, teclistamab was given accelerated approval for use in advanced refractory or relapsed multiple myeloma after at least four prior lines of therapy in the United States in 2022.
Dosage and Administration:
Teclistamab is supplied in liquid solution in vials containing 30 mg in 3 mL (10 mg/mL) and 153 mg in 1.7 mL (90 mg/mL). The recommended regimen includes a step-up phase over one week to a maintenance dose of 1.5 mg/kg subcutaneously (SC) which is then continued once weekly until disease progression or intolerance. Pretreatment with corticosteroids, antihistamines, and antipyretics is required, particularly with initial doses.
Potential Side Effects:
Side effects with Teclistamab are frequent and often severe including cytokine release syndrome in 72% of treated patients. Severe infections, hypersensitivity reactions, neutropenia, and immune-related injury including neurotoxicity, renal toxicity, and hepatotoxicity have also been mentioned and the overall fatality rate is 5%. Other common side effects include injection site reactions, musculoskeletal pain, nausea, fever, diarrhea, and fatigue. Early recognition and prompt management of the side effects of teclistamab is an integral component of its proper use.
Warning and Precautions:
- Teclistamab can cause serious or life-threatening neurologic toxicity, including Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS). Monitor patients for symptoms of neurologic toxicity during treatment. At the initial sign of neurologic toxicity, including ICANS, promptly assess patients and provide supportive therapy depending on severity.
- Treatment with Teclistamab can cause hepatotoxicity, including fatalities. Monitor liver enzymes and bilirubin at baseline and throughout treatment as clinically required. Withhold treatment or consider permanent discontinuation of treatment depending on severity.
- The medicine can cause critical, life-threatening, or fatal infections. Monitor patients for signs and symptoms of infection before and during treatment and treat them appropriately. Monitor immunoglobulin levels during treatment and treat them according to guidelines, including infection precautions and antibiotic or antiviral prophylaxis.
- Teclistamab can cause neutropenia and febrile neutropenia. Monitor complete blood cell counts periodically during therapy and provide supportive care per local institutional guidelines. Monitor neutropenia patients for signs and symptoms of infection. Withhold treatment based on severity.
- Based on its mechanism of action, Teclistamab may cause fetal harm when used by a pregnant woman. Females of reproductive potential should use effective contraception during treatment with Teclistamab and for 5 months after the final dose.
How and Where to Buy Teclistamab:
Teclistamab is a prescription drug that can be ordered from the Indian Pharma Network (IPN) if the drug has not been approved or is not available in your country. Inquire and we will help you calculate the total price to buy online and have them delivered to your location. From your end, we’ll generally need a prescription from your treating doctor. In some countries, we might also need an import license. Our Patient Support team will help you throughout the process.
References:
https://www.tecvaylihcp.com/
https://www.ncbi.nlm.nih.gov/books/NBK589227/
