SUMMARY

• Summarized below are real-world, observational and retrospective studies and registries which evaluated the step-up dosing (SUD) schedule of TECVAYLI, specific to the timeframe between doses or length of stay (LOS), in adult patients with multiple myeloma (MM).^1-5 
• Additional data in smaller sample sizes have been identified and are included below for your reference.^6-9 

Real-world data

Abrams et al (2025)⁴ presented the outcomes of a retrospective, observational study of patients with relapsed/refractory multiple myeloma (RRMM) who initiated TECVAYLI or talquetamab with SUD in outpatient (OP), inpatient (IP), or hybrid (HY) settings within a large United States (US) community oncology network.

Study Design/Methods

• Patients were identified from the OneOncology network, a large consortium of community oncology practices across the US.
• Eligible patients included adults (≥18 years of age) who received TECVAYLI after October 25, 2022. Data were collected through February 28, 2025.
• Data were extracted from patient charts and electronic medical records (EMRs), including clinical characteristics, treatment history, SUD patterns, adverse events, and healthcare resource utilization (HCRU).
• Treatment followed US prescribing information guidelines, with pre-treatment and prophylactic measures administered at the physician’s discretion.
• Patients were categorized into 3 cohorts based on the SUD administration setting:
  • OP: patients received all SUD doses in an OP setting. Grade 1 cytokine release syndrome (CRS) was managed with acetaminophen or dexamethasone at the physician’s discretion, while grade ≥2 CRS warranted hospitalization.
  • IP: patients received all SUD doses in an IP setting.
  • HY: patients began SUD in an OP setting, followed by a 48-hour IP observation period.

Results

Patient Demographics and Baseline Characteristics

• A total of 120 patients were included in the study, of whom 84 received TECVAYLI (OP cohort, n=13; IP cohort, n=42; HY, n=29).
• The median number of prior lines of therapy (LOTs) for TECVAYLI-treated patients was 4 across all settings.

Step-up Dosing

• All patients in the OP cohort successfully completed SUD.
• The most frequent SUD schedule for TECVAYLI was 1-3-5 in the OP (62%) and HY (38%) cohorts, and 1-4-7 in the IP cohort (48%).

Safety

• CRS and ICANS during SUD was reported in patients who received either TECVAYLI or talquetamab (OP, n=23; IP, n=54; HY, n=43).
  • CRS during SUD was reported in 61% of patients in the OP cohort (n=14), 50% in the IP cohort (n=27), and 63% in the HY cohort (n=27).
    • CRS events were grade 1 or 2 across all cohorts.
    • No recurrent CRS events were reported in the OP cohort; recurrence rates were 7% in the IP cohort and 26% in the HY cohort.
  • ICANS during SUD was reported in 4% of patients in the OP cohort (n=1), 6% in the IP cohort (n=3), and 14% in the HY cohort (n=6).
    • The highest grade of ICANS was 2 in the OP and HY cohorts, and 4 in the IP cohort.
    • No recurrent ICANS events were reported in the OP or IP cohorts; recurrence rate was 5% in the HY cohort.
• No patients discontinued TECVAYLI due to CRS; 1 patient in the HY cohort discontinued TECVAYLI due to ICANS of unknown grade.
• A total of 70% of patients in the OP cohort, who received either TECVAYLI or talquetamab, completed the SUD phase without requiring hospitalization. The median hospital stay was 4 days for 5 patients in the OP cohort who developed grade 2 CRS and were hospitalized.
• Tocilizumab and steroids were administered for the management of CRS and ICANS, respectively.

Tan et al (2025)^1,5 reported a retrospective, observational study that evaluated patient characteristics, LOS during the SUD and the real-world incidence and management of CRS in patients with MM who had initiated TECVAYLI.

Study Design/Methods

• Patients with ≥1 hospital encounter involving TECVAYLI administration were identified using the Premier Healthcare Database (which represents approximately 1 in 5 IP hospital stays in the US), an all-payer US hospital administrative database.
• Eligible patients included adults (≥18 years of age) with MM who had hospital encounters (including IP admissions and OP encounters) and received ≥1 TECVAYLI administration between November 1, 2022, and September 21, 2023, and were not part of a clinical trial.
• The date of the earliest hospital encounter for the first TECVAYLI 30 mg/3 mL vial was defined as an index date.
• Patients were classified as having a complete SUD schedule if they received the 2 step-up doses (0.06 mg/kg and 0.3 mg/kg) followed by the first full treatment dose of 1.5 mg/kg.
• The accuracy and completeness of SUD schedules were assessed using an algorithm that evaluated the TECVAYLI vials administered and time of administration.
  • The algorithm required an initial vial size of 30 mg/3 mL for the initial SUD, followed by a 153 mg/1.7 mL vial as the final dose in the SUD period.
• CRS-related outcomes during the SUD period were analyzed only in patients who completed the SUD period.
  • CRS was identified via International Classification of Diseases, 10^th Revision, Clinical Modification (ICD-10-CM) codes and an algorithm based on related symptoms and treatment codes.

Results

Patient Demographics and Baseline Characteristics

• A total of 413 patients were included in the study.
• Patient demographics, clinical characteristics, and comorbidities were evaluated as of the index date. Baseline characteristics are presented in Table: Baseline Characteristics of Real-World Patients Treated With TECVAYLI.

Step-up Dosing

• TECVAYLI was administered to 96.4% of patients in an urban hospital.
• Out of 302 patients who completed the SUD period by the data cutoff, 276 (91.4%) received the full course of SUD during a single IP admission, 14 (4.6%) in OP settings, and 3 (<1%) were treated across both IP and OP settings. See Table: Real-World SUD Pattern Among Patients Who Completed SUD for additional details.
• Out of 276 patients who completed TECVAYLI SUD during a single IP admission, 243 (88.0%) were administered TECVAYLI on the first day of hospitalization, while 44 (15.9%) received it on or after the second day of hospitalization.

CRS Incidence and Severity

• Of the 302 patients with a completed SUD period as of the data cutoff, 96 (31.8%) were diagnosed with CRS.
• Details pertaining to CRS are presented in Table: CRS Incidence and Severity Among Patients Who Completed TECVAYLI SUD.
• Incidence and management of CRS were assessed from the index date through the end of the SUD period.

Adverse Event Management

• Adverse event management is detailed in Table: Adverse Event Management Among Patients Who Completed TECVAYLI SUD.
• Medication administered during the SUD period was assessed overall and in relation to TECVAYLI SUDs: ≥1 day prior, same day, and ≥1 day post-TECAVYLI SUD administration.

Banerjee et al (2023)² presented a retrospective, observational analysis that evaluated patient profiles and HCRU during the SUD period and the incidence of real-world CRS in patients with MM who had received TECVAYLI.

Study Design/Methods

• The study utilized data from the ARMMRD registry, sourced from STATinMED RWD insights, encompassing all-payer claims data that spanned approximately 87% of the nationally insured population in the US, spanning from January 1, 2014, to July 31, 2023.
• Adult patients (≥18 years of age) with MM who had ≥1 commercial TECVAYLI claim within the ARMMRD registry during the identification period (October 26, 2022, to July 31, 2023) were included in this study.
• The index date was determined as the earliest OP claim for a TECVAYLI 30 mg/3 mL vial or the admission date of the earliest hospitalization claim containing TECVAYLI.
• Patients who had received TECVAYLI on or before the approval date were excluded from the analysis.
• A claim-based algorithm was employed to identify patients with a complete SUD period based on the following criteria:
  • Patients who have had ≥1 IP admission or ≥1 OP claim for a TECVAYLI 30 mg/3 mL vial; the earliest admission date (if IP) or claim date (if OP) was defined as the start date of the SUD period.
  • All IP or OP claims for TECVAYLI with a <5-day gap between claims within a 21-day continuous enrollment period were rolled up as part of the SUD period. If the index claim was an OP claim, an additional OP claim for a TECVAYLI 153 mg/1.7 mL vial was required.
  • The end date of the SUD period was the discharge date, if the last encounter was an IP admission, or claim date +4 days, if the last encounter was an OP claim for a 153 mg/1.7 mL vial.

Results

• In total, 182 patients with a claim for TECVAYLI were included in the study.
• The mean (SD) Quan-Charlson Comorbidity Index (Quan-CCI) score was 4.0 (3.6) for the overall population, and the cohort indexed in March 2023 had the highest Quan-CCI score of 5.6 (3.8).
• Of the 92 patients who met the criteria for evaluable treatment history, 15 (16.3%) had prior exposure to a commercial B-cell maturation antigen (BCMA) therapy.

HCRU During SUD

• Of the 131 patients who had a complete SUD period by the data cutoff, 112 (85.5%) completed TECVAYLI SUD in 1 IP admission.
  • Of the 19 (14.5%) patients with >1 encounter with SUD, 2 (10.5%) were all IP admissions, 5 (26.3%) were all OP administrations, and 12 (63.2%) were in IP IP/OP settings.
• The median (interquartile range) LOS was 8.0 (4.0) days (mean [SD], 8.5 [3.0] days) after omitting extreme outliers (N=115) among 126 (96.2%) patients with ≥1 TECVAYLI-related hospitalization during SUD.
• Over time, the mean (SD) LOS in patients who had ≥1 TECVAYLI-related hospitalization during SUD decreased from 11.4 (9.0) days for patients indexed through February 2023 to 7.0 (1.4) days for those indexed in July 2023 (outliers included). See Table: Mean LOS Among Patients With ≥1 TECVAYLI-Related Admission During SUD (n=126).

Safety - CRS Events

• Of the 131 patients with a complete SUD period, 54 (41.2%) had an ICD-10-CM diagnosis code for CRS and 32 (24.4%) experienced CRS-related symptoms per the Keating algorithm. See Table: Real-World CRS Events Among Patients Who Completed TECVAYLI SUD.

• During the complete SUD period, 7 (5.3%) patients had tocilizumab-related claims, 14 (10.7%) had dexamethasone-related claims, 8 (6.1%) had antihistamine-related claims, and 4 (3.1%) had acetaminophen-related claims.

Banerjee et al (2023)³ presented a real-world, retrospective analysis of Acentrus MM electronic medical records (EMRs) that evaluated the dosing patterns, HCRU, and the early safety outcomes during TECVAYLI SUD among US patients receiving TECVAYLI.

Study Design/Methods

• Adult patients (≥18 years old) with MM who had received ≥1 dose of TECVAYLI between October 26, 2022, and May 31, 2023, were included.
• Patients with diagnosis codes for clinical trials on the index date or those who had indicators of receiving TECVAYLI in a clinical trial setting were excluded.
• Patients were indexed on the day of the first TECVAYLI dose.
• Patient characteristics were captured during the 6-month baseline period before the index date.
• Dosing patterns, healthcare settings (IP or OP), LOS at the hospital, and rate, severity, and treatment for CRS and ICANS were described among patients with complete SUD data.
• Patients were considered to have complete SUD data if they had received the 2 SUDs (30 mg/3 mL vial size) and the first treatment dose (153 mg/1.7 mL vial size), with strength confirmed in the database, and had at least 7 days of data or the next dose observed after the first treatment dose (to allow sufficient time for capturing treatment outcomes of the first dose) by the data cutoff.

Results

• A total of 104 patients (median age, 65 years [range, 43-89]; male, 58%) were included in the study.
• Prevalent baseline comorbidities included anemia (67%), hypertension (57%), renal impairment/failure (54%), lytic bone lesions (35%), hypogammaglobulinemia (25%), and extramedullary plasmacytomas (12%).
• Twenty-five percent of patients were previously treated with BCMA-targeted therapies.

SUD Patterns

• In the cohort of 104 patients, data pertaining to SUD were available for 76 patients. Within this subset, 65 patients (86%) completed the SUD in an all-IP setting. Additionally, 64/65 (98%) patients received all 3 doses in a single admission. Alternatively, 10 patients (13%) received all 3 doses in an OP setting. One patient received SUD in IP as well as OP settings.
• A total of 42% of patients had an exact 2-day dosing interval (eg, days 1-3-5), and 16% of patients had an exact 3-day dosing interval (eg, days 1-4-7); 75% of patients received the third dose within 7 days of TECVAYLI initiation.
• Among the 36 patients with detailed IP data, the median LOS for IP SUD was 8.0 days, excluding 1 extreme outlier. Median LOS generally trended downward over time, from 11 days in December 2022 to 6.5 days in May 2023. See Table: Hospital LOS for TECVAYLI SUD by Index Month.

Safety

• Data pertaining to CRS and ICANS in patients with complete SUD (n=76) have been summarized in Table: CRS and ICANS Outcomes in Patients With Complete SUD.
• A total of 99% of patients received acetaminophen, 96% received diphenhydramine, and 71% received corticosteroids on the days of TECVAYLI administration.
  • No patients received prophylactic treatments within 2 days prior to the administration of the first TECVAYLI dose.
• A total of 3% of patients received tocilizumab on the same day as their first dose (unclear whether tocilizumab was given for prophylaxis or treatment), and 12% received tocilizumab after TECVAYLI dosing.

Literature Search

A literature search of MEDLINE^®, Embase^®, BIOSIS Previews^®, and Derwent Drug File databases (and/or other resources, including internal/external databases) was conducted on 15 October 2025.