Prophylactic tocilizumab to prevent cytokine release syndrome (CRS) with teclistamab: A single-center experience
Open accessAbstract
Teclistamab (Tecvayli®) is a first-in-class T-cell redirecting bispecific antibody that targets CD3 on the surface of T-cells and B-cell maturation antigen (BCMA) on plasma cells [ 1 ]. Teclistamab was approved by the FDA for patients with relapsed/refractory multiple myeloma (RRMM) after 4 lines of therapy including an immunomodulatory drug (IMID), proteasome inhibitor (PI), and anti-CD38 monoclonal antibody (mAb) based on the results of the phase 1/2 MajesTEC-1 study. Among the 165 patients treated with teclistamab, the overall response rate (ORR) was 63% with 58.8% of patients achieving a very good partial response (VGPR) or better. The median duration of response (DOR) was 18.4 months, median progression free survival (PFS) was 11.3 months, and median overall survival (OS) was 18.3 months [ 2 ].
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Prophylactic tocilizumab is now recommended in guidelines and reduces the incidence and severity of cytokine release syndrome.
“Of note, prophylactic tocilizumab, not permitted in this study, is now recommended in guidelines and reduces the incidence and severity of cytokine release syndrome.34,35”
From Teclistamab plus Daratumumab in Relapsed or Refractory Multiple Myeloma (2026) · cites this paper as [34]
The paper’s discussion (page unavailable) says prophylactic tocilizumab reduced the incidence and severity of CRS in heavily pretreated patients receiving teclistamab. It does not say that guidelines recommend prophylactic tocilizumab; its reference to institutional guidelines concerns management of CRS and ICANS, not a recommendation for prophylaxis. (LLM, conf=0.88)
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Cites
Teclistamab in Relapsed or Refractory Multiple Myeloma
Moreau, P., Garfall, A. L., van de Donk, N. W. C. J., Nahi, H., San-Miguel, J. F., Oriol, A., Nooka, A. K., Martin, T., Rosinol, L., Chari, A., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2203478 · Cited by 1,269 · cited 3× · see citing works
“The median duration of response (DOR) was 18.4 months, median progression free survival (PFS) was 11.3 months, and median overall survival (OS) was 18.3 months [2].”
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Research works printed but not linked: 2
- [3]Lee DW Santomasso BD Locke FL Ghobadi A Turtle CJ Brudno JN ASTCT consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells Biology of Blood and Marrow Transplantation 2019 25 625 38 10.1016/j.bbmt.2018.12.758 30592986 PMC12180426 · DOI · Paper page
- [4]Firestone RS, McAvoy D, Shekarkhand T, Serran E, Hamadeh I, Wang A, et al. CD8 effector T cells enhance response in BCMA-exposed and -naïve multiple myeloma. Blood Advances. 2023; 10.1182/bloodadvances.2023011225. 37878808 · DOI
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Teclistamab plus Daratumumab in Relapsed or Refractory Multiple Myeloma
Costa, L. J., Bahlis, N. J., Perrot, A., Nooka, A. K., Lu, J., Pawlyn, C., Mina, R., Caeiro, G., Kentos, A., Hungria, V., et al. (2026) · New England Journal of Medicine · doi:10.1056/nejmoa2514663 · Cited by 94 · see citing works
“34,35 Nearly all patients experienced a grade 3 or higher adverse event (7.1% deaths due to treatment-emergent adverse events), most of which were cytopenias and infections.”
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- Authors
- Scott, S. A., Marin, E. M., Maples, K. T., Joseph, N. S., Hofmeister, C. C., Gupta, V. A., Dhodapkar, M. V., Kaufman, J. L., Lonial, S., & Nooka, A. K.
- Affiliations
- Emory University (US)
- Corresponding author
- Scott, Sara A.
- ORCID
- Venue
- Blood Cancer Journal
- Published
- 2023-12-20
- Volume
- 13
- Issue
- 1
- Pages
- 191-191
- ISSN
- 2044-5385 (ISSN-L)
- PMC
- PMC10730907
- OpenAlex
- W4389975461
- Cited by
- 63
- References
- 1
- Citations by year
- 2026: 18 · 2025: 30 · 2024: 15
- FWCI
- 13.01
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Blood Cancer Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Monoclonal and Polyclonal Antibodies Research
- Health Sciences › Medicine › Oncology › CAR-T cell therapy research
- Keywords
- teclistamab, tocilizumab, cytokine release syndrome, prophylaxis, relapsed/refractory multiple myeloma, bispecific antibodies, T cell redirection, plasma cells, cytokine storm
- MeSH terms
- Cytokine Release Syndrome, Humans, Cytokines, Antibodies, Monoclonal, Humanized
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