Current experiences with teclistamab in patients with multiple myeloma and renal impairment.

Introduction: Renal impairment (RI), defined as a creatinine clearance of < 40 mL/min, affects up to half of patients with multiple myeloma (MM). Patients with MM and RI historically had poorer outcomes, likely due to the limited access to novel treatments available through clinical trials. Strict eligibility criteria for MM clinical trials often exclude patients with RI, necessitating reliance on patient data acquired from real-world (RW) clinical practice to guide therapeutic decisions. Therefore, there is a need for RW data and expert recommendations to guide treatment strategies for patients with MM and RI.

Areas covered: Teclistamab treatment and pharmacokinetics in patients with mild-to-moderate RI, including the first report of a RI patient subgroup from the MajesTEC-1 study, as well as published RW experiences of teclistamab, primarily in patients with moderate-to-severe RI.

Expert opinion: Current guidelines, available data, and our clinical experience broadly support the feasibility and potential benefit of teclistamab for patients with MM and RI, including those on dialysis, providing appropriate precautions are taken. This expert opinion offers recommendations for optimizing the management of patients with MM and RI treated with teclistamab. Additional RW data will further inform the safety and efficacy profile of teclistamab in this patient population.