{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:30:39Z","timestamp":1792683039053,"version":"4.5.0"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,3,15]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Patients with relapsed\/refractory multiple myeloma are at increased risk of infection. Infections during treatment with teclistamab, the first B\u2010cell maturation antigen\u2010directed bispecific antibody approved for triple\u2010class\u2013exposed relapsed\/refractory multiple myeloma, was examined in the phase 1\/2 MajesTEC\u20101 study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Patients (\n N<\/jats:italic>\n \u00a0=\u00a0165) received subcutaneous teclistamab 1.5\u00a0mg\/kg weekly after a step\u2010up dosing schedule (0.06\u00a0mg\/kg and 0.3\u00a0mg\/kg, each separated by 2\u20134\u00a0days). Patients were monitored frequently for infections; prophylaxis and management were per institutional guidelines.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At a median follow\u2010up of 22.8\u00a0months (range, 0.3\u201333.6), infections were reported in 132 patients (80.0%). Grade 3\/4 infections occurred in 91 patients (55.2%), including COVID\u201019 (21.2%), respiratory infections (19.4%),\n Pneumocystis jirovecii<\/jats:italic>\n pneumonia (4.2%), viral infections (4.2%), and gastrointestinal infections (1.2%). Twenty\u2010one patients died from infections (18 from COVID\u201019). Median time to first onset of any\u2010grade and grade 3 to 5 infections was 1.7 and 4.2\u00a0months, respectively. Overall, 70.9% of patients had \u22651 postbaseline immunoglobulin G (IgG) level <400\u00a0mg\/dL; median time to IgG <400\u00a0mg\/dL was 1.2\u00a0months (range, 0.2\u201319.8) and 46.1% received \u22651 dose of IgG replacement. Grade 3\/4 neutropenia occurred in 65.5% of patients (median time to grade \u22653 neutropenia\/febrile neutropenia was 2.3\u00a0months [range, 0\u201318.1]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Based on the infection profile of B\u2010cell maturation antigen\u2013targeted bispecific antibodies such as teclistamab, it is recommended that clinicians and patients remain vigilant for a range of infection types throughout treatment to facilitate prompt intervention. Appropriate screening, prophylaxis, and management of infections, hypogammaglobulinemia, and neutropenia are important.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration<\/jats:title>\n \n NCT03145181\/NCT04557098 (\n ClinicalTrials.gov<\/jats:ext-link>\n )\n <\/jats:p>\n <\/jats:sec>\n \n Plain Language Summary<\/jats:title>\n \n \n \n Before starting teclistamab, patients should be up to date with vaccinations (including COVID\u201019) and screened for hepatitis B and C and HIV. Teclistamab should not be given to patients with any active infections.<\/jats:p>\n <\/jats:list-item>\n \n \n Prophylactic antimicrobials should be administered per institutional guidelines. Prophylaxis for\n Pneumocystis jirovecii<\/jats:italic>\n pneumonia and herpes simplex\/varicella zoster virus is recommended during teclistamab treatment.\n <\/jats:p>\n <\/jats:list-item>\n \n Close monitoring of infections and immunoglobulin G (IgG) levels should continue throughout teclistamab treatment. IgG replacement (administered every 3\u20136\u00a0weeks) should be used to maintain IgG \u2265400\u00a0mg\/dL. Growth factors should be considered for grade \u22653 neutropenia with infection\/fever and grade 4 neutropenia.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cncr.35107","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T03:35:27Z","timestamp":1699932927000},"page":"886-900","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":98,"title":["Incidence, timing, and management of infections in patients receiving teclistamab for the treatment of relapsed\/refractory multiple myeloma in the MajesTEC\u20101 study"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4165-6869","authenticated-orcid":false,"given":"Ajay K.","family":"Nooka","sequence":"first","affiliation":[{"name":"Winship Cancer Institute Emory University Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Victoria","family":"Mateos","sequence":"additional","affiliation":[{"name":"University Hospital of Salamanca\/IBSAL\/CIC\/CIBERONC Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salomon","family":"Manier","sequence":"additional","affiliation":[{"name":"Lille University Hospital Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Chastain","sequence":"additional","affiliation":[{"name":"Janssen Research & Development LLC Raritan New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnob","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Janssen Research & Development LLC Spring House Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Kobos","sequence":"additional","affiliation":[{"name":"Janssen Research & Development LLC Raritan New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keqin","family":"Qi","sequence":"additional","affiliation":[{"name":"Janssen Research & Development LLC Titusville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca","family":"Verona","sequence":"additional","affiliation":[{"name":"Janssen Research & Development LLC Spring House Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Doyle","sequence":"additional","affiliation":[{"name":"Janssen Global Services Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1752-5092","authenticated-orcid":false,"given":"Thomas G.","family":"Martin","sequence":"additional","affiliation":[{"name":"University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels W. 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