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Tecvayli (teclistamab-cqyv) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with multiple myeloma.
These insights are based on 183 comments about Tecvayli from MyMyelomaTeam members. These are the experiences of a small number of people and are not meant to be medical advice.
Tecvayli is a type of medicine called a bispecific antibody, also known as a bispecific T-cell engager (BiTE) therapy. It connects to T cells, which are part of the immune system, and to B-cell maturation antigen (BCMA), a protein found on myeloma cells. This helps bring T cells close to the myeloma cells, which helps the immune system destroy them.
In multiple myeloma, this helps reduce abnormal myeloma cell activity.
Doctors prescribe Tecvayli for adults with multiple myeloma that has come back or has not responded to other treatments. It is used alone (monotherapy) after at least four prior lines of therapy, and it is used in combination with other medication (daratumumab and hyaluronidase-fihj) after at least one prior line of therapy.
Tecvayli is given as a shot under the skin. Treatment starts with a step-up dosing schedule, followed by once weekly doses. For some adults who have a complete response for at least six months, the dosing schedule may be changed to once every two weeks.
Typical Dosing for Multiple Myeloma
The recommended starting dose of Tecvayli for multiple myeloma is step-up dose 1 of 0.06 milligrams per kilogram, step-up dose 2 of 0.3 milligrams per kilogram, and then 1.5 milligrams per kilogram injected under the skin. The dose is based on body weight, which is a standard way healthcare providers calculate treatment amounts.
For people receiving Tecvayli alone who respond to treatment, the recommended maintenance dose is 1.5 milligrams per kilogram once weekly. For people who achieve and maintain a complete response or better for at least six months, doctors may reduce dosing by extending the time between doses to 1.5 milligrams per kilogram every two weeks.
Doctors may withhold treatment or permanently stop it for certain side effects, and people should not stop treatment without medical guidance.
This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 183 comments about Tecvayli from MyMyelomaTeam members.Members who use Tecvayli often say it helps to prepare for the first doses, keep an eye on side effects, and stay in close contact with the care team about labs and scheduling. Many also describe asking their doctor about longer gaps between injections after they are doing well on treatment.
Expect extra monitoring during the first doses.
“I started treatment with Tecvayli a month ago, with a visit to the hospital for five days for the three initial doses and as precaution against possible serious side effects.”
Keep track of side effects and tell your doctor.
“I soon started having headaches and upper respiratory symptoms, which are side effects of the drug.”
Get blood work and follow your counts closely.
“Monday will be comprehensive blood tests. Physically, I feel like it works, but we will see with the tests.”
Talk to your doctor about changing injection timing.
“I started once a week, then once every two weeks, now I’m every three weeks, and the doctors feel they can stretch it to four weeks.”
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In a clinical study in adults with multiple myeloma who received Tecvayli alone (monotherapy), the most common side effects were reported in about 20 percent to 76 percent of people. They include:
In a clinical study in adults with multiple myeloma who received Tecvayli in combination with other medication (daratumumab and hyaluronidase-fihj), the most common side effects were reported in about 20 percent to 84 percent of people. They include:
Tecvayli can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious side effect from Tecvayli.
Johnson & Johnson, the manufacturer of Tecvayli, offers the J&J withMe Savings Program. Eligible people with commercial insurance may pay as little as $5 per dose.
To learn more, visit the Tecvayli savings and support page, or call 833-565-9631.
Before starting Tecvayli, your doctor will check your pregnancy status if you are able to become pregnant. Your healthcare provider will also check your liver enzymes and white blood cell counts before you start treatment with Tecvayli.
Tell your doctor if you have any allergies to teclistamab-cqyv or any ingredients in Tecvayli.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements.
Also let your doctor know if you have had recent infections or nervous system problems in the past.
Do not drive or operate heavy or dangerous machinery during and for 48 hours after your Tecvayli step-up dosing schedule is completed, or at any time during treatment with Tecvayli if you develop new neurologic symptoms such as dizziness, confusion, tremors, sleepiness, or any other symptoms that impair your consciousness, until the symptoms go away.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Tecvayli, talk with your doctor about the risks and benefits. Tecvayli may harm your baby if you are pregnant. If you are able to become pregnant, use effective birth control during treatment and for five months after your last dose.
Do not breastfeed during treatment and for five months after your last dose.
These answers are fact-checked by our editorial staff.
How effective is Tecvayli?
In a study of adults with multiple myeloma that has come back or has not responded to treatment, about 62 percent responded to treatment with Tecvayli alone (monotherapy), and about 28 percent of them had a complete response or better. The median time to first response was 1.2 months, meaning half of the participants began seeing results within approximately 1.2 months of starting treatment.
In a separate study of Tecvayli used with daratumumab and hyaluronidase-fihj, 89 percent of people responded compared with about 75 percent with the control group. Out of those who responded to the Tecvayli combination, about 82 percent had a complete response or better, and about 58 percent had no minimal residual disease detected.
How long does Tecvayli take to work for multiple myeloma?
Of the people in the study who responded to Tecvayli (68/110), half began seeing results within approximately 1.2 months of starting treatment. The time until people started to see results ranged from 0.2 months to 5.5 months.
Should I take Tecvayli for multiple myeloma if I have an infection?
Tecvayli can cause serious infections that may be life-threatening or lead to death. Your doctor will check for signs of infection before and during treatment. If a person has an active infection during the step-up dosing period, Tecvayli should be stopped until the infection improves.
If a severe infection happens later, treatment may need to be paused or stopped based on how serious it is.
What tests or monitoring are needed with Tecvayli for multiple myeloma?
Doctors monitor for cytokine release syndrome and neurologic side effects during treatment, especially early in the step-up dosing period. Blood tests are used to check blood cell counts, liver enzymes, bilirubin, and immunoglobulin levels before and during treatment. People stay in the hospital for 48 hours after the first and second step-up doses.
After the first full treatment dose, they should stay close to a healthcare facility and be checked daily for 48 hours.
On MyMyelomaTeam, people share their experiences with multiple myeloma, get advice, and find support from others who understand.
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