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Restarting TECVAYLI After Dosage Delay

Last Updated: 12/10/2024

Abbreviations: CRS, cytokine release syndrome; ICANS, immune effector cell-associated neurotoxicity.

aTECVAYLI (teclistamab-cqyv) [Prescribing Information].1 bAdminister pretreatment medications prior to TECVAYLI dose and monitor patients
accordingly. cConsider the benefit-risk of restarting TECVAYLI in patients who require a dose delay of more than 28 days due to an adverse
reaction.

Summary

Other relevant data have been identified in addition to the data summarized above:

  • van de Donk (2024)2 applied population pharmacokinetic modeling to a retrospective clinical analysis of MajesTEC-1 (at a data cut-off of August 22, 2023) to evaluate repeat step-up doses (SUD) and cytokine release syndrome (CRS) events in the setting of prolonged dosing intervals (>28-62 days, ≥63–111 days, and ≥112 days).    

PRODUCT LABELING

Restarting TECVAYLI after Dosage Delay


Recommendations for Restarting Therapy With TECVAYLI After Dose Delay1
Last Dose Administered
Time Since the Last Dose Administered
Action
Step-up dose 1
More than 7 days
Restart TECVAYLI step-up dosing schedule at step-up dose 1 (0.06 mg/kg).a
Step-up dose 2
8 days to 28 days
Repeat step-up dose 2 (0.3 mg/kg)a and continue TECVAYLI step-up dosing schedule.
More than 28 daysb
Restart TECVAYLI step-up dosing schedule at step-up dose 1 (0.06 mg/kg).a
Any weekly treatment dose
28 days or less
Continue TECVAYLI at last treatment dose in weekly schedule (1.5 mg/kg once weekly).
29 days to 56 daysb
Restart TECVAYLI step-up dosing schedule at step-up dose 2 (0.3 mg/kg).a
More than 56 daysb
Restart TECVAYLI step-up dosing schedule at step-up dose 1 (0.06 mg/kg).a
Any biweekly (every 2 weeks) treatment dose
63 days or lessb
Continue TECVAYLI at last treatment dose in biweekly schedule (1.5 mg/kg every 2 weeks).
64 days to 112 daysb
Restart TECVAYLI step-up dosing schedule at step-up dose 2 (0.3 mg/kg).a
More than 112 daysb
Restart TECVAYLI step-up dosing schedule at step-up dose 1 (0.06 mg/kg).a
aAdminister pretreatment medications prior to TECVAYLI dose and monitor patients accordingly.
bConsider the benefit-risk of restarting TECVAYLI in patients who require a dose delay of more than 28 days due to an adverse reaction.

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 09 December 2024.

 

References

1 TECVAYLI (teclistamab-cqyv) [Prescribing Information]. Horsham, PA: Janssen Biotech, Inc;https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/TECVAYLI-pi.pdf
2 van de Donk NWCJ, Chari A, Karlin L, et al. Analysis of repeat step-up dosing and cytokine release syndrome events following prolonged dosing intervals of teclistamab in the phase 1/2 MajesTEC-1 study. Poster presented at: 66th American Society of Hematology (ASH) Annual Meeting and Exposition; December 7-10, 2024; San Diego, CA.