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Patients with relapsed multiple myeloma experienced an 89% lower risk of disease progression or death when treated with a combination of two bispecific antibodies, according to phase 3 MonumenTAL-6 trial results.

The study compared Tecvayli (teclistamab-cqyv) and Talvey (talquetamab-tgvs) against standard three-drug regimens. A second pairing—Talvey plus pomalidomide—cut progression risk by 73%. Both combinations target proteins on myeloma cells, though the dual-antibody approach delivered stronger results.

Dr. Ajay Nooka, director of the Myeloma Program at Emory Winship Cancer Institute and a lead investigator, described the 89% reduction as “the best hazard ratio we have ever seen in the history of multiple myeloma.”

“If someone is looking for a cure, this could be the first step,” he said. The drugs attack myeloma cells from two directions, reducing resistant cells. “Whatever residual cells remain that resist one target are handled by the other.”

Side effects, such as cytokine release syndrome and neurologic issues, did not worsen with the combination. The safety profile stayed manageable, with initial doses given in hospitals before moving to outpatient care. Some patients may later extend treatment intervals to once a month.

Life beyond chemotherapy

Unlike chemotherapy, these bispecific antibodies let patients keep up daily routines. “I have patients working full time while using these treatments,” Nooka said. The trial focused on relapsed cases, but researchers expect the combination to be tested in earlier treatment lines, including newly diagnosed patients.

Multiple myeloma, a cancer of plasma cells, has seen gradual survival improvements over the past decade. Standard treatments often rely on three-drug regimens, but most patients develop resistance. The MonumenTAL-6 results point to a move toward targeted, less toxic therapies that could change outcomes.

Dual-targeting has been tried in other cancers like lymphoma and leukemia, with uneven results. The success here depends on the proteins targeted—BCMA and GPRC5D—which are common in myeloma cells but rare in healthy tissue. That selectivity may explain why the combination works so well without a rise in side effects.

The trial findings were presented before peer review, leaving questions about long-term durability. However, the benefit’s scale has already sparked talks about expanding access through compassionate use programs.

Nooka noted that while the results are promising, they mark progress toward a cure rather than achieving it. “We’re not there yet, but this is the closest we’ve come.”

Future studies will determine whether the approach can be used earlier in treatment or combined with other therapies. For now, the data offer new hope for patients who have exhausted other options.