ASCO 2026: Tecvayli Trial Shows Strong Survival Benefit in Multiple Myeloma

Among the most closely watched multiple myeloma presentations at the 2026 ASCO Annual Meeting was the phase 3 MajesTEC-9 trial, which found that Tecvayli (teclistamab) significantly improved outcomes over standard therapy. CareSet’s analysis of Medicare claims shows the bispecific antibody has also been the most widely used therapy in its class over the past few years. 

Published simultaneously in the New England Journal of Medicine, the MajesTEC-9 trial found that nearly 70% of patients receiving Tecvayli had no disease progression after 18 months, compared with about 27% of patients receiving standard treatments. Nearly two-thirds of patients in the Tecvayli group also achieved a complete response. 

Tecvayli belongs to a newer class of immunotherapies known as bispecific antibodies, which simultaneously bind cancer cells and immune cells to trigger a targeted immune response. The therapy has led Medicare utilization among bispecific treatments for multiple myeloma in recent years, outperforming Talvey (talquetamab-tgvs) and Elrexfio (elranatamab-bcmm), as well as CAR-T therapies Abecma (idecabtagene vicleucel) and Carvykti (ciltacabtagene autoleucel), according to CareSet’s analysis of Medicare claims from October 2024 through February 2026. 

Tecvayli was approved in October 2022 for adult patients with relapsed or refractory multiple myeloma (RRMM) who had previously received four or more prior lines of therapy. In March 2026, the FDA approved it in combination with Darzalex Faspro (daratumumab and hyaluronidase-fihj) for adults with RRMM who have received at least one prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent.

CareSet’s analysis showed steady growth in Tecvayli utilization, with the number of Medicare patients peaking at 1,025 in October 2025. Since October 2024, monthly utilization has consistently been more than twice that of Talvey.

The phase 3 MajesTEC-9 trial enrolled nearly 600 patients across 24 countries whose multiple myeloma had relapsed after one to three prior lines of therapy, including lenalidomide and an anti-CD38 monoclonal antibody. They were randomly assigned to receive either Tecvayli monotherapy or the investigator’s choice of standard combination therapy.

In addition to significantly delaying disease progression, Tecvayli demonstrated an overall survival benefit: 79% of patients receiving the drug were alive at 18 months, compared with 69% of those receiving standard therapies.

“The significant [progression-free survival] and [overall survival] advantage seen with teclistamab monotherapy supports moving this bispecific antibody earlier in the treatment paradigm and reinforces its potential role as a new [standard-of-care option] for patients with relapsed/refractory multiple myeloma after 1 to 3 prior lines of therapy,” according to lead author Roberto Mina, MD, of Winship Cancer Institute of Emory University in Atlanta, Georgia, and AOU Città della Salute e della Scienza di Torino, University of Torino in Italy.

The researchers also noted that patients receiving Tecvayli face a higher infection risk, requiring close monitoring and preventive antiviral and antibiotic medications to help ward off infections.