In Miami, C. Ola Landgren watched a transformation unfold that would have seemed impossible three decades ago. When Landgren trained in myeloma medicine back in the 1990s, chemotherapy was the only real weapon against multiple myeloma. Today, the immunotherapy teclistamab has rewritten that story entirely.
Results from the Phase III MajesTEC-9 trial, presented at the 2026 American Society of Clinical Oncology Annual Meeting and published in The New England Journal of Medicine, reveal the depth of that shift. Landgren, who leads the Sylvester Myeloma Institute at the University of Miami Miller School of Medicine, guided a study that enrolled 593 patients across 24 countries. The patients had one thing in common: their myeloma had returned after one to three previous treatments. About three-quarters had already failed standard immunotherapies like daratumumab and lenalidomide—leaving them exhausted of options in routine practice.
Teclistamab works through an elegant mechanism. It's a bispecific antibody that acts as a molecular bridge, linking the body's T cells directly to BCMA, a protein found on myeloma cancer cells. This connection allows the immune system to recognize and destroy cancer with precision that chemotherapy cannot match. The results speak clearly: nearly 70 percent of teclistamab-treated patients had no disease progression at 18 months, compared with just 27 percent of those on standard treatments. Even more striking, nearly two-thirds of teclistamab patients achieved complete remission—meaning physicians could find no detectable cancer, even using highly sensitive testing that hunts for minimal residual disease.
The impact extends beyond statistics. For patients who had exhausted conventional options, teclistamab offered something many had stopped hoping for: genuine remission, sometimes sustained remission, and a chemotherapy-free path forward. "We are seeing very deep responses and long clinical benefit from these therapies," Landgren said. "This is part of a much bigger transformation happening in myeloma care."
Like any powerful immunotherapy, teclistamab carries risks. By activating immune cells broadly, it increases vulnerability to infection, particularly in the first six months of treatment. Managing that risk requires vigilance: antiviral and antibiotic medications, careful monitoring of antibody levels, and occasional immunoglobulin infusions when immunity dips too low. Yet for many patients, this managed risk is far preferable to the toxicity of traditional chemotherapy or the trap of treatment failure.
The real future, Landgren believes, lies even earlier in the disease course. Researchers are now exploring whether bispecific antibodies could work when myeloma first returns—or even before that. The goal is transformation from control to cure. "We are working toward treatments that can either eliminate the disease entirely or control it for very long periods while minimizing the burden on patients and preserving quality of life," he said. For myeloma patients and their families, that shift from "manage the disease" to "end the disease" represents hope that seemed impossible just a few years ago.