e19502 Background: Talquetamab (TQ) and Teclistamab (TC) are both FDA approved bispecific antibodies used in the treatment of relapsed/refractory multiple myeloma. Here we report real world data comparing both the bispecfic t-cell engagers (BiTe). Methods: A retrospective study was performed using TriNetX, a global research de-identified database with data from 172 health care organizations as of January 2026. ICD-10 codes were used for associated diagnosis and medications. The database was queried to identify MM patients who had received either TC or TQ. These treatments were set as the index event for outcome analysis. Demographics and prevalence of comorbidities were extracted. Outcome analysis queried for Overall Survival (OS), MM in remission, cytokine release syndrome (CRS), and use of tocilizumab (toci). Propensity Score Matching (PSM) was done for age, race, gender, diabetes mellitus, hypertension, chronic kidney disease, autoimmune conditions, obesity, use of CD38 antagonist and receipt of either CAR-T therapy or autologous stem cell transplant. The Measure of Association Analysis was used to calculate Risk Ratio (RR), Odds ratio (OR), Kaplan Meier (KM) curves were generated for OS and Log-Rank (LR) test. Results: 1941 cases were identified, out of whom 27.82% cases received TQ (n=540). Cases in TQ group were younger (mean age 65. Vs 69.8, p<0.0001), more often unknown race (12% vs 9%, p=0.045), and less often African Americans (17% vs 22%, p=0.0101), with no significant difference in gender. 22% of cases in TQ group received CAR-T, while only 7% received it in TC group (p<0.0001). After PSM, both groups had 465 cases. The median follow up period was 188 days in TQ group and 284 days in TC group. TQ group had higher risk for developing CRS (RR 1.91 (1.34, 2.72), p<0.0001) and use of Toci (RR 1.80 (1.39, 2.34), p<0.0001). Cases achieving remission were similar in both groups (OR 0.93 (0.55, 1.57), p=0.783) while survival probability at 5 years was significantly more in TQ group (65.33% vs 57.88%, LR - p=0.017, HR 0.72 (0.55, 0.94)). Conclusions: Our study determines that patients receiving TQ have higher odds of developing CRS, but also has better OS, even after matching covariates including the CAR-T receipt. Further studies are needed to determine if there is any difference in pharmacodynamics of B-cell maturation antigen (BCMA) or G protein-coupled receptor, family C group 5 member D (GPCR5D) bites.
Niforatos et al. (Thu,) studied this question.