Decision brief · what the records say, not our assessment
Phase 3 Study of Teclistamab in Combination With Lenalidomide and Teclistamab Alone Versus Lenalidomide Alone in Participants With Newly Diagnosed Multiple Myeloma as Maintenance Therapy Following Autologous Stem Cell Transplantation
NCT05243797 · European Myeloma Network B.V. · PHASE3 · active not recruiting · Multiple myeloma · Open Targets disease: plasma cell myeloma
Six questions a reader deciding whether to spend more time on this asks, each answered with flags: yes, no, or not published (hatched), each with its rule and source record. Flags are never added up into a score or a verdict, because published success rates disagree by a factor of two and more.
1. Is the biology right?
- Somatic driver evidence: no · None of CD3E, CD3G, CD3D has somatic-mutation evidence in plasma cell myelomaRule: Open Targets has somatic-mutation evidence for the target in this cancer. Source: Open Targets: CD3E in plasma cell myeloma, 2026-11-11
- Human genetic evidence: no · No germline or somatic evidence for CD3E, CD3G, CD3D in plasma cell myelomaRule: Any germline or somatic human genetic evidence for the target in this cancer, counted apart from animal-model and literature evidence. Source: Open Targets: CD3E in plasma cell myeloma, 2026-11-11
- Pediatric target: no · Not on the FDA listRule: Target is on FDA's Pediatric Molecular Target List (relevant targets); membership alone neither requires nor waives a study. Source: FDA Pediatric Molecular Target List (Listed as February 2026 on the FDA Pediatric Oncology page; the file served is 9.7.22_the_relevant_molecular_target_list.xlsx, whose Summary of Changes sheet is headed 'SEPTEMBER 2022 UPDATE' (footnote date 2022-09-01)), 2026-11-11
- Haematologic cancer: yes · HaematologicRule: From the indication, or the registry conditions when no indication matches. Source: ClinicalTrials.gov NCT05243797, 2026-11-11Published context: Likelihood of approval from phase 1: 7.5% haematologic vs 4.6% solid (BIO / Informa / QLS 2021, 2011–2020). Population-level, not a prediction.
- Background therapy: Lenalidomide: standard agents, not counted in these flags.
- CD3E (via Teclistamab): Evidence types in plasma cell myeloma: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc. · Open Targets: CD3E in plasma cell myeloma
- CD3G (via Teclistamab): Evidence types in plasma cell myeloma: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc. · Open Targets: CD3G in plasma cell myeloma
- CD3D (via Teclistamab): Evidence types in plasma cell myeloma: literature, clinical; literature listed separately from human genetics. Datasources: clinical_precedence, europepmc. · Open Targets: CD3D in plasma cell myeloma
- Not loaded on this app yet: Normal-tissue expression in vital organs. Source: Human Protein Atlas (ticket 36).
- Not loaded on this app yet: Pan-essential in cell lines. Source: DepMap (ticket 36).
- Not loaded on this app yet: Approved drug on this target. Source: Drugs@FDA (ticket 30).
2. Can the result be trusted?
- Randomised: yes · Randomised allocationRule: Registry allocation field. Source: ClinicalTrials.gov NCT05243797, 2026-11-11
- Small denominator: no · 1594 planned; each patient moves a rate by 100 ÷ 1594 = 0.1 pointsRule: Enrolment under 30; the arithmetic is shown, not a benchmark. Source: ClinicalTrials.gov NCT05243797, 2026-11-11
- Primary endpoint is overall survival: no · Progression Free Survival (PFS); Minimal Residual Disease (MRD)-negative Complete Response (CR)Rule: A registered primary outcome measure names overall survival. Source: ClinicalTrials.gov NCT05243797, 2026-11-11Published context: Non-OS primary endpoint: odds ratio 2.79 for a positive phase 3 (Otsuka 2021, 400 phase 3 oncology trials, to 2020). Shown with the next figure: a surrogate is easier to hit, and often a weak guide to survival.Published context: 52% of surrogate-to-OS correlations are low (Prasad 2015, published to 2014). Shown with the figure above.
- Results overdue: no · Primary completion expected 2028-04; not yet dueRule: Primary completion (actual) more than 12 months ago and no results posted to the registry. Source: ClinicalTrials.gov NCT05243797, 2026-11-11
- Not loaded on this app yet: Treated and evaluable counts, assessor, confirmed response, follow-up and data cutoff. Source: Readout extraction (ticket 32).
- Not loaded on this app yet: Primary endpoint changed between registry versions. Source: Registry versions in the store (ticket 32).
3. What must it beat?
- Not loaded on this app yet: Control-arm result and approved therapies for the same segment, with label links. Source: Drugs@FDA, FDA labels and readouts (tickets 30, 32).
4. Too crowded, or too late?
- Stopped on this target: 87 terminated, withdrawn or suspended trials of drugs against CD3E; 9 give no reason. Reasons are quoted as the registry gives them on the target page. · CD3E: what already stopped
- Not loaded on this app yet: Programs on the target by phase and months behind the leader. Source: Programs and Drugs@FDA (ticket 33).
5. Can it be approved, and stay approved?
- Single-country: no · 201 sites in 25 countries; 39 in the United States (19%)Rule: All listed sites are in one country; the share of US sites is shown. Source: ClinicalTrials.gov NCT05243797, 2026-11-11
- EU paediatric investigation plan: no · No EMA paediatric investigation plan decision names TeclistamabRule: An EMA PIP decision (agreement, modification or waiver) lists the drug as its active substance, exact name. Source: EMA data download (dated snapshot), 2026-11-11
- EU orphan designation: yes · EU/3/20/2331 withdrawn 19 Jul 2022: Treatment of multiple myelomaRule: An EU orphan designation lists the drug as its active substance (exact name) or belongs to a medicine that does; withdrawn and expired designations are listed with their status. Source: EMA EU/3/20/2331, 2026-11-11
- Authorised in the EU: yes · Tecvayli: authorised since 23 Aug 2022Rule: An EMA medicine record lists the drug as its active substance or INN, exact name; national-only authorisations are not in this file. Source: EMA EPAR Tecvayli, 2026-11-11
- FDA orphan designation: not published · FDA's orphan designation database turns away automated requests, so this app does not read it; search it by hand at the linkRule: Would be: an FDA orphan designation names the drug. Source: FDA orphan designations search
- FDA pediatric oncology approval: no · FDA's table lists no pediatric approval of TeclistamabRule: FDA's Pediatric Oncology Drug Approvals table names the drug. Source: FDA Pediatric Oncology Drug Approvals (content current as of 2026-03-03), 2026-11-11
- Registered studies open to children: yes · 1 interventional studies of Teclistamab include patients under 18; 1 is recruiting, not yet recruiting or activeRule: The registry's age group includes Child (birth to 17 years), which also counts studies that set no minimum age. Source: ClinicalTrials.gov search, 2026-11-11
- Caveat: Site counts are not patients per country, and trials registered only outside ClinicalTrials.gov are not covered. Where the sites are is a fact about the record, not a judgement of its quality.
- Rare pediatric disease voucher: FDA, content current as of 29 Apr 2026: “As of February 3, 2026, enactment of the Consolidated Appropriations Act, 2026, the rare pediatric disease PRV program will sunset after September 30, 2029. FDA may not award any PRVs under this program after September 30, 2029.” Voucher sale prices are not shown here; they appear only as company-reported news. · FDA: Rare Pediatric Disease Designation and Priority Review Voucher Programs
- Not loaded on this app yet: Precedent approvals for target, modality and endpoint; accelerated-approval status. Source: Drugs@FDA and FDA accelerated-approval tables (ticket 30).
6. Can the sponsor finish?
- Sponsor: European Myeloma Network B.V. (academic or other) · ClinicalTrials.gov NCT05243797
- principal investigator: Niels van de Donk, Professor, Amsterdam UMC, Vrije Universiteit Amsterdam · Person page
- principal investigator: Elena Zamagni, Professor, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" · Person page
- Not loaded on this app yet: Filed cash, quarterly spend and the runway arithmetic. Source: SEC XBRL company facts (ticket 37).
- Not loaded on this app yet: Sponsor's completed vs stopped oncology trials and results-reporting record. Source: Registry, by company (ticket 37).
What public data cannot tell you
Public records cannot show: sales forecasts; a probability of success for this asset; full deal terms and net prices; FDA designations and action dates before approval (shown only as company-reported); clinical holds unless the company disclosed them; manufacturing; patents on unapproved drugs; whether preclinical findings have been replicated.
Sources: ClinicalTrials.gov NCT05243797 (2026-11-11); Open Targets Platform (2026-11-11); FDA Pediatric Molecular Target List (Listed as February 2026 on the FDA Pediatric Oncology page; the file served is 9.7.22_the_relevant_molecular_target_list.xlsx, whose Summary of Changes sheet is headed 'SEPTEMBER 2022 UPDATE' (footnote date 2022-09-01)) (2026-11-11). JSON: /api/brief/trial/NCT05243797. Not medical advice.