The RedirecTT-1 trial is an open-label, phase 1b-2 study evaluating the combination of two bispecific antibodies—talquetamab and teclistamab—in patients with relapsed or refractory multiple myeloma (RRMM) who had been previously exposed to three major drug classes. Using a recommended phase 2 regimen of talquetamab 0.8 mg/kg and teclistamab 3.0 mg/kg every two weeks, the trial demonstrated an overall response rate (ORR) of 80%, with 86% of those responses maintained at 18 months. High response rates were observed even among patients with aggressive extramedullary disease. However, the combination therapy was associated with a high incidence of grade 3/4 adverse events, particularly infections, including infection-related mortality. The study was prominently featured at the IMS24 conference, where Dr. Yael Cohen presented the findings. Commentary from leading hematologists—including Dr. Rahul Banerjee, Dr. Tom Curley, and Dr. Aaron Goodman—highlighted the therapy’s potential advantages over CAR-T treatments in specific settings, while also emphasizing the need for careful management of toxicity risks.
Myeloma Cancer
RedirecTT-1
About the RedirecTT-1 Trial
Table of Contents
Major Presentations and Milestones
RedirecTT-1 Trial design, results, and conclusions
RedirecTT-1 Sentiments and Criticisms
RedirecTT-1 Temporal Sentiment Arc
Professional Resources : Interactive Tweet History, Influence Diagram, Sentiment Table, AI Chatbot
RedirecTT-1 Trial: Major Presentations and Milestones
Primary speakers driving the story
At ASH 2025, RedirecTT-1 (talquetamab + teclistamab) was presented with simultaneous New England Journal of Medicine (NEJM) publication, followed by a Late-Breaking session at EHA 2025 led by Shaji Kumar, MD (Mayo Clinic). KOLs emphasized that this is a dedicated study in true extramedullary disease (EMD), an area of high unmet need, and discussed both efficacy and infection signals under bispecific-bispecific combination therapy.
@myelomaMD presenting RedirecTT-1 (Ph2 tec + tal in RRMM with EMD) as Late-Breaking at #EHA2025 . Some real hope for these EMD patients, a true unmet need. ORR of 78.9% (≥CR of 54.4%), 12-mo PFS of 81%, 12-month PFS at 74.3%. Good safety #mmsm https://t.co/gIdGPWPSzo
— Daniel Auclair (@AuclairDan) June 15, 2025
Original Article: Dual Targeting of Extramedullary Myeloma with Talquetamab and Teclistamab (RedirecTT-1 phase 1b–2 study) https://t.co/PFvXEjnh5R #ASH25 | @ASH_hematology https://t.co/DSsgrwAGWX
— NEJM (@NEJM) December 8, 2025
RedirecTT-1 Trial Design, Results, and Conclusions
Trial Design:
RedirecTT-1 is a phase 1b–2 study of talquetamab (GPRC5D-directed bsAb) plus teclistamab (BCMA-directed bsAb) in relapsed/refractory multiple myeloma, including a dedicated cohort with true extramedullary disease (EMD). Dosing shared by a KOL for the RP2D cohort: teclistamab 3 mg/kg every 2 weeks plus talquetamab 0.8 mg/kg every 2 weeks; populations included heavily pretreated patients (e.g., triple-class and penta-refractory proportions reported in session commentary).
Primary Results:
NEJM and meeting summaries consistently reported high response rates with the combination in drug-resistant EMD, with 12‑month PFS and OS signals but notable infection risk. KOLs highlighted:
#Myeloma Paper of the Day: Talquetamab + teclistamab in pts w/ drug-resistant true extramedullary myeloma show ORR 79%, PFS @ 12 mos was 61%, OS was 74%; common grade 3/4 AEs were heme in 76% & infection in 31%; 10 deaths (5 treatment, 5 infection): https://t.co/ouWZgWaKYH. #mmsm https://t.co/OJylESjwiu
— Robert Z. Orlowski (@Myeloma_Doc) December 9, 2025
Visceral EMD durability at RP2R was underscored by an 18‑month duration of response (DOR) estimate, with experts discussing implications versus cellular therapies:
🚨 RedirecTT-1 out in @NEJM ! (Side note: @bdermanmd already wins the pun game 🥰) Tec + tal as a bsAb cocktail in #MMsm. Impressive responses , including 18-mo DOR 82% even in visceral EMD (≥ 2cm lesions). My take - in visceral EMD, tal/tec combo probably beats BCMA CAR-T! https://t.co/eDefM88VgL https://t.co/ECRIXNPcV9
— Rahul Banerjee, MD, FACP (@RahulBanerjeeMD) January 9, 2025
Additional cohort summaries shared by KOLs:
- “Updated RedirecTT-1 results … N = 90. All true EMD. … ORR 79% … 12m PFS 57.5%. Median PFS 15m. 12m OS 73.8%. 33.3% Grade 3/4. 6.5% deaths 2 to infection.” https://x.com/gjmccaughan/status/1997789043908878831
- “More data … N = 138 … Grade 3+ infections in 53.2% … ORR at RP2D 80%, 92% in no EMD. Median PFS 38.6m. Median OS not reached.” https://x.com/gjmccaughan/status/1997800666392400279
- “RP2D dosing … 86% triple class and 33% penta refractory … Grade 3-4 infections in 64% (!). AEs leading to discontinuation 16% …” https://x.com/bdermanmd/status/1877147001290186950
Safety:
KOLs emphasized infection risk with the dual-bispecific regimen. Reported rates varied by cohort/cut (e.g., grade 3/4 infections ~31% to 64%), with several posts noting IVIG use and infection prophylaxis as critical mitigations and multiple AE‑related deaths in datasets presented at ASH25.
Key Conclusions:
Talquetamab + teclistamab produces high response rates and meaningful 12‑month PFS/OS in drug‑resistant true EMD, with especially notable DOR in visceral EMD at RP2R. Infection is the dominant safety concern and a driver of supportive‑care strategy; clinicians highlighted the need for rigorous prophylaxis/IVIG and careful patient selection. Comparative positioning versus BCMA CAR‑T and optimal sequencing remain active discussion points.
RedirecTT-1 Sentiments and Criticisms
Positive Reception:
Vincent Rajkumar, MD: "Just out in @NEJM Effective therapy of extra medullary relapsed myeloma with teclistamab plus talquetamab (Tec-Tal). RedirecTT-1 #ASH25 @myelomaMD @szusmani @mvmateos 80% response rate. 60% PFS at 12 months." https://x.com/VincentRK/status/1997810461019144676
Multiple Myeloma Hub (Shaji Kumar presentation): "Tal + Tec led to an ORR of 78.9% and a ≥CR rate of 54.4%; efficacy exceeded standard therapies" https://x.com/MM_Hub/status/1934152824541118753
Rahul Banerjee, MD, FACP: "Tec + tal as a bsAb cocktail in #MMsm. Impressive responses … tal/tec combo probably beats BCMA CAR-T!" https://x.com/RahulBanerjeeMD/status/1877178863370789271
Critical Perspectives:
How the hell did this make the NEJM. Let’s combine two active drugs in a single arm study and show we can do it (and cause a lot of toxicity). Talquetamab plus Teclistamab in Relapsed or Refractory Multiple Myeloma | New England Journal of Medicine https://t.co/sK5ytbygB7
— Aaron Goodman - “Papa Heme” (@AaronGoodman33) January 8, 2025
Urvi Shah, MD: "@bdermanmd @hhashmi87 Agreed and the high infection risk and mortality is concerning. For most patients sequencing the drugs is likely a safer option." https://x.com/UrviShahMD/status/1879314800414732497
On the one hand - the combo seems to be more effective than either agent individually and we know sequencing of these drugs is problematic (second one unlikely to work as well). On the other hand - there’s a lot of toxicity to contend with. Infections being the most concerning… https://t.co/BVXjsfol3u
— Ben Derman (@bdermanmd) January 9, 2025
RedirecTT-1 Temporal Sentiment Arc
2024 (IMS24: Early Signal and Safety Focus)
Primary/KOL tweets:
#IMS24 AMAZING data from RedirecTT-1 of Tec + tal. bsAb #MMsm cocktail works well even in visceral EMD. 80% ORR and 18-month DOR 86%! 🤯 For context, TEC-1 DOR *was* 18 months. Progress being made! Visceral EMD ORR 61% still impressive but of course needs to be improved… https://t.co/ImeSBp7pe3
— Rahul Banerjee, MD, FACP (@RahulBanerjeeMD) September 27, 2024
- https://x.com/Rfonsi1/status/1839645403978830185
- Tone: Emerging enthusiasm for combination activity even in visceral EMD, with early recognition of infection management (IVIG/prophylaxis) as essential.
- Shift: From proof‑of‑concept signal to operational infection mitigation.
January 2025 (NEJM Publication)
Primary/KOL tweets:
- https://x.com/NEJM/status/1877354735709335620
- https://x.com/RahulBanerjeeMD/status/1877179967043141994
- https://x.com/bdermanmd/status/1877147001290186950
- Tone: Strong interest in DOR and visceral EMD efficacy; active debate on single‑arm design and infection burden.
- Shift: From efficacy headlines to nuanced dosing, RP2D cohort interpretation, and comparative positioning vs CAR‑T.
June 2025 (EHA25 Late-Breaking)
Primary/KOL tweets:
- https://x.com/AuclairDan/status/1934153667944292677
- https://x.com/MM_Hub/status/1934152824541118753
- https://x.com/AuclairDan/status/1934155899708313845
- Tone: Recognition of RedirecTT‑1 as a benchmark dataset for true EMD with high response rates; continued emphasis on safety vigilance.
- Shift: Consolidation of RedirecTT‑1 as reference data for EMD, with increasing calls for standardized infection prophylaxis.
December 2025 (ASH25 Simultaneous Presentation and NEJM Coverage)
Primary/KOL tweets:
A simultaneous presentation and NEJM publication for ReDirecTT-1: Tec + Tal in EMD by @szusmani n=90; ORR 79% 12-month PFS 57.5% Grade 3+ infections 32%. 8 discontinuations due to AEs. 10 AE-related deaths. Overall, amazing to have a dedicated EMD study. This is truly a https://t.co/MtyyykgQ8u
— Ben Derman (@bdermanmd) December 7, 2025
- https://x.com/NEJM/status/1997781922010079280
- https://x.com/Myeloma_Doc/status/1998392194269675942
- Tone: High-impact visibility with NEJM and ASH; community balances enthusiasm for efficacy with sober assessment of infection-related morbidity/mortality.
- Shift: From demonstrating activity to codifying best practices for prophylaxis/IVIG and defining sequencing relative to CAR‑T.
Across cycles, the discourse moved from early efficacy signals to mature, benchmark-level data in true EMD. The clinical community converged on the regimen’s strong activity and durability—particularly at RP2R in visceral EMD—while emphasizing comprehensive infection prevention, monitoring, and individualized sequencing.
RedirecTT-1 Professional Resources