[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Bispecific T-cell engagers](https://durgical.com/en/pharmacology/classes/bispecific-t-cell-engagers/) › Teclistamab # Teclistamab ## Bispecific T-cell engagers? Bispecific T-cell engagers ## High alert? An error with this medicine can cause serious harm: double checks and protocols are used. Bispecific antibody that links CD3 on T cells to BCMA on myeloma cells; for relapsed multiple myeloma. Boxed risks: cytokine release syndrome and neurotoxicity. Updated Nov 1, 2026 Also called: teclistamab-cqyv, BCMA × CD3 bispecific antibody ## Quick facts **Group** [Bispecific T-cell engagers](https://durgical.com/en/pharmacology/classes/bispecific-t-cell-engagers/) **Target** BCMA (B-cell maturation antigen, TNFRSF17) on myeloma cells, and CD3 on T cells **Key effects** Injection-site reactions · Fever · Joint **Monitor** Temperature · Neurological checks · Liver tests **ATC** L01FX24 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◎**BCMA (B-cell maturation antigen, TNFRSF17) on myeloma cells, and CD3 on T cells**Teclistamab ⓘ The cryo-EM structure shows BCMA held by the BCMA-binding Fab arm of teclistamab (with a second Fab used to stabilise the complex); the CD3 arm is not in the structure. **Target in 3D:** BCMA (B-cell maturation antigen, TNFRSF17) on myeloma cells, and CD3 on T cells. PDB structure 12ER (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/12ER) · Drag to rotate · pinch to zoom Teclistamab is a bispecific T-cell engager: one arm binds CD3 on the patient's T cells and the other binds BCMA, a receptor expressed on myeloma plasma cells. Bringing the two cells together activates the T cell without MHC presentation; it releases cytotoxic granules and kills the myeloma cell, and the activation releases cytokines. - One arm binds BCMA on the myeloma cell - The other arm binds CD3 on a T cell - The T cell is activated and kills the plasma cell - Cytokines are released (CRS risk, worst early) ## Indications - Relapsed or refractory multiple myeloma after several prior lines including an immunomodulatory drug, a proteasome inhibitor and an anti-CD38 antibody; also with daratumumab after fewer prior lines. [Multiple myeloma →](https://durgical.com/en/conditions/multiple-myeloma/) ## Adverse effects ### Common - Injection-site reactions - Fever, fatigue - Joint, back or bone pain - Nausea, diarrhoea, constipation - Swelling of the legs - Low blood counts ### Serious (rare, important) - Cytokine release syndrome (boxed warning) - Immune effector cell-associated neurotoxicity syndrome, ICANS (boxed warning) - Serious and opportunistic infections, including reactivation of herpes zoster - Neutropenia and bleeding - Liver toxicity ## Contraindications - Known allergy to the drug - Active serious infection is treated before starting ## Key interactions **Other prescription and non-prescription medicines, vitamins and herbal products** The full list is reviewed before starting, because doses of other drugs may need adjusting. ## What is monitored - Temperature, blood pressure and oxygen saturation after each step-up dose - Neurological checks (orientation, writing, speech) - Complete blood count and signs of infection - Liver tests - History of shingles before starting ## Administration and safety - Subcutaneous injection by a health professional; the step-up doses are usually given in hospital with monitoring afterwards. - Premedication is given before the step-up doses as ordered. - Available only through a FDA risk management programme (REMS) with certified prescribers and centres. - Check the drug name and the dose step carefully: step-up and treatment doses differ. ## Pregnancy and breastfeeding May harm the fetus; a pregnancy test is done before starting and effective contraception is used during and after treatment. ## Nursing care - Check vital signs often after the first doses and report fever, hypotension or hypoxia. - Do neurological checks and report confusion, drowsiness or trouble writing. - Watch for infection; report fever, cough or a painful rash. - Teaching: do not drive or operate machinery for 48 hours after each step-up dose or while having neurological symptoms; use effective contraception. ## Pharmacokinetics **Absorption** Subcutaneous injection; first step-up doses, then regular treatment doses. **Elimination** Broken down like other antibodies. ## Memory aid «TEC-list-AMAB TEChnically LISTs two targets»: BCMA (myeloma) + CD3 (T cell). First doses = «Fever and Fog» (CRS, ICANS). ## Test yourself Think of the answer, then tap the question to see it. ## Which two antigens does teclistamab bind? BCMA on myeloma cells and CD3 on T cells. ## Why are teclistamab's first doses given as step-up doses in hospital? Because cytokine release syndrome and neurotoxicity are most frequent after the first doses. ## For which cancer is teclistamab used? Relapsed or refractory multiple myeloma. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/teclistamab/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **High alert** An error with this medicine can cause serious harm: double checks and protocols are used. ## Connections ## Related drugs 3 - [Blinatumomab](https://durgical.com/en/pharmacology/blinatumomab/) - [Tocilizumab](https://durgical.com/en/pharmacology/tocilizumab/) - [Bortezomib](https://durgical.com/en/pharmacology/bortezomib/) ## Related conditions 1 - [Multiple myeloma](https://durgical.com/en/conditions/multiple-myeloma/) [← Back to the class: Bispecific T-cell engagers](https://durgical.com/en/pharmacology/classes/bispecific-t-cell-engagers/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Teclistamab-cqyv - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/teclistamab-cqyv) (National Cancer Institute, 2026); [Teclistamab-cqyv Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a622076.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01FX24) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/teclistamab/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/teclistamab/