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Tecvayli + Revlimid + Velcade + dexamethasone (Tec-RVd) is an investigational quadruplet combination therapy being evaluated for the treatment of newly diagnosed multiple myeloma. This regimen integrates teclistamab, a bispecific T-cell engager targeting B-cell maturation antigen (BCMA) and CD3, with the established RVd triplet consisting of lenalidomide (an immunomodulatory agent), bortezomib (a proteasome inhibitor), and dexamethasone (a corticosteroid). Teclistamab works by redirecting CD3-positive T cells to BCMA-expressing myeloma cells, leading to targeted cytotoxicity. Lenalidomide modulates the cereblon E3 ubiquitin ligase complex, bortezomib inhibits the 26S proteasome to induce cell cycle arrest and apoptosis, and dexamethasone provides synergistic anti-tumor activity. This specific combination is the focus of the Phase 1/2 ALTITUDE trial led by Memorial Sloan Kettering Cancer Center, which explores alternating induction therapies to achieve deep molecular responses in transplant-eligible patients.
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