Binod Dhakal, MD, MS

Panelists discuss how CARTITUDE-4 demonstrated superior progression-free survival and overall response rates with ciltacabtagene autoleucel (cilta-cel) compared with standard treatment options in relapsed/refractory multiple myeloma (R/R MM) patients who received 1 to 3 prior lines of therapy.

Panelists discuss how to address practical challenges in delivering chimeric antigen receptor (CAR) T cell therapy, including patient selection, bridging therapy, manufacturing delays, access barriers, and coordination of care to optimize real-world outcomes.

Panelists discuss how to manage an aggressive case of early posttransplant progression in a young woman with functionally high-risk multiple myeloma (MM), focusing on rapid intervention strategies and novel therapeutic approaches to overcome poor prognosis disease.

Panelists discuss how to approach treatment selection and sequencing for a 58-year-old woman with high-risk multiple myeloma (MM) who has developed progressive disease after stem cell transplantation, considering factors such as prior therapy exposure, available options, and disease biology.

Panelists discuss how to optimize maintenance therapy following autologous stem cell transplantation by evaluating factors such as duration, drug selection, and risk-adapted approaches to maximize long-term outcomes in multiple myeloma patients.

Panelists discuss how the paradigm in transplant-eligible newly diagnosed multiple myeloma (NDMM) has shifted to considering which patients should not receive quadruplet CD38-containing regimens rather than who should, given the compelling efficacy data supporting this approach.

Panelists discuss how the PERSEUS trial demonstrated superior progression-free survival with daratumumab-VRd compared to VRd alone in patients with transplant-eligible newly diagnosed multiple myeloma (NDMM), potentially establishing a new standard of care in this setting.

Panelists discuss how to navigate and choose among multiple guideline-recommended induction regimens for patients with transplant-eligible newly diagnosed multiple myeloma (NDMM) by considering factors such as efficacy data, toxicity profiles, and individual patient characteristics.

Panelists discuss how to optimize treatment selection and sequencing for a 65-year-old patient with standard-risk, transplant-eligible newly diagnosed multiple myeloma (NDMM) through assessment of disease characteristics, patient factors, and available therapeutic options.

Panelists discuss how the IMROZ trial demonstrated improved outcomes with quadruplet therapy combining daratumumab, lenalidomide, melphalan, and prednisone in patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM), highlighting its potential as a new treatment standard.

Panelists discuss how the CEPHEUS trial demonstrates the comparative efficacy and safety of subcutaneous daratumumab combined with VRd vs VRd alone in patients with transplant-ineligible or transplant-deferred newly diagnosed multiple myeloma, highlighting key outcomes and clinical implications.

Panelists discuss how guideline-recommended treatment regimens for patients with transplant-ineligible or transplant-deferred newly diagnosed multiple myeloma should be evaluated and selected based on patient characteristics, efficacy data, and safety profiles to achieve optimal outcomes.

Panelists discuss how to approach treatment decisions for a 74-year-old patient with transplant-ineligible newly diagnosed multiple myeloma patient, considering factors such as age, comorbidities, and available therapeutic options to develop an optimal care plan.

Panelist discusses how there are many significant attributes of the bispecific antibody, which has broader applicability and can be used in widespread community centers. There are more community centers that are staring to use bispecific antibodies, and there is now a much lower rate of CRS and immune effector cell–associated neurotoxicity syndrome (ICANS).

Panelist discusses how pivotal studies led to the approval of teclistamab in patients with less refractory multiple myeloma; the overall response rate was 63% and the progression of survival rate was 11.3 months.

Panelist discusses how, based on the patient achieving sCR with emerging oral, skin, and nail toxicities, panelist would recommend initiating supportive care, including oral hygiene protocols, topical treatments, and prophylactic nail care. These toxicities are generally less severe than those of BCMA-targeted bispecifics, which often present with more systemic CRS and neurotoxicity.

Panelists discuss how recent therapeutic advances, including novel drug combinations and personalized treatment approaches, are reshaping the standard of care for patients with newly diagnosed multiple myeloma (NDMM) while emphasizing the importance of risk stratification and early intervention strategies.

Panelist discusses how talquetamab’s step-up dosing strategy aims to mitigate cytokine release syndrome, a common immunologic toxicity. The reported grade 1 CRS with altered taste and dry mouth represents a mild manifestation compared with the MonumenTAL-1 trial, where the initial SUD schedule showed varying CRS rates. Real-world evidence has largely validated trial findings, though alternative SUD approaches may offer different risk-benefit profiles. The optimal SUD strategy continues to evolve as clinical experience expands, balancing efficacy with tolerability.

Panelist discusses how the MonumenTAL-1 study led to the approval of talquetamab in patients with 4 or more prior lines of therapy, and the initial response rate was 70%. There were also several toxicities associated with MonumenTAL-1, including oral, nail, and skin toxicities.

Panelist discusses how the RRMM treatment landscape has evolved significantly, with BiTEs emerging as a promising approach. BCMA-targeted BiTEs showed efficacy, while GPRC5D-targeting agents like talquetamab represent promising new options, particularly for patients with BCMA-refractory disease. Key challenges include managing cytokine release syndrome, developing optimal sequencing strategies, addressing drug resistance, and improving accessibility and affordability of novel therapies.

Panelist discusses the clinical patient, a 72-year-old man who was previously diagnosed 6 years ago with multiple myeloma, 60% plasma cells, which he presents to his oncologist after 5 prior treatment regimens. The patient also has had 2 episodes of pneumonia and multiple episodes of bronchitis over the prior 10 years.

Binod Dhakal, MD, MS, discusses some of the next steps for evaluating ciltacabtagene autoleucel in multiple myeloma and the CARTITUDE-4 trial.

Binod Dhakal, MD, MS, discusses the key takeaways from the CARTITUDE-4 trial which were presented at the 2024 International Myeloma Society Annual Meeting.

Binod Dhakal, MD, MS, discusses how the efficacy results observed with ciltacabtagene autoleucel in the CARTITUDE-4 trial compare with other therapies that are used for the treatment of relapsed/refractory multiple myeloma.

Binod Dhakal, MD, MS, discusses the safety and efficacy findings from the CARTITUDE-4 trial.

Binod Dhakal, MD, MS, provides an overview of the CARTITUDE-4 trial, including its methods, design, and inclusion criteria.

Binod Dhakal, MD, MS, discusses some of the challenges often seen in the myeloma space, particularly those with lenalidomide-refractory multiple myeloma.

Binod Dhakal, MD, MS, discusses why patients could benefit from earlier use of chimeric antigen receptor T-cell therapy in relapsed/refractory multiple myeloma.

Binod Dhakal, MD, MS, discusses selecting patients for chimeric antigen receptor T-cell therapy by considering each patient’s condition and logistics.

In this episode of Targeted Talks, Binod Dhakal, MD, MS, discusses the recent FDA approval of ciltacabtagene autoleucel for the treatment of relapsed/refractory multiple myeloma.