MULTIPLE MYELOMA

Ashraf Z. Badros, MB, ChB, discusses the results of the phase 3 AURIGA trial which evaluated daratumumab and lenalidomide vs lenalidomide maintenance in patients with newly diagnosed multiple myeloma.

Ashraf Z. Badros, MB, ChB, discusses the background, methods, and design of the phase 3 AURIGA trial.

The panelist discusses how the treatment landscape for early-stage relapsed/refractory multiple myeloma (R/R MM) has evolved significantly with CAR T-cell therapies (idecabtagene vicleucel, ciltacabtagene autoleucel [ide-cel, cilta-cel]) and novel drug combinations. Treatment selection now considers prior therapies, patient characteristics, and response duration. For third-line chimeric antigen receptor (CAR) T after no prior CAR T use, cilta-cel shows favorable efficacy data with deeper, more durable responses than ide-cel, though both are viable options.

The panelist discusses how the patient had triplet therapy 6 years ago, which was the standard for myeloma treatment at the time. Since then, the patient has had a biochemical relapse, renal insufficiency, and moderate anemia, so he needs therapy but not immediate therapy.

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 intravenous immunoglobulin (IVIG) therapy may reduce infection risk in patients with multiple myeloma who are receiving teclistamab treatment.

Panelists discuss how minimal residual disease assessment demonstrates superior depth of response with ciltacabtagene autoleucel compared with standard of care in patients who have lenalidomide-refractory multiple myeloma and received 1 to 3 prior therapies.

Panelists discuss how adding a fourth drug (daratumumab) to standard triplet induction therapy may improve outcomes for patients with newly diagnosed, transplant-eligible multiple myeloma.

Panelists discuss how the AQUILA trial evaluated whether daratumumab monotherapy provides superior outcomes compared with active monitoring in high-risk smoldering multiple myeloma patients.

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.

During a Case-Based Roundtable® event, Omar Nadeem, MD, and participants discussed managing toxicities of talquetamab in the second article of a 2-part series.

In a discussion with Peers & Perspectives in Oncology, fellowship program director Marc J. Braunstein, MD, PhD, FACP, and hematology/oncology fellow Olivia Main, MD, talk about how recent trials shape their approach for a patient with transplant-eligible multiple myeloma.

During a Case-Based Roundtable® event, Hana Safah, MD, discussed updated data and adverse event management related to teclistamab in patients with multiple myeloma in the second article of a 2-part series.

Anita D'Souza, MD, discusses an abstract looking at the combination of teclistamab-cqyv, daratumumab, and pomalidomide in 2 phase studies for patients with multiple myeloma.

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.

Treatment with anitocabtagene autoleucel produced durable efficacy in patients with relapsed/refractory multiple myeloma.

Ciltacabtagene autoleucel achieved a 100% complete response rate in patients with high-risk smoldering multiple myeloma, as reported in findings from a single-arm phase 2 trial.

Anita D'Souza, MD, discusses some of the potentially practice-changing data that were presented at the 2024 ASH Annual Meeting.

Arlocabtagene autoleucel led to antitumor activity and an acceptable safety profile in heavily pretreated relapsed/refractory multiple myeloma, according to updated phase 1 trial data.

The induction regimen of isatuximab plus RVd significantly improved progression-free survival vs RVd alone in transplant-eligible patients with newly diagnosed multiple myeloma.

Lisaftoclax, a BCL-2 inhibitor, demonstrated efficacy and tolerability in combination with pomalidomide and dexamethasone in patients with relapsed/refractory multiple myeloma as well as amyloidosis.

In a retrospective cohort of patients with central nervous system manifestations of multiple myeloma, ide-cel CAR T-cell therapy was effective.

Cilta-cel improved minimal residual disease negativity in lenalidomide-refractory multiple myeloma vs standard care, per CARTITUDE-4 results.

The phase 3 IMROZ trial showed isatuximab plus VRd and Rd maintenance improved MRD negativity and responses versus VRd alone in transplant-ineligible newly diagnosed multiple myeloma.