MULTIPLE MYELOMA

Ciltacabtagene autoleucel improved minimal residual disease negativity and sustained responses vs standard care in lenalidomide-refractory multiple myeloma.

One concern with bispecific antibody therapies in community settings is managing adverse events, with emerging patterns guiding management strategies.

During a Case-Based Roundtable® event, Muhammad Umair Mushtaq, MD, discussed managing long-term toxicity concerns related to CAR T-cell therapy in multiple myeloma.

The FDA has accepted the resubmitted biologics license application for linvoseltamab to treat relapsed/refractory multiple myeloma in heavily pretreated adults.

The panelist discusses how real-world evidence for CAR T in relapsed/refractory multiple myeloma shows promising efficacy but with some differences from clinical trials. Ide-cel demonstrates effectiveness in patients with prior BCMA exposure, though responses may be impacted. Compared with standard of care (SOC), both ide-cel and cilta-cel show superior outcomes in terms of response rates and progression-free survival, though long-term data are still emerging in real-world settings.

The panelist discusses how the KarMMa-3 trial data demonstrated the superior efficacy of ide-cel vs standard regimens in triple-class exposed R/R MM, with a median progression-free survival of 13.3 vs 4.4 months and an overall response rate of 71% vs 42%. The favorable safety profile and significant survival benefit support ide-cel as a preferred option for third-line and greater treatment, particularly in patients with good performance status who can tolerate bridging therapy.

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.

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.

Bispecific antibody therapy is transforming cancer treatment, especially in multiple myeloma, with ongoing studies exploring early-line and maintenance use.

During a Case-Based Roundtable® event, Rahul Banerjee, MD, discussed approaches to dosing and tolerability when using talquetamab in patients with relapsed/refractory multiple myeloma.

The phase 3 IRAKLIA trial of subcutaneous isatuximab met its co-primary end points in multiple myeloma.

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).

During a Case-Based Roundtable® event, Hira Shaikh, MD, and participants discussed how they would treat a patient with lenalidomide-refractory multiple myeloma after 1 prior line of therapy.

In separate, live events, Binod Dhakal, MD, MS; and Laahn H. Foster, MD, polled oncologists on therapeutic options for a patient with multiple myeloma and progressive disease.

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.