MULTIPLE MYELOMA

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.

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.

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.

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.

Samer A. Al’Hadidi, MD, discusses social determinants and resources that can help patients receive chimeric antigen receptor T-cell therapy for relapsed/refractory multiple myeloma.

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.

Samer A. Al’Hadidi, MD, discusses the follow-up data for ciltacabtagene autoleucel in patients with multiple myeloma.