Ajai Chari, MD

Dr. Ajai Chari and Dr. Rahul Banerjee conclude the discussion by exploring future opportunities to further improve outcomes for patients with relapsed/refractory multiple myeloma (RRMM).

Dr. Ajai Chari and Dr. Rahul Banerjee discuss the increasingly complex treatment sequencing decisions facing clinicians in relapsed/refractory multiple myeloma (RRMM) as the number of highly active immunotherapy options continues to expand.

Dr. Ajai Chari and NP Samantha Shenoy conclude the program by summarizing the key clinical insights surrounding the management of newly diagnosed multiple myeloma (NDMM) and the evolving role of daratumumab-based treatment strategies. The faculty reflect on the importance of achieving deep and durable responses, the growing clinical relevance of minimal residual disease (MRD) assessment, and the value of long-term follow-up data in informing frontline treatment decisions. They discuss how contemporary evidence from studies such as MAIA and CEPHEUS has contributed to current treatment paradigms while emphasizing the need for individualized care based on patient characteristics, treatment goals, and tolerability. Dr. Chari and NP Shenoy reinforce the importance of multidisciplinary collaboration, patient engagement, and ongoing evaluation of emerging evidence to optimize long-term outcomes. The discussion concludes with practical perspectives on integrating clinical trial findings into routine management of patients with NDMM.

Dr. Ajai Chari and Dr. Rahul Banerjee explore future directions for talquetamab in relapsed/refractory multiple myeloma (RRMM), focusing on emerging combination strategies designed to enhance the activity of T-cell–redirecting therapies.

Dr. Ajai Chari and Dr. Rahul Banerjee discuss the evolving understanding of neurologic adverse events associated with GPRC5D-directed therapies in relapsed/refractory multiple myeloma (RRMM).

Dr. Ajai Chari and NP Samantha Shenoy discuss practical aspects of managing newly diagnosed multiple myeloma (NDMM) in routine clinical practice, emphasizing the importance of individualized care throughout the treatment journey. The faculty review strategies for monitoring patients receiving long-term therapy, addressing treatment-related adverse events, and maintaining adherence through proactive supportive care and patient education. The conversation highlights the value of multidisciplinary collaboration, including the role of advanced practice providers in coordinating care, reinforcing treatment expectations, and facilitating shared decision-making. Dr. Chari and NP Shenoy also discuss how ongoing communication with patients can help manage quality-of-life concerns while supporting treatment continuity and long-term disease control. The discussion underscores the importance of integrating clinical trial evidence with practical experience to optimize frontline management and deliver patient-centered care for individuals living with NDMM.

Dr. Ajai Chari and NP Samantha Shenoy conclude the discussion by reflecting on the evolving management of newly diagnosed multiple myeloma (NDMM) and the clinical implications of recent advances in CD38-directed therapy. The faculty summarize how long-term follow-up from contemporary clinical trials has reinforced the importance of achieving deep responses while balancing efficacy, safety, and patient-centered treatment goals. The conversation explores the growing role of minimal residual disease (MRD) assessment, ongoing therapy, and individualized treatment duration as areas of continued clinical interest, while emphasizing that treatment decisions should remain tailored to each patient's overall health status and preferences. Dr. Chari and NP Shenoy also discuss practical considerations for multidisciplinary care, patient education, and longitudinal follow-up, highlighting the importance of shared decision-making as frontline treatment strategies continue to evolve and additional long-term evidence becomes available for patients with NDMM.

Dr. Ajai Chari and Dr. Rahul Banerjee review the key efficacy and safety findings from the phase 3 MonumenTAL-3 study in relapsed/refractory multiple myeloma (RRMM).

Dr. Ajai Chari and Dr. Rahul Banerjee discuss the clinical rationale behind the phase 3 MonumenTAL-3 study and its role in confirming the benefit-risk profile of talquetamab in relapsed/refractory multiple myeloma (RRMM).

Dr. Ajai Chari and NP Samantha Shenoy discuss practical considerations for long-term management of newly diagnosed multiple myeloma (NDMM), focusing on treatment duration, ongoing therapy, and patient-centered care. The faculty explore the rationale for continuous treatment approaches and how response depth, including minimal residual disease (MRD) negativity, may continue to evolve with extended therapy. The conversation emphasizes that treatment duration decisions should be individualized based on tolerability, patient preferences, comorbidities, and long-term management goals. Dr. Chari and NP Shenoy also review real-world follow-up strategies, highlighting the importance of multidisciplinary collaboration, symptom management, patient education, and shared decision-making throughout the treatment journey. Practical insights are provided regarding the role of advanced practice providers in supporting adherence, monitoring treatment-related toxicities, and helping patients navigate prolonged therapy while maintaining quality of life and optimizing clinical outcomes in NDMM.

Dr. Ajai Chari and NP Samantha Shenoy review the CEPHEUS trial and discuss its contribution to the evolving frontline treatment landscape in newly diagnosed multiple myeloma (NDMM). The faculty summarize the study design and examine the rationale for incorporating daratumumab into a quadruplet regimen for patients without planned upfront transplant. The discussion focuses on the achievement of deeper responses and higher rates of minimal residual disease (MRD) negativity observed with the daratumumab-containing regimen, as well as the clinical relevance of sustained MRD negativity and response depth over time. Dr. Chari and NP Shenoy explore how MRD assessment may provide additional insight into long-term disease control and discuss the potential implications of these findings for treatment duration and future management strategies. The conversation emphasizes interpretation of emerging data while considering how evolving evidence may influence clinical decision-making in patients with NDMM.

Dr. Ajai Chari and Dr. Rahul Banerjee review the clinical development of talquetamab in relapsed/refractory multiple myeloma (RRMM), focusing on key findings from the MonumenTAL-1 study and the evolution of GPRC5D-directed therapy.

Dr. Ajai Chari and Dr. Rahul Banerjee discuss the growing need for therapeutic targets beyond BCMA in relapsed/refractory multiple myeloma (RRMM) and examine the rationale for GPRC5D-directed therapies.

Dr. Ajai Chari and NP Samantha Shenoy examine the long-term efficacy outcomes from the MAIA trial and discuss the clinical significance of response depth in newly diagnosed multiple myeloma (NDMM). The faculty review progression-free survival improvements, increasing rates of complete response, and the achievement of minimal residual disease (MRD) negativity with daratumumab-based therapy compared with the control regimen. The conversation focuses on how responses may continue to deepen with ongoing treatment and explores the relationship between MRD negativity, durable disease control, and long-term patient outcomes. Dr. Chari and NP Shenoy also discuss the evolving role of MRD assessment as a tool for evaluating treatment effectiveness and highlight how long-term follow-up data can inform clinical decision-making regarding continued therapy. The discussion emphasizes practical interpretation of the MAIA findings and their relevance to contemporary frontline management strategies for patients with NDMM.

Dr. Ajai Chari and NP Samantha Shenoy review the design and long-term follow-up results of the MAIA trial and discuss their clinical implications for the management of newly diagnosed multiple myeloma (NDMM) in transplant-ineligible patients. The faculty examine key efficacy outcomes, including progression-free survival, overall survival, and minimal residual disease (MRD) negativity, while highlighting the continued deepening of responses observed with ongoing daratumumab-based therapy. Dr. Chari and NP Shenoy discuss the relevance of continuous treatment until disease progression, the durability of clinical benefit demonstrated with extended follow-up, and the applicability of the MAIA patient population to everyday clinical practice. The conversation also addresses safety and tolerability considerations associated with long-term treatment and explores how these findings have influenced frontline treatment decisions and expectations for sustained disease control in patients with NDMM.

New trials show BCMA bispecifics and CAR‑T boost survival in early relapsed, high‑risk myeloma, outperforming Dara-based triplets.

Experts unpack how frontline CD38 quadruplets reshape relapse strategy and high‑risk definitions, spotlighting talquetamab’s promise in myeloma.

Dr. Ajai Chari and NP Samantha Shenoy discuss the clinical rationale for incorporating daratumumab-based regimens into the frontline management of newly diagnosed multiple myeloma (NDMM). The conversation explores the biologic rationale for targeting CD38 and reviews how daratumumab-based combinations have contributed to deeper responses and improved minimal residual disease (MRD) negativity in clinical studies. The faculty discuss patient selection in transplant-ineligible disease, emphasizing the importance of balancing efficacy with tolerability, comorbidities, and long-term treatment goals. Dr. Chari and NP Shenoy also share their perspectives on how CD38-directed therapy has influenced frontline treatment strategies and discuss practical considerations when selecting regimens for older or medically complex patients. The discussion provides important clinical context for understanding the evidence supporting daratumumab-based approaches and their role in optimizing outcomes for patients with NDMM.

Dr. Ajai Chari and NP Samantha Shenoy introduce the program by reviewing the evolving treatment landscape in newly diagnosed multiple myeloma (NDMM) and discussing the factors that influence contemporary frontline treatment decisions. The faculty highlight the shift toward individualized treatment selection based on patient fitness, frailty, comorbidities, and treatment goals rather than transplant eligibility alone. They explore the growing incorporation of CD38-targeted therapies into frontline treatment strategies, the increasing emphasis on achieving deep and durable responses, and the importance of long-term disease control. Dr. Chari and NP Shenoy also discuss the expanding role of quadruplet regimens, minimal residual disease (MRD) assessment, and treatment duration considerations as part of modern NDMM management. The conversation establishes the clinical context for the subsequent review of MAIA and CEPHEUS trial data and their implications for everyday practice.

Panelists discuss how patients relapsing shortly after BCMA CAR T-cell therapy should receive GPRC5D-targeted bispecifics rather than repeat BCMA therapies, given the evidence that prior BCMA exposure reduces efficacy of subsequent BCMA-directed treatments.

Panelists discuss how a triple class–exposed patient with comorbidities like COPD represents an ideal candidate for BCMA-directed bispecific therapy over CAR T-cell therapy due to the ability to titrate dosing and manage respiratory infection risks.

Panelists discuss how community practices need clear protocols for after-hours fever management, adequate caregiver support assessment, and standardized algorithms for cytokine release syndrome treatment across multiple bispecific products.

Panelists discuss how step-up dosing has successfully transitioned from inpatient-only to hybrid and outpatient models using prophylactic tocilizumab and standardized protocols for managing cytokine release syndrome.

Panelists discuss how talquetamab’s unique skin and taste toxicities are manageable through dose modifications and supportive care, with IVIG prophylaxis being crucial for BCMA-targeted but not necessarily GPRC5D-targeted therapies.

Panelists discuss how real-world data consistently show bispecific efficacy matching clinical trial results despite treating higher-risk patients, and how prophylactic interventions have reduced cytokine release syndrome severity.

Panelists discuss how CAR T-cell therapy should generally precede bispecifics when possible due to T-cell exhaustion concerns, though they agree there are virtually no absolute contraindications to bispecific therapy.

Panelists discuss how bispecifics are reversing the historical paradigm of diminishing returns in relapsed/refractory multiple myeloma, achieving 60% to 70% response rates lasting over a year in heavily pretreated patients.

Panelists discuss how patient preferences for treatment-free intervals are increasingly important in therapy selection, with bispecifics offering potential for response-adapted dosing and early discontinuation while maintaining remissions.

Panelists discuss how their key takeaways emphasize the importance of communication and collaboration between academic centers and community practices to ensure equitable access to bispecific therapies, highlighting that it’s an exciting time in myeloma treatment with patient-friendly options that can be administered closer to home, and concluding that virtually no patient should be denied exposure to bispecific therapy before discontinuing treatment, while anticipating that de-escalated Q4 weekly schedules and trispecific agents will transform current practice patterns in the coming years.

Panelists discuss how a woman aged 69 years with standard-risk relapsed/refractory multiple myeloma (R/R MM), significant comorbidities including chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD), and history of respiratory infections would be a reasonable candidate for talquetamab despite infection concerns, citing that GPRC5D-targeting agents show much lower infection rates (less than 10%) compared with B-cell maturation antigen (BCMA) bispecifics (around 50%) due to preferential expression on malignant cells rather than normal B cells, with no requirement for prophylaxis and evidence of preserved humoral immunity including COVID-19 vaccine responses.