Hans Lee, MD

Experts discuss the transformative impact of T-cell –redirecting therapies in relapsed or refractory multiple myeloma, while highlighting ongoing challenges in optimizing treatment sequencing, managing toxicities, and expanding access—particularly in community settings—to ensure patients can safely and effectively benefit from these novel options.

In relapsed or refractory multiple myeloma, treatment becomes increasingly challenging as patients progress through multiple lines of therapy. With each relapse, response rates diminish and the duration of remission shortens. Although there are several approved drug classes available—including immunomodulatory agents, proteasome inhibitors, and monoclonal antibodies—treatment sequencing is complex and individualized. Many patients become have triple-class– exposed or even penta-refractory disease, limiting the effectiveness of standard options and highlighting the need for innovative therapies and optimized care strategies. The real-world use of these therapies is often complicated by cumulative toxicities and logistical barriers. For example, immune-based therapies such as bispecific antibodies and CAR -T cells offer promising efficacy but can require hospitalization, intensive monitoring, and specialized infrastructure. In addition, therapies like such as bispecific antibodies may necessitate step-up dosing protocols to mitigate risks such as cytokine release syndrome. These factors can impact affect access and adherence, especially in community settings where supportive care resources may be limited. As data from ongoing studies and real-world registries accumulate, it becomes increasingly important to close gaps in care for patients with advanced disease. Incorporating novel agents earlier in treatment, managing toxicities more effectively, and improving access to cellular therapies are key goals. Continued collaboration between academic and community providers will be essential to ensure that the growing arsenal of myeloma therapies translates into improved outcomes across all practice settings.

Panelists discuss how 4-drug regimens anchored by CD38 antibodies are becoming the standard of care in myeloma, with future directions focusing on integrating novel immunotherapies and potentially redefining the role of transplant.

Panelists discuss that Dara-VRD offers significant benefits in sustained minimal residual disease (MRD) negativity and progression-free survival with a manageable safety profile, emphasizing dose adjustments and supportive care to balance efficacy and toxicity in frontline multiple myeloma treatment.

Panelists discuss recent data showing that sustained minimal residual disease (MRD) negativity strongly predicts long-term progression-free survival (PFS) in multiple myeloma, regardless of whether patients receive a 4-drug daratumumab-based regimen or standard-drug therapy, emphasizing MRD negativity as a key surrogate end point; they also highlight challenges in predicting who benefits most from intensive therapy and the importance of individualized dosing strategies to balance efficacy and tolerability across different patient populations.

Panelists discuss updated American Society of Clinical Oncology (ASCO) data confirming that daratumumab-based quadruplet therapy (Dara-VRD) significantly improves progression-free survival (PFS) and sustains minimal residual disease (MRD) negativity in patients with newly diagnosed transplant-eligible multiple myeloma, reducing early relapses and reinforcing this regimen as the evolving standard of care with potential for unprecedented long-term outcomes.

Panelists discuss the Perseus study, which compared daratumumab-based quadruplet therapy (Dara-VRD) with VRD alone in patients with newly diagnosed, transplant-eligible multiple myeloma, highlighting its focus on a generally fit population and demonstrating improved progression-free survival and deeper responses with the 4-drug regimen, while noting some limitations in applicability to patients with significant comorbidities.

Panelists discuss the adoption of 4-drug regimens—including a CD38 monoclonal antibody—as the standard frontline therapy for patients with transplant-eligible multiple myeloma, emphasizing tailored modifications based on age and frailty, and evolving maintenance strategies that incorporate daratumumab to deepen and sustain responses post-transplant.

Panelists discuss the manageable safety profile of 4-drug regimens in patients with transplant-eligible multiple myeloma, highlighting dose modifications such as weekly bortezomib and dexamethasone tapering to reduce adverse effects, alongside vigilant infection monitoring to optimize tolerability and quality of life.

Panelists discuss updated American Society of Clinical Oncology (ASCO) data showing that 4-drug regimens significantly improve outcomes even in patients with transplant-ineligible multiple myeloma, with real-world dose modifications enabling broader use while maintaining efficacy and tolerability.

Panelists discuss updated American Society of Clinical Oncology (ASCO) data showing that adding a CD38 monoclonal antibody to frontline triplet therapy improves minimal residual disease (MRD) negativity and progression-free survival in standard and intermediate-risk multiple myeloma, while reinforcing the need for tailored strategies in high-risk patients.

Panelists discuss how recent data support the use of quadruplet regimens—including anti-CD38 antibodies—even in older or moderately frail patients with newly diagnosed multiple myeloma, shifting treatment decisions from transplant eligibility to functional status and depth of response.

Panelists discuss how subcutaneous anti-CD38 monoclonal antibodies are reshaping frontline multiple myeloma treatment by improving efficacy, tolerability, and patient convenience across both transplant-eligible and ineligible populations.

The panel concludes its discussion with key takeaways on the evolving treatment landscape for multiple myeloma.

Experts on multiple myeloma look to the future treatment landscape and discuss exciting updates presented at the 2024 ASCO Annual Meeting, highlighting belantamab mafodotin and combination therapies.

Samer Al'Hadidi, MD, provides a comprehensive overview of adverse event management practices for patients with multiple myeloma who receive CAR T-cell therapy.

Hans Lee, MD, discusses recent updates presented at ASCO 2024 surrounding cilta-cel CAR T-cell therapy in relapsed/refractory multiple myeloma.

Myeloma specialists discuss considerations they consider when determining how they sequence CAR T-cell therapies and bispecific antibodies.

Following ASCO 2024, Samer Al'Hadidi, MD, discusses recent updates from the PERSEUS trial evaluating the role of testing for minimal residual disease (MRD) in guiding treatment for relapsed/refractory multiple myeloma.

Experts on multiple myeloma provide comprehensive insights on treatment spacing and step-up dosing practices and discuss the long-term utilization of bispecific antibodies.

The expert panel shares clinical insights on sequencing CAR T-cell therapies and bispecific antibodies for patients with relapsed/refractory multiple myeloma.

Naresh Bumma, MD, and Hans Lee, MD, recap recent updates on the MagnetisMM-30 an MagnetisMM-32 studies investigating elranatamab, a BCMA-directed bispecific antibody.

Samer Al'Hadidi, MD, provides an overview of recent updates presented at ASCO 2024 from the MajesTEC-1 trial evaluating teclistamab in patients with relapsed/refractory multiple myeloma.

Hans Lee, MD, discusses recent updates from the MonumenTAL-2 study investigating talquetamab in patients with relapsed/refractory multiple myeloma.

Focusing on recent approvals in earlier lines of relapsed/refractory multiple myeloma, the panel has a comprehensive discussion on the CARTITUDE-4 and KarMMa-3 studies and shares clinical insights on administering CAR T-cell therapy and monitoring patients.

A panel of experts on multiple myeloma introduce themselves and discuss recent data presented on the phase 3 IMROZ trial for transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM).