Multiple Myeloma

This segment highlights the treatment journey of a 68-year-old IT professional with high-risk multiple myeloma, detailing progression after initial D-RVd therapy, refusal of ASCT, and successful transition to cilta-cel CAR-T therapy with manageable adverse events.

This segment discusses the process and critical importance of bridging strategies for patients awaiting CAR T-cell therapy.

Panelists discuss how isatuximab- and daratumumab-based quadruplet regimens compare in patients with transplant-ineligible/deferred newly diagnosed multiple myeloma (NDMM), with a particular focus on minimal residual disease (MRD) negativity data from the IMROZ and CEPHEUS trials, presented at the 2024 American Society of Hematology (ASH) Annual Meeting and Exposition.

Panelists discuss how treatment strategies and sequencing decisions for patients with multiple myeloma who decline transplantation despite eligibility must be carefully tailored, considering both immediate therapeutic goals and potential future treatment options.

Findings from RedirecTT-1 show responses across different dose levels of talquetamab/teclistamab among those with multiple myeloma.

Clonal hematopoiesis may be associated with the early development of toxic events in patients with newly diagnosed multiple myeloma.

Real-world data show that closer monitoring may be necessary for patients with relapsed/refractory multiple myeloma and baseline renal impairment.

This segment examines the decision-making process between CAR-T therapy and other innovative treatments, exploring scenarios where alternative therapies may be more appropriate.

This segment highlights clinical experiences with ide-cel in the second-line setting, focusing on observed improvements in efficacy and quality of life, as well as challenges in administration

Panelists discuss how the CEPHEUS study comparing subcutaneous daratumumab plus VRd vs VRd alone in patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM) provides important insights into the role of quadruplet therapy in this specific population.

Panelists discuss how UCSF Health has learned that successful integration of CAR T-cell therapy in multiple myeloma requires multidisciplinary collaboration, patient selection optimization, and management of toxicities. Future research includes exploring CAR T-cell therapy in earlier treatment lines and combining it with novel agents to enhance efficacy.

Panelists discuss collaborating with community practices on CAR T-cell therapy for multiple myeloma through joint clinical trials, patient education programs, and shared data initiatives. These partnerships enhance treatment access, foster innovation, and improve patient outcomes across diverse settings.

Panelists discuss how the evolving treatment landscape for patients with transplant-eligible newly diagnosed multiple myeloma (NDMM) is being shaped by emerging data on optimal treatment sequencing strategies, both in frontline settings and subsequent lines of therapy.

Having extramedullary disease correlated with worse PFS and OS among patients who received belantamab mafodotin for relapsed/refractory multiple myeloma.

Panelists discuss how recent findings from the GMMG-HD7 trial comparing isatuximab-RVd vs RVd have shaped treatment decision-making in patients with multiple myeloma by providing comparative efficacy and safety data between the 2 regimens.

Complete response rate strongly correlated with lower SLiM-CRAB incidence and biochemical progression in those with high-risk smoldering multiple myeloma.

Patients who received the isatuximab combination in the IMROZ trial experienced prolonged MRD-negativity, which correlated with improved PFS.

Additionally, the Chinese Society of Clinical Oncology and Chinese Anti-Cancer Association guidelines recommend the isatuximab regimen for this population.

Panelists discuss how, when considering earlier lines of CAR T-cell therapy for relapsed/refractory multiple myeloma, key institutional factors include patient fitness/age, cytogenetic risk status, prior therapy response duration, and BCMA expression levels. Manufacturing timelines, financial considerations, and center-specific outcomes data also influence timing decisions. For patients receiving early-line CAR T therapy, subsequent treatment options typically focus on novel agent combinations or clinical trials exploring additional cellular therapies, with choices guided by response duration to CAR T and the patient’s individual disease characteristics and treatment goals.

Panelists discuss how, for second-line treatment of relapsed/refractory multiple myeloma (R/R MM), patients suitable for CAR T-cell (cilta-cel vs ide-cel) therapy typically have a poor prognosis with limited response to prior therapies. Institutional guidelines focus on factors such as prior lines of therapy, organ function, and cytogenetics. Non-medical factors, such as geographic access and financial constraints, also influence CAR T-cell therapy referral eligibility.

Panelists explain how CAR-T cell therapy works and describe the treatment process, discussing whether CAR -T is considered a complex procedure at their institution or if the logistics have been streamlined into clinical workflows, and they also detail their institution's approach to bridging therapy for patients awaiting CAR-T manufacturing and infusion, including whether patients are managed in-house or sent back to community centers.

Panelists discuss which patients are considered for CAR-T therapy in second-line treatment for relapsed/refractory multiple myeloma (R/R MM) (cilta-cel vs ide-cel), describe the specific criteria and institutional guidelines used to determine patient eligibility, and explore how non-medical factors like such as location and financial considerations impact patient selection, while also outlining the typical CAR-T referral process from community physician outreach to patient evaluation and selection.

Subcutaneous isatuximab yields noninferior results vs intravenous isatuximab when paired with pomalidomide and dexamethasone in the phase 3 IRAKLIA trial.

Panelists discuss how recent pivotal trials like PERSEUS and CASSIOPEIA demonstrate superior outcomes with daratumumab-based quadruplet and triplet combinations compared with standard regimens in transplant-eligible newly diagnosed multiple myeloma patients, particularly showing improved progression-free survival when daratumumab is added to VRd (bortezomib, lenalidomide, and dexamethasone) or VTd (bortezomib, thalidomide, and dexamethasone) backbones.

Life After CAR T: Patient and Clinical Perspectives on the Promise of CAR T in Multiple Myeloma