Medscape InDiscussion: Multiple Myeloma

Drs Joseph Mikhael and Shaji Kumar discuss the future of multiple myeloma, including enhanced diagnostics for detecting myeloma, frontline therapy, and durable responses.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002718. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Multiple Myeloma https://emedicine.medscape.com/article/204369-overview

Updated Diagnostic Criteria and Staging System for Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/27249749/

Mass Spectrometry for the Evaluation of Monoclonal Proteins in Multiple Myeloma and Related Disorders: An International Myeloma Working Group Mass Spectrometry Committee Report https://pubmed.ncbi.nlm.nih.gov/33563895/

Multiple Myeloma Imaging https://emedicine.medscape.com/article/391742-overview

Next-Generation Biomarkers in Multiple Myeloma: Understanding the Molecular Basis for Potential Use in Diagnosis and Prognosis https://pubmed.ncbi.nlm.nih.gov/34299097/

Monoclonal Gammopathy of Undetermined Significance https://www.ncbi.nlm.nih.gov/books/NBK507880/

Primary Plasma Cell Leukemia: Consensus Definition by the International Myeloma Working Group According to Peripheral Blood Plasma Cell Percentage https://pubmed.ncbi.nlm.nih.gov/34857730/

Advancing MRD Detection in Multiple Myeloma: Technologies, Applications, and Future Perspectives https://pubmed.ncbi.nlm.nih.gov/40214184/

Genomic Landscape of Multiple Myeloma and Its Precursor Conditions https://pubmed.ncbi.nlm.nih.gov/40399554/

Quadruplet Regimens for Patients With Newly Diagnosed Multiple Myeloma: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/39348665/

Subcutaneous Daratumumab (Dara) + Bortezomib/Lenalidomide/Dexamethasone (VRd) With Dara + Lenalidomide (DR) Maintenance in Transplant-Eligible (TE) Patients With Newly Diagnosed Multiple Myeloma (NDMM): Analysis of Sustained Minimal Residual Disease Negativity in the Phase 3 PERSEUS Trial https://ascopubs.org/doi/10.1200/JCO.2025.43.16_suppl.7501

Isatuximab, Carfilzomib, Lenalidomide, and Dexamethasone Induction in Newly Diagnosed Myeloma: Analysis of the MIDAS Trial https://pubmed.ncbi.nlm.nih.gov/39841461/

Comparing Combinations of Drugs to Treat Newly Diagnosed Multiple Myeloma (NDMM) When a Stem Cell Transplant Is Not a Medically Suitable Treatment https://www.clinicaltrials.gov/study/NCT05561387

Cytokine Release Syndrome and Associated Neurotoxicity in Cancer Immunotherapy https://pubmed.ncbi.nlm.nih.gov/34002066/

The Role of CELMoD Agents in Multiple Myeloma https://pmc.ncbi.nlm.nih.gov/articles/PMC12399888/

Phase 2 Study of Talquetamab + Teclistamab in Patients With Relapsed/Refractory Multiple Myeloma and Extramedullary Disease: REDIRECTT-1 https://library.ehaweb.org/eha/2025/eha2025-congress/4173809/shaji.kumar.phase.2.study.of.talquetamab.2B.teclistamab.in.patients.with.html

Discovery of a Novel Class NSD2 Inhibitor for Multiple Myeloma With t(4;14) https://pubmed.ncbi.nlm.nih.gov/40949769/

Long-Term (≥5 Year) Remission and Survival After Treatment With Ciltacabtagene Autoleucel (Cilta-Cel) in CARTITUDE-1 Patients (Pts) With Relapsed/Refractory Multiple Myeloma (RRMM) https://ascopubs.org/doi/10.1200/JCO.2025.43.16_suppl.7507

Drs Joseph Mikhael and Sigurdur Y. Kristinsson discuss whether it is time to screen for multiple myeloma and what we can learn from the iStopMM study.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002717. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Multiple Myeloma https://emedicine.medscape.com/article/204369-overview

Screening in Multiple Myeloma and Its Precursors: Are We There Yet? https://pubmed.ncbi.nlm.nih.gov/38175579/

Iceland Screens, Treats, or Prevents Multiple Myeloma (iStopMM): A Population-Based Screening Study for Monoclonal Gammopathy of Undetermined Significance and Randomized Controlled Trial of Follow-Up Strategies https://pubmed.ncbi.nlm.nih.gov/34001889/

Identifying Associations Between Race and Gender in the Incidence and Mortality of Patients With Multiple Myeloma https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.e20052

Revisiting Wilson and Jungner in the Genomic Age: A Review of Screening Criteria Over the Past 40 Years https://pubmed.ncbi.nlm.nih.gov/18438522/

International Myeloma Foundation https://www.myeloma.org/

Prevalence of Monoclonal Gammopathy of Undetermined Significance https://pubmed.ncbi.nlm.nih.gov/16571879/

Monoclonal Gammopathy of Undetermined Significance https://www.ncbi.nlm.nih.gov/books/NBK507880/

Prevalence and Risk of Progression of Light-Chain Monoclonal Gammopathy of Undetermined Significance: A Retrospective Population-Based Cohort Study https://pubmed.ncbi.nlm.nih.gov/20472173/

Mode of Progression in Smoldering Multiple Myeloma: A Study of 406 Patients https://pubmed.ncbi.nlm.nih.gov/38228628/

Observation or Treatment for Smoldering Multiple Myeloma? A Systematic Review and Meta-Analysis of Randomized Controlled Studies https://pubmed.ncbi.nlm.nih.gov/40419473/

Drs Joseph Mikhael and Peter Voorhees discuss considerations for treating smoldering multiple myeloma, including recent studies and shared decision-making.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002716. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Observation or Treatment for Smoldering Multiple Myeloma? A Systematic Review and Meta-Analysis of Randomized Controlled Studies https://pubmed.ncbi.nlm.nih.gov/40419473/

Monoclonal Gammopathy of Undetermined Significance https://www.ncbi.nlm.nih.gov/books/NBK507880/

From Criteria to Clinic: How Updated Slim CRAB Criteria Influence Multiple Myeloma Diagnostic Activity https://ascopubs.org/doi/pdf/10.1200/JCO.2024.42.16_suppl.7556

International Myeloma Working Group Risk Stratification Model for Smoldering Multiple Myeloma (SMM) https://pubmed.ncbi.nlm.nih.gov/33067414/

Daratumumab or Active Monitoring for High-Risk Smoldering Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/39652675/

Lenalidomide-Dexamethasone Versus Observation in High-Risk Smoldering Myeloma After 12 Years of Median Follow-Up Time: A Randomized, Open-Label Study https://pubmed.ncbi.nlm.nih.gov/36067617/

Long-Term Outcome With Lenalidomide and Dexamethasone Therapy for Newly Diagnosed Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/23648667/

CD38-Directed Therapies for Management of Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/34235096/

Fixed Duration Therapy With Daratumumab, Carfilzomib, Lenalidomide and Dexamethasone for High Risk Smoldering Multiple Myeloma – Results of the Ascent Trial https://ashpublications.org/blood/article/140/Supplement%201/1830/492739/Fixed-Duration-Therapy-with-Daratumumab

Curative Strategy for High-Risk Smoldering Myeloma: Carfilzomib, Lenalidomide, and Dexamethasone (Krd) Followed by Transplant, Krd Consolidation, and Rd Maintenance https://pubmed.ncbi.nlm.nih.gov/39038268/

Early Safety and Efficacy of CAR-T Cell Therapy in Precursor Myeloma: Results of the CAR-PRISM Study Using Ciltacabtagene Autoleucel in High-Risk Smoldering Myeloma https://ashpublications.org/blood/article/144/Supplement%201/1027/531466/Early-Safety-and-Efficacy-of-CAR-T-Cell-Therapy-in

Joseph Mikhael, MD, and Krina K. Patel, MD, MSc, discuss considerations for CAR T-Cell therapy in multiple myeloma, including age, access, and bridging therapy.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002715. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Multiple Myeloma https://emedicine.medscape.com/article/204369-overview

CARTITUDE-1 Final Results: Phase 1b/2 Study of Ciltacabtagene Autoleucel in Heavily Pretreated Patients With Relapsed/Refractory Multiple Myeloma https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.8009

Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/37272512/

Plain Language Summary of the KarMMa-3 Study of Ide-cel or Standard of Care Regimens in People With Relapsed or Refractory Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/38651976/

CAR T-Cell Therapy Toxicity https://www.ncbi.nlm.nih.gov/books/NBK592426/

Immunomodulatory Drugs in Multiple Myeloma: Mechanisms of Action and Clinical Experience https://pubmed.ncbi.nlm.nih.gov/28205024/

Incidence and Outcomes of Cytomegalovirus Reactivation After Chimeric Antigen Receptor T-Cell Therapy https://pubmed.ncbi.nlm.nih.gov/38838226/

Long-Acting Granulocyte Colony-Stimulating Factor in Primary Prophylaxis of Early Infection in Patients With Newly Diagnosed Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/35064823/

Revisiting the Role of Alkylating Agents in Multiple Myeloma: Up-to-Date Evidence and Future Perspectives https://pubmed.ncbi.nlm.nih.gov/37244325/

Bispecific Antibodies for the Treatment of Relapsed/Refractory Multiple Myeloma: Updates and Future Perspectives https://pubmed.ncbi.nlm.nih.gov/38660139/

FDA Eliminates REMS for Approved CAR T-Cell Therapies https://www.aabb.org/news-resources/news/article/2025/06/30/fda-eliminates-rems-for-approved-car-t-cell-therapies

Drs Joseph Mikhael and Saad Usmani discuss why quadruplet therapy is now the new standard of care for treating newly diagnosed multiple myeloma patients.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002714. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Daratumumab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/38084760/

Isatuximab, Lenalidomide, Dexamethasone and Bortezomib in Transplant-Ineligible Multiple Myeloma: The Randomized Phase 3 BENEFIT Trial https://pubmed.ncbi.nlm.nih.gov/38830994/

Daratumumab Plus Bortezomib, Lenalidomide and Dexamethasone for Transplant-Ineligible or Transplant-Deferred Newly Diagnosed Multiple Myeloma: The Randomized Phase 3 CEPHEUS Trial https://pubmed.ncbi.nlm.nih.gov/39910273/

Isatuximab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/38832972/

A Phase 2 Study of Modified Lenalidomide, Bortezomib and Dexamethasone in Transplant-Ineligible Multiple Myeloma https://pubmed.ncbi.nlm.nih.gov/29740809/

Bortezomib With Lenalidomide and Dexamethasone Versus Lenalidomide and Dexamethasone Alone in Patients With Newly Diagnosed Myeloma Without Intent for Immediate Autologous Stem-Cell Transplant (SWOG S0777): A Randomised, Open-Label, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/28017406/

Daratumumab, Lenalidomide, Bortezomib, and Dexamethasone for Transplant-Eligible Newly Diagnosed Multiple Myeloma: The GRIFFIN Trial https://pubmed.ncbi.nlm.nih.gov/32325490/

Carfilzomib Induction, Consolidation, and Maintenance With or Without Autologous Stem-Cell Transplantation in Patients With Newly Diagnosed Multiple Myeloma: Pre-Planned Cytogenetic Subgroup Analysis of the Randomised, Phase 2 FORTE Trial https://pubmed.ncbi.nlm.nih.gov/36528035/

Results of the Phase III Randomized Iskia Trial: Isatuximab-Carfilzomib-Lenalidomide-Dexamethasone Vs Carfilzomib-Lenalidomide-Dexamethasone As Pre-Transplant Induction and Post-Transplant Consolidation in Newly Diagnosed Multiple Myeloma Patients https://www.sciencedirect.com/science/article/abs/pii/S0006497123735416

Joseph Mikhael, MD, and Surbhi Sidana, MD, discuss the importance of balancing treatment intervals, managing side effects, and maximizing quality of life in multiple myeloma patients.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002713. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Acyclovir Prophylaxis Against Varicella Zoster Virus Reactivation in Multiple Myeloma Patients Treated With Bortezomib-Based Therapies: A Retrospective Analysis of 100 Patients https://pubmed.ncbi.nlm.nih.gov/22222250/

Monitoring, Prophylaxis, and Treatment of Infections in Patients With MM Receiving Bispecific Antibody Therapy: Consensus Recommendations From an Expert Panel https://pubmed.ncbi.nlm.nih.gov/37528088/

Characterization of Dysgeusia and Xerostomia in Patients With Multiple Myeloma Treated With the T-Cell Redirecting GPRC5D Bispecific Antibody Talquetamab https://pubmed.ncbi.nlm.nih.gov/38092979/

Idecabtagene Vicleucel for Relapsed/Refractory Multiple Myeloma: Real-World Experience From the Myeloma CAR T Consortium https://pubmed.ncbi.nlm.nih.gov/36623248/

Incidence, Prognostic Impact and Clinical Outcomes of Renal Impairment In Patients With Multiple Myeloma: A Population-Based Registry https://pubmed.ncbi.nlm.nih.gov/31773154/

International Myeloma Working Group https://www.myeloma.org/international-myeloma-working-group

IMWG Scientific and Working Committees https://www.myeloma.org/international-myeloma-working-group/imwg-scientific-working-committees

Drs Joseph Mikhael and Brandon Blue reveal the impact of disparities in multiple myeloma and pave a path forward to culturally competent care.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/964342). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Multiple Myeloma Awareness and African American Disparities https://www.cancer.gov/about-nci/organization/crchd/blog/2017/multiple-myeloma-disparities

Multiple Myeloma https://emedicine.medscape.com/article/204369-overview

International Myeloma Foundation https://www.myeloma.org/

International Myeloma Foundation Launches "M-Power Charlotte" to Improve Outcomes in Multiple Myeloma, a Cancer That Disproportionately Affects African Americans https://www.myeloma.org/international-myeloma-foundation-launches-m-power-charlotte-improve-outcomes-multiple-myeloma

The Tuskegee Timeline https://www.cdc.gov/tuskegee/timeline.htm

Drs Joseph Mikhael and Nina Shah discuss the exciting future in multiple myeloma in which bispecifics, CELMoDs, modakafusp, and easily delivered CAR T-cell therapy all may play a role.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/964340). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

International Myeloma Foundation https://www.myeloma.org/

CAR T-Cell Therapy for Multiple Myeloma https://decisionpoint.medscape.com/oncology/viewarticle/951727

Bispecific Antibodies Versus CAR T-Cells in Multiple Myeloma Treatment: Pros and Cons https://decisionpoint.medscape.com/oncology/viewarticle/967868

Cytokine Release Syndrome https://emedicine.medscape.com/article/2500111-overview

Bispecific Antibodies With Multiple Targets Moving Forward in Multiple Myeloma https://ascopost.com/issues/may-10-2022-supplement-hematologic-oncology-almanac/bispecific-antibodies-with-multiple-targets-moving-forward-in-multiple-myeloma/

Study to Evaluate the Safety and Tolerability of CC-92328 in Participants With Relapsed and/or Refractory Multiple Myeloma https://clinicaltrials.gov/ct2/show/NCT04975399

B-Cell Maturation Antigen (BCMA) in Multiple Myeloma: Rationale for Targeting and Current Therapeutic Approaches https://www.nature.com/articles/s41375-020-0734-z

GPRC5D Is a Target for the Immunotherapy of Multiple Myeloma With Rationally Designed CAR T Cells https://www.science.org/doi/10.1126/scitranslmed.aau7746

Phase I Study of the Anti-FcRH5 Antibody-Drug Conjugate DFRF4539A in Relapsed or Refractory Multiple Myeloma https://www.nature.com/articles/s41408-019-0178-8

belantamab mafodotin https://reference.medscape.com/drug/blenrep-belantamab-mafodotin-4000056

idecabtagene vicleucel https://reference.medscape.com/drug/abecma-idecabtagene-vicleucel-4000133

ciltacabtagene autoleucel https://reference.medscape.com/drug/carvykti-ciltacabtagene-autoleucel-4000224

A Study of Talquetamab in Participants With Relapsed or Refractory Multiple Myeloma https://clinicaltrials.gov/ct2/show/NCT04634552

Dose-Escalation Study of Cevostamab in Participants With Relapsed or Refractory Multiple Myeloma (R/R MM) https://www.clinicaltrials.gov/ct2/show/NCT03275103

Molecular Mechanisms of Cereblon-Interacting Small Molecules in Multiple Myeloma Therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623651/

Open-Label Study Comparing Iberdomide, Daratumumab and Dexamethasone (IberDd) Versus Daratumumab, Bortezomib, and Dexamethasone (DVd) in Participants With Relapsed or Refractory Multiple Myeloma (RRMM) (EXCALIBER-RRMM) https://clinicaltrials.gov/ct2/show/NCT04975997

Modakafusp Alfa (TAK-573), an Immunocytokine, Shows Clinical Activity in Patients with Relapsed/Refractory Multiple Myeloma; Updated Results from a First-in-Human Phase 1 Study https://www.sciencedirect.com/science/article/pii/S0006497121028858

A Phase I Study of MCARH109 and MCARH125 CAR T-Cell Therapy in People With Multiple Myeloma https://www.mskcc.org/cancer-care/clinical-trials/22-052

Joseph Mikhael, MD, and Saad Usmani, MD, discuss options in managing triple-class refractory multiple myeloma including selinexor, belantamab mafodotin, and CAR T-cell therapy.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/964339). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Multiple Myeloma https://emedicine.medscape.com/article/204369-overview

Selinexor Prescribing Information https://www.karyopharm.com/wp-content/uploads/2019/07/NDA-212306-SN-0071-Prescribing-Information-01July2019.pdf

Belantamab Mafodotin Prescribing Information https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Blenrep/pdf/BLENREP-PI-MG.PDF

Cytokine Release Syndrome https://emedicine.medscape.com/article/2500111-overview

Trending Clinical Topic: CAR T-cell Therapy https://reference.medscape.com/viewarticle/965011

Consensus Recommendations for the Clinical Management of Patients With Multiple Myeloma Treated With Selinexor https://www.karyopharm.com/wp-content/uploads/2020/06/Consensus-Recommendations_June2020.pdf

Selinexor, Bortezomib and Dexamethasone: An Effective Salvage Regimen for Heavily Pretreated Myeloma Patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8932935/

Once Weekly Selinexor, Carfilzomib, and Dexamethasone (XKd) in Carfilzomib Nonrefractory Multiple Myeloma (MM) Patients. https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.8038

Ide-cel Prescribing Information https://packageinserts.bms.com/pi/pi_abecma.pdf

Belantamab Mafodotin for Relapsed or Refractory Multiple Myeloma (DREAMM-2): A Two-Arm, Randomised, Open-label, Phase 2 Study https://linkinghub.elsevier.com/retrieve/pii/S1470-2045(19)30788-0

DREAMM Trials https://dreammtrials.com/

Blenrep (Belantamab Mafodotin) REMS https://www.accessdata.fda.gov/scripts/cder/rems/index.cfm?event=IndvRemsDetails.page&REMS=403

Band Keratopathy https://emedicine.medscape.com/article/1194813-overview

Cilta-cel Prescribing Information https://www.fda.gov/media/156560/download

BCMA-Directed CAR T-cell Therapy in Adult Patients With Relapsed and/or Refractory Multiple Myeloma https://clinicaltrials.gov/ct2/show/NCT04318327

Joseph Mikhael, MD, and Ashley Rosko, MD, discuss the role of comorbidities in multiple myeloma and stress the importance of shifting away from the sole use of age-based treatment decisions.

Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/964338). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Multiple Myeloma https://emedicine.medscape.com/article/204369-overview

International Myeloma Working Group Frailty Score Calculator http://www.myelomafrailtyscorecalculator.net/

R-MCI: Myeloma Comorbidity Index https://www.myelomacomorbidityindex.org/en_calc.html

A Simplified Frailty Scale Predicts Outcomes in Transplant-Ineligible Patients With Newly Diagnosed Multiple Myeloma Treated in the FIRST (MM-020) Trial https://www.nature.com/articles/s41375-019-0539-0

Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline https://ascopubs.org/doi/full/10.1200/JCO.18.02096

Frailty in Older Adults: Evidence for a Phenotype https://academic.oup.com/biomedgerontology/article/56/3/M146/545770

Comprehensive Geriatric Assessment https://www.uptodate.com/contents/comprehensive-geriatric-assessment

Carfilzomib or Bortezomib in Combination With Lenalidomide and Dexamethasone for Patients With Newly Diagnosed Multiple Myeloma Without Intention for Immediate Autologous Stem-Cell Transplantation (ENDURANCE): A Multicentre, Open-Label, Phase 3, Randomised, Controlled Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591827/