Multiple Myeloma Hub

During the 19th International Myeloma Society Annual Meeting, the Multiple Myeloma Hub was pleased to speak to Roman Hájek, University of Ostrava, Ostrava, CZ. We asked, Which patients might benefit the most from isatuximab-based combinations in the relapsed setting?

Hájek begins by explaining that isatuximab is an anti-CD38 monoclonal antibody currently approved for treatment in combination with pomalidomide + dexamethasone or carfilzomib + dexamethasone. This is followed by a discussion on why these combinations may be helpful for patients previously exposed or refractory to lenalidomide.

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During a meeting of the Multiple Myeloma Hub Steering Committee on April 26, 2022, María‑Victoria Mateos chaired a recorded discussion that also featured Nina Shah, Paul Richardson, Morie Gertz, and Heinz Ludwig. The topic of this discussion was “Integrating B-cell maturation antigen (BCMA)-directed agents in the treatment landscape for relapsed/refractory multiple myeloma”, which was identified as an unmet need within multiple myeloma treatment.

Mateos begins the discussion by posing the question of how to integrate chimeric antigen receptor (CAR) T-cell and other BCMA-directed products into clinical practice. Shah discusses the problems of CAR T-cell product availability, as well as the potential of bispecific therapies as they are more readily available. Richardson talks about antibody—drug conjugates (ADCs) and combination therapies, and the risk of keratopathy with some treatments. The committee discuss the convenience of ADCs and the potential of combinations using bispecific therapies and ADCs, with Gertz mentioning the exclusion of some patient subgroups from CAR T-cell trials, meaning bispecifics may be the best alternative for these individuals. Finally, Ludwig talks about the importance of more data becoming available to evaluate the use of BCMA-directed agents in earlier lines of therapy.

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During a meeting of the Multiple Myeloma Hub Steering Committee on April 26, 2022, Morie Gertz chaired a recorded discussion that also featured María-Victoria Mateos, Nina Shah, Paul Richardson, and Elena Zamagni. The topic of this discussion was “The role of consolidation after autologous stem cell transplantation”, which was identified as an unmet educational need within multiple myeloma treatment.

Gertz begins the discussion by explaining that patients often have confusion over what consolidation therapy is and when it can be used. Mateos then discusses how the number of induction therapy cycles a patient receives can affect the use of consolidation. Richardson talks about the STAMINA trial and how tolerability posttransplant can affect treatment choices, with Shah commenting on the difficulty of replicating trials in the real-world setting. The committee then discuss how historically in trials, the same drug that was used in induction is used as consolidation, and what the potential results would be if a different drug was used for consolidation.

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During the ASCO 2022 Congress, the Multiple Myeloma Hub was pleased to speak to Roberto Mina, University of Turin, Turin, IT, and Andrzej J. Jakubowiak, The University of Chicago, Chicago, US. We asked, What are the pros and cons of bispecific antibodies for multiple myeloma? 

Mina and Jakubowiak discuss the MajesTEC-1 and MagnetisMM-1 trials, the efficacy and response rates of bispecific antibodies, and the challenges of using bispecific antibodies, such as infection risk. They also compare bispecific antibodies to CAR T-cell therapies and talk about the sequencing of therapies in myeloma treatment.

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During the 3rd European Myeloma Network Meeting, the Multiple Myeloma Hub was pleased to speak with María-Victoria Mateos, University Hospital of Salamanca, Salamanca, ES. We asked, How can bispecific antibodies be combined with monoclonal antibodies to treat relapsed/refractory multiple myeloma?

Mateos begins by giving an overview of the bispecific antibodies, talquetamab and teclistamab. These antibodies have been investigated in combination with daratumumab in two clinical trials; Mateos provides a summary of the results of these trials, including the safety and efficacy data.

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During the 63rd ASH Annual Meeting and Exposition, the Multiple Myeloma Hub was pleased to speak to Jacob Laubach, Dana-Farber Cancer Institute, Boston, US, and Peter Voorhees, Levine Cancer Institute, Charlotte, US. We asked, Daratumumab as maintenance therapy for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM): What have we learned from GRIFFIN and CASSIOPEIA trials?

In this podcast, Laubach and Voorhees discuss the findings from the randomized phase II GRIFFIN trial (NCT02874742) and the CASSIOPEIA trial (NCT02541383). 

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During the 18th International Myeloma Workshop, the Multiple Myeloma Hub spoke with Michel Delforge, UCLouvain, Louvain-la-Neuve, BE and Noopur Raje, Massachusetts General Hospital, Boston, US. In this podcast, they discuss the topic: Managing infections with novel immunotherapies: Prevention, treatment, and impact on the quality of life of patients with multiple myeloma.

Raje and Delforge discuss the management of infections with novel immunotherapies, including: monoclonal antibodies, antivirals, risk of infection, intravenous immunoglobulin, and the impact of COVID-19. This podcast closely links to our latest editorial theme, in which the Multiple Myeloma Hub explores how to manage adverse events from novel agents, with our first article examining proteasome inhibitors and cardiovascular events.

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During the 7th World Congress on Controversies in Multiple Myeloma (COMy), the Multiple Myeloma Hub hosted its first Satellite Symposium: Should 'cure' be the goal for multiple myeloma?

This podcast captures the roundtable discussion with Mohamad Mohty, Hôpital Saint-Antoine and Sorbonne University (Paris, FR), María-Victoria Mateos, University Hospital of Salamanca (Salamanca, ES), and Sagar Lonial, Winship Cancer Institute of Emory University (Atlanta, US), and includes the concluding remarks of the Satellite Symposium as a whole.

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During the 7th World Congress on Controversies in Multiple Myeloma (COMy), the Multiple Myeloma Hub hosted its first Satellite Symposium: Should 'cure' be the goal for multiple myeloma? Vincent Rajkumar, Mayo Clinic, Rochester, US, discussed: Treating elderly and frail patients with MM: Cure versus disease control.

In this podcast, Rajkumar discusses the current standard of treatment for elderly, frail patients (VRd−bortezomib, lenalidomide, dexamethasone) and regimens that are currently being tested across various clinical trials to improve upon this standard, such as replacement of bortezomib with carfilzomib or daratumumab, and quadruplet combinations. He then discusses if a cure is really feasible for MM, and highlights some key considerations for a true cure; when treatment is given for a finite time and the disease never returns. He concludes with his recommendations for assessing MM cure in future trials.

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During the 7th World Congress on Controversies in Multiple Myeloma (COMy), the Multiple Myeloma Hub hosted its first Satellite Symposium: Should 'cure' be the goal for multiple myeloma? Sagar Lonial, Winship Cancer Institute of Emory University, Atlanta, US, answered: Is transplantation still relevant? If yes, in which context?

In this podcast, Lonial describes results from the FORTE (NCT02203643) and IFM 2009 (NCT01191060) trials, which investigated the use of triplet combinations with and without transplant. He warns of the 'siren song' of early MRD negativity that may lead one to believe novel agents are just as good as transplant. Lonial highlights that the focus needs to be on sustained MRD negativity; rates of which were higher in the patients who received a transplant. He also highlights two reasons for the discrepancy seen among early MRD negativity and sustained MRD negativity between patients who received a transplant and those who did not.

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