Multiple Myeloma

A phase 1b study demonstrated that continuous subcutaneous infusion of low-dose lenalidomide in patients with relapsed or refractory (R/R) multiple myeloma achieved promising efficacy with significantly reduced hematologic toxicity compared to conventional oral dosing.

The multiple myeloma landscape is evolving, with bispecific T-cell engagers offering hope.

CAV-1 is a key protein in lipid rafts that helps control cellular processes such as growth, survival, and migration.

Real-time profiling of T-cell activation states in non-CAR T-cells may help guide treatment decisions.

Adding daratumumab improved minimal residual disease (MRD) negativity rates, leading to superior progression-free survival (PFS).

Patients with central nervous system (CNS) involvement achieved favorable outcomes with chimeric antigen receptor (CAR) T-cell therapy.

A phase 2 study showed that elotuzumab combined with pomalidomide, bortezomib, and dexamethasone was safe and efficacious.

Approximately 10% of patients with multiple myeloma have pathogenic germline variants, indicating a hereditary risk.

Use of dexamethasone over tocilizumab was associated with significant cost-savings for patients with relapsed/refractory multiple myeloma (RRMM).

Pharmacists also navigate the REMS program and monitor and manage adverse effect profiles associated with bispecifics.

The data supports quadruplet therapy’s potential in the first line for patients with newly diagnosed multiple myeloma (NDMM).

Risk stratification remains a challenge when selecting patients for treatment of smoldering multiple myeloma.

The 75 minutes of infusion time typically required is costly and difficult for patients.

C. Brooke Adams, PharmD, BCOP, discusses the evolving diagnostic criteria and management strategies for cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) in CAR T-cell therapy, highlighting advances in toxicity prevention and treatment selection.

OPN-6602 is an oral EP300/CBP bromodomain inhibitor that yielded 100% tumor regression as a combination therapy in mouse models.

The quadruple treatment was active and safe as initial therapy for older patients with transplant-ineligible multiple myeloma.

Isatuximab is a CD38-targeting monoclonal antibody that has demonstrated significant clinical success in improving minimal residual disease rates and progression-free survival.

Managing bispecific antibodies requires collaboration and meticulous protocols.

The international cohort study evaluated the safety, efficacy of BCMA-targeting agents ciltacabtagene autoleucel and idecabtagene vicleucel.

The combination yields promising results but was associated with high incidence of toxicity and infection.

The analysis shows patients achieved deep and durable responses despite being ineligible for the CARTITUDE-1 trial.

Patients with relapsed, refractory disease achieved deep, durable responses with equecabtagene autoleucel.

Here is an updated overview of the role of BCMA-directed therapies following the 2024 ASCO Annual Meeting and EHA Congress.

The treatment landscape for multiple myeloma continues to evolve.

Sonja Zweegman, MD, PhD, explains the improvements in minimum residual disease negativity found after treatment with daratumumab and the VRd regimen in patients with newly-diagnosed multiple myeloma who are transplant-ineligible.

Luca Bertamini, MD highlights the potential clinical implications of using circulating tumor cells as a biomarker in patients with newly-diagnosed multiple myeloma.

The phase 3 CEPHEUS trial demonstrated that adding daratumumab (DARA) to the VRd regimen significantly improves minimal residual disease negativity, progression-free survival, and overall response in transplant-ineligible or transplant deferred patients with newly diagnosed multiple myeloma, establishing a new standard of care.

The GMMG-HD7 trial evaluated the addition of isatuximab to standard induction therapy in patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplantation, demonstrating significantly higher rates of minimal residual disease negativity and improved progression-free survival (PFS).

Panelists discuss how bispecific antibody therapies in relapsed/refractory multiple myeloma commonly present with cytokine release syndrome (CRS), immune effector cell–associated neurotoxicity syndrome (ICANS), and increased infection risks, while talquetamab specifically exhibits distinctive adverse events including nail changes, skin reactions, and oral toxicities.

Panelists discuss how infrastructure including specialized staff training, updated protocols, enhanced monitoring systems, and comprehensive educational resources for health care providers is essential for institutions to successfully implement and optimize bispecific antibody therapies while ensuring patient safety and treatment efficacy.