Iber-DVD in Newly Diagnosed Multiple Myeloma ! Early and exciting data by @MyelomaDrKapoor et al. Congratulations! I love seeing more data on small molecules in MM were the field is now seeing a monumental shift towads T-cell directed therapies ! Such a huge unmeet need in community oncology.
Question we are going to beasked - are we going to see improvement in induction therapy with novel small molecules esp in TE NDMM; OR with generic Len and better consolidation, e.g., CAR-T and Bispecifics, we will see the field moving in a different direction ??
Exciting times ahead!
#EHA2026
MajesTEC-4 was the most fascinating study reported at EHA 2026 for me.
Not because 100% MRD negativity (10⁻⁵) was achieved.
What truly caught my attention was the magnitude and speed of CR/sCR conversion.
After ASCT, CR/sCR rates were approximately 25-40%.
Within 6-12 months of Tec-based maintenance, CR/sCR approached 100%.
That is breathtaking.
MASTER, CASSIOPEIA, and PERSEUS established an extraordinarily high bar. MajesTEC-4 is now challenging those landmark studies despite being an early run-in cohort of ~90 patients.
The deeper question is not whether teclistamab is active.
We already know it is.
The question is why it appears so active in the post-ASCT setting.
Where do the effector T cells come from?
Are they predominantly reinfused with the autograft?
Do the classic Mayo observations linking early lymphocyte recovery to superior outcomes offer a clue?
Perhaps ASCT is doing more than cytoreduction.
Perhaps maintenance is doing more than maintaining.
Step by step.
Trial by trial.
Not only are responses becoming deeper.
More patients are achieving them, and they are achieving them faster.
#EHA26 #MultipleMyeloma #ASCT #MRD #Myeloma
🦴 MajesTEC-4 (a post transplant maintenance trial) May Delay the Retirement of ASCT 😱
Fellow:
“Professor, with CARTITUDE-4, MajesTEC-3, MajesTEC-9, MonumenTAL-3, and future frontline studies such as MajesTEC-5/7, I think High-Dose Melphalan + AutoSCT will be honorably discharged soon!”
Professor:
“Not so fast.”
The updated MajesTEC-4 Safety Run-In (SRI) cohorts reported:
✅ Nearly 100% CR
✅ Nearly 100% MRD negativity
✅ Median PFS not reached
✅ Only 3 progressions reported
Importantly, MajesTEC-4 remains an ongoing Phase III study and the randomized portion is still actively enrolling.
Still, these data raise an interesting biological question.
For years, we viewed AutoSCT primarily as a delivery system for high-dose melphalan.
Perhaps it is more than that.
Perhaps HDM + AutoSCT serves as a platform for the next generation of immunotherapy through:
🦴 Deep cytoreduction
🦴 Marrow niche disruption
🧬 Immune ecosystem reset
🚀 An optimal setting for maintenance immunotherapy
First it was lenalidomide maintenance.
Now it may be teclistamab ± lenalidomide.
Whether this hypothesis is correct remains to be proven, but MajesTEC-4 certainly makes the discussion more interesting.
Perhaps AutoSCT is not the treatment.
🚀 Perhaps AutoSCT is the launchpad.
AutoSCT may stay around longer than me. 😄
#EHA2026 #Myeloma #Bispecifics
CONGRESS | #EHA2026 | PRESENTATION
Niels van de Donk presents updated safety run-in results from the MajesTEC-4 study evaluating teclistamab ± lenalidomide versus lenalidomide alone as post-transplant maintenance for NDMM.
Teclistamab-based maintenance was associated with grade 1/2 CRS events only and no cases of ICANS. During maintenance, ≥CR rates were 96.7–100% across cohorts, with MRD-negative CR rates at 12 months of 90–100% among evaluable patients. Median PFS was not reached in any cohort, with estimated 24-month PFS rates of 94–96.6%.
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Intended for HCPs only. This congress coverage is independently supported by pharmaceutical companies, who are allowed no influence on the content; a full list of supporters can be found on our website.
#MultipleMyeloma #myeloma #mmsm #MedEd @amsterdamumc
CONGRESS | #EHA2026 | PRESENTATION
Binod Dhakal presents long-term follow-up results from the phase I CaMMouflage trial evaluating CB-011, an allogeneic anti-BCMA CAR T-cell therapy with immune cloaking, for the treatment of RRMM (N = 48).
Among BCMA-naïve patients treated at the recommended expansion dose (450M CAR-T cells; n = 12), CB-011 demonstrated an ORR of 92% and a ≥CR rate of 83%. MRD negativity (10^-5) was observed in 91% of evaluable patients (n = 11). Grade ≥3 infections and CRS occurred in 25% and 8%, respectively. There were no instances of GvHD, IEC-EC, parkinsonism, or cranial nerve palsies. Enrolment in the dose-expansion portion is ongoing in both BCMA-naïve and BCMA-exposed patients.
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#MultipleMyeloma #myeloma #mmsm #MedEd @bhemato
#EHA2026 and congrats #cyrilletouzeau and the whole MajesTEC-9 team for such excellent results!
Tec monotherapy joins our growing landscape of excellent treatment options as early as first relapse 👏
#EHA2026 a new standard of care about to emerge in myeloma!
@PlasmaCellPete looking as presidential as ever at the plenary session 💪
MonumenTAL-3: tal-dara +/- pom versus Dara-Pd.
Tal-DP and tal-D both dramatically outperformed D-Pd!
CONGRESS | #EHA2026 | PRESENTATION
Rahul Banerjee presents results from an analysis of the phase III MajesTEC-3 study evaluating teclistamab plus daratumumab (Tec-Dara) in patients with RRMM, stratified by cytogenetic and functional risk.
Tec-Dara improved PFS versus DPd/DVd across all cytogenetic and functional risk groups. In patients with prespecified HR cytogenetics, median PFS was not reached with Tec-Dara versus 14.4 months with DPd/DVd (HR, 0.15), while estimated 36-month PFS rates were 77.7% versus 11.5%, respectively. Tec-Dara also increased MRD-negative ≥CR rates across risk groups, including among patients with functional high-risk disease (42.9% vs 5.6% at 10⁻⁵sensitivity; OR, 12.75).
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#MultipleMyeloma #myeloma #mmsm #MedEd @RahulBanerjeeMD
CONGRESS | #EHA2026 | PRESENTATION
Prashant Kapoor presents results from the phase I/II IDEAL study evaluating iberdomide-based quadruplet therapy for NDMM (N = 44).
The ORR was 100%. The CR rate increased from 43% at induction to 57% at deepest response, while the MRD-negative CR rate increased from 34% to 52%. At a median follow-up of 22.8 months, 12- and 18-month PFS rates were 92.0% and 88.9%, respectively, and 12- and 18-month OS rates were 97.4% and 94.5%. The most common Grade 3 and 4 TEAE was neutropenia (40.9% and 18.2%). 29.5% required G-CSF support.
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Intended for HCPs only. This congress coverage is independently supported by pharmaceutical companies, who are allowed no influence on the content; a full list of supporters can be found on our website.
#MultipleMyeloma #myeloma #mmsm #MedEd