Simon Stern

Consultant Haematologist. Interested in haemato-oncology in general and multiple myeloma in particular.

[john sturgis @sturgios]

Quality headline writing here

[Simon Stern @DrSStern]

Latest results from @iStopMM show that screening for MGUS decreases the diagnostic delay for myeloma requiring treatment by a year. Longer follow-up is required to show any survival benefit.
Journal of Clinical Oncology https://t.co/9dd7t8nnvr

[Simon Stern @DrSStern]

Latest results from @iStopMM show that screening for MGUS decreases the diagnostic delay for myeloma requiring treatment by a year. Longer follow-up is required to show any survival benefit.
Journal of Clinical Oncology https://t.co/biyBuI0xL8

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

My #IMS26 Top 5 myeloma abstracts:

1️⃣ CARTITUDE-2 A: 50% CAR-T cure fraction
2️⃣ PERSEUS: 6-yr PFS 🤩, but HR need better
3️⃣ MajesTEC-3: 86% functional cure with BsAb/dara?
4️⃣ EXCALIBER-RRMM: CELMODs & MRD approvals!
5️⃣ CERVINO: Q4W is in, CRS is out 👋🏽

https://t.co/I2FTqlLrDo

[Pablo Tenorio Feixas @ptenfei]

#IMS26: Dr Sina Beer shares data from MUKnine/OPTIMUM, challenging how we define (and treat) ultra-high-risk myeloma.

Key lessons:
- Intensified, risk-adapted treatment improves outcomes.
- SKY92 gene-expression profiling identifies high-risk patients missed by DNA-based criteria.
- Combine IMS-IMWG HRCA + SKY93 testing could help with treatment selection.

Better knowledge of disease biology → better risk stratification → better outcomes!

Fascinating talk, congratulations Sina, @MyMKaiser and rest of colleagues!

@Myeloma_Society

[Vincent Rajkumar @VincentRK]

We have a cure definition for myeloma.

Requires:
1) Off all therapy and sustained MRD negative for 5 years
2) Negative imaging studies

Presented by @NikhilMunshiMD #IMS26 @Myeloma_Society

Note:
1) We need to see how this definition performs. Relapse rate for patients meeting these cure criteria must ideally be less than 5%. If not, we may have to adjust the criteria.

2) I hope the cure criteria will be the impetus to stop doing trials with endless therapy. You cannot claim cure with continuous therapy. I’m glad the field is mostly aligned on this.

Cure for patients and public in any disease has a deep meaning. Cure means cure. We cannot dilute it.

[Martyn Ziegler @martynziegler]

Oasis at Knebworth 1996: shortly after Man City relegated to the Championship.
Oasis at Knebworth 2027: .....???

Whatever

[Simon Stern @DrSStern]

OK, so AI might be threatening to wipe out humanity, but before it does that it looks like it could be used to predict progression in smouldering myeloma. Really interesting presentation by @aksimhal from MSK at #IMS2026

[Raj Chakraborty @rajshekharucms]

Incredible 2-year PFS with Ramantamig in a ~95% CD38-refractory and 100% triple-class exposed population! These results are substantially superior compared to single-agent BCMA BsAbs and BCMA or GPRC5D CAR Ts in similar population. Based on these results, its plausible that we will see a near-flat PFS curve with Ram in Trilogy-5!
#IMS26
@AlGarfall @MileHighMyeloma

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

#IMS26 Elegant (post hoc) MajesTEC-3 analysis by @End_myeloma

Unlike other myeloma drugs, I bet real-world tec-dara OS will look *better* than MajesTEC-3 did.

Why? Because we now know PPx toci, PPx IVIG, etc - early BsAb deaths can be prevented, vs fatal PD with Dara-Pd can't.

[Simon Stern @DrSStern]

@_DrCP flying the flag for the UK on day 1 of #IMS2026 with an excellent overview of maintenance approaches in myeloma.

[Vincent Rajkumar @VincentRK]

Three things I recommend for using Bispecific antibodies in myeloma:

1) Prophylactic tocilizumab with first dose

2) Monthly IVIG regardless of the IgG level

3) Consider reducing frequency/stopping after excellent response.

This applies to all the approved bispecifics: teclistamab, elranatamab, linvoseltamab, and talquetamab.

Academic centers with expertise and close monitoring capabilities may skip the prophylactic tocilizumab but in general I do not see community adoption without it.

The data on routine IVIG and early use before the IgG levels drop or infections occur is good and sufficient to move forward. It’s recommended in NCCN and mSMART. Bispecifics are better at controlling myeloma than standard triplets and quads, but pose a much higher risk of serious life threatening infections without prophylaxis and careful adjustment of dosing schedule based on response and patient characteristics.

#IMS26

[Robert Z. Orlowski @Myeloma_Doc]

Bonus #Myeloma Paper of the Day: Soluble B-cell maturation antigen may be a biomarker of both risk of progression from, and treatment response in patients with myeloma precursors #MGUS and smoldering myeloma: https://t.co/Fz1ULqTCmW. #mmsm @MDAndersonnews

[Robert Z. Orlowski @Myeloma_Doc]

#Myeloma Paper of the Day: 5-year follow-up of induction & consolidation with Dara/Cy/Vel/Rev/dex in HRMM (OPTIMUM/MUKnine) shows median PFS NR vs 24.4 mos for Myeloma XI; OS NR vs 57.4 mos ; median PFS2 NR vs 43.9 mos in Myeloma XI (HR 0.26): https://t.co/BhEOuEwmQz. #mmsm

[Vincent Rajkumar @VincentRK]

Profound sorry that my mentor, friend, and colleague, the legend Bob Kyle passed away. His contributions to patients, medicine, myeloma, @IMFmyeloma @MayoClinic myeloma group, and the institution are monumental. A role model who will be remembered for his integrity and commitment to patients. I owe my career to him. He leaves behind a legacy of experts at Mayo Clinic as well as world over who were influenced greatly by him.

See thread for links to a video an article on him that I wrote for @MayoProceedings

Post your memories below.

[Mahmoud Gaballa @mahrefat]

Our work on bispecifics in plasma cell leukemia is now published. Talquetamab showed markedly better outcomes than BCMA bispecifics in patients with active PCL (≥5% circulating PCs), including those who were BCMA-naive. With virtually no prospective trial data in this space, this striking signal may help inform treatment choice. https://t.co/oB3BTjHg3f #mmsm @DrKrinaPatel @MDAndersonnews @MyelomaSLC @RahulBanerjeeMD @Transplant_Doc

[Breno Moreno de Gusmão @morenodegusmao]

Final MAIA analysis: D-Rd reached median OS of 90.3 months (HR 0.67 vs. Rd) after 89.3 months of follow-up in transplant-ineligible NDMM. A tough number to beat - will quadruplet regimens have to work hard to surpass it? https://t.co/FqBAWQUd0p #MM #mmsm

[Florence Lox 🇬🇧🏴󠁧󠁢󠁳󠁣󠁴󠁿 @floboflo]

Happy birthday to Robert De Niro. 83 today!

[Vincent Rajkumar @VincentRK]

I am worried about the exploding number of “monoclonal gammopathy of clinical significance” entities. MGNS, MGRS, MGDS, MGTS etc

It’s time to become strict with diagnosis of these disorders. MGUS is now more common because everyone is using very sensitive tests. Add to this some researchers saying you don’t even need a clone or M protein to diagnosis this. I disagree.

Even for the most well documented MGCS entity, PGNMID if there is no M protein, whatever you see on the renal biopsy is most likely driven by some oligoclonal process not monoclonal. So, no M protein, no MGCS/MGRS should be the default.

Over diagnosis and trying to eradicate the M protein is far more dangerous than under diagnosis. So you need a level of proof or compelling evidence that it’s the M protein that’s causing the problem. If that’s difficult to establish then it’s on us to get the testing right. Otherwise except for like established syndromes like POEMS, we need this rigor. Some entities like AL amyloidosis, cryo, PGNMID etc routine available testing gives the proof we need. Some others especially neuropathy and clots, are so common and so many causes, we simply need a very high bar for diagnosis. See our paper here: https://t.co/tRSllzGlL2

[Raj Chakraborty @rajshekharucms]

Long term outcomes of stage IIIb AL #Amyloidosis with Dara-based frontline therapy. Hopefully, we will be able to do better with BCMA-targeted BsAbs upfront!
https://t.co/sQpiy8AM4l