Sandy Wong

[Anupama Kumar @anupamakumar05]

Delayed neurotoxicity poster with my mentor @AjaiChari

[Multiple Myeloma Hub @MM_Hub]

CONGRESS | #ASH24 | POSTER

Caitlin Costello @Ccostello7, UCSD Moores Cancer Center, shares results from the optimized lymphodepletion cohort (N = 21) of a phase I study of P-BCMA-ALLO1, a BCMA-directed CAR-T in RRMM.

P-BCMA-ALLO1 demonstrates a promising ORR and favorable safety profile when administered with optimized LD. It is highly active, regardless of prior exposure to BCMA-targeted autologous CAR-T or TCE therapy.

Follow our live feed for more updates: https://t.co/7NOfZTHMg8
#mmsm #myeloma #MedicalCongress

[Hira Mian @HiraSMian]

The coolest ASH presentation 😎

[Raj Chakraborty @rajshekharucms]

In AL #Amyloidosis, we are no longer in an era of ~30% early mortality!
New data by @Slade_Mellgard shows 6 mo early mortality ~11% in 335 pts with Dara-VCd/Dara-Vd (44%
stage IIIa/IIIb)
Predictors of EM-Age, ECOG/NYHA, NT-proBNP & absence of t(11;14)!
#ASH24
https://t.co/KQRjNExWSK

[Murali Janakiram @JanakiramMurali]

Now we are asking the correct q in the correct setting …..

[Beth Faiman PhD @Bethfaiman]

#BCL2 inhibitors in #myeloma and #Amyloidosis? Yes please! Lisaftoclax in #RRMM @khouri_jack @CleClinicMD #ASH24

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

#ASH24 MajesTEC-4! Zamagni et al: Safety run-in for tec + len maintenance after ASCT.

First time we're seeing bsAb maintenance data in #MMsm 👏 Bottom line: it works!

But important to see: Tec as maintenance is same as tec in RRMM: CRS and infections can happen. Use IVIG!

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

#ASH24 excellent work by my @fredhutch colleague @DimaDanai on behalf of the US #MMsm consortium 👏

Prior BCMA therapy before BCMA CAR-T: same principle as CARTITUDE-2C, but much larger RW data.

Small n, but BCMA bsAb ➡️ CAR-T doing much worse than BCMA ADC ➡️ CAR-T.

[Samer Al Hadidi, MD,MS,FACP @HadidiSamer]

#ASH24 #mmsm @ASH_hematology

Oral myeloma: MagnetisMM-20

Carf+Elra
low no. of pts
Responses are high (ORR 100%)

1 death with COVID-19

Most infections were G1 and G2 (G3 or higher of 17%)

CMV re-activation in 50% of pts

Seems to have nice synergistic effect with Carf and era

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

#ASH24 Excellent work by @hcheruvalath @MeeraMohanMD et al showing value of IVIG with BCMA-targeted bsAbs in #MMsm.

🤯 OS benefit??

Likely other confounders, e.g. evolving ⬆️ IVIG use vs ⬇️ pandemic lethality...

... But clearly the days of waiting for IVIG ≤400 are gone!

[Samer Al Hadidi, MD,MS,FACP @HadidiSamer]

#ASH24 #mmsm @ASH_hematology

Oral amyloidosis: Final update of ANDROMEDA

A great study with OS improvement (despite more than 70% of pts in control arm received Dara based regimen)

This is coupled with better organ responses

#ASHKudos for an excellent study with OS benefit !!

[Ben Derman @bdermanmd]

Even in the best case scenario (>9 months), still leaves something to be desired. Is switching target after BCMA CAR T a better move?

[Samer Al Hadidi, MD,MS,FACP @HadidiSamer]

#ASH24 #mmsm @ASH_hematology

Oral myeloma: Anti-BCMA/GPRC5D Bispecific CAR T-Cells in Patients with Refractory and Relapsed Multiple Myeloma with Extramedullary Disease

Short follow up with low n of pts- median follow up of only 6 months

It is unclear that targeting both targets of BCMA and GPRC5D at the same time with CAR-T will be better than doing one target.

[Ben Derman @bdermanmd]

Tec-Len safety run in as post-ASCT maintenance #ASH24 #mmsm #mmMRD
- Convenient dosing schedule
- Nearly everyone got significant neutropenia (94% G3+)
- CRS rates are lower overall in this low-disease burden setting (40-50%)

[Ben Derman @bdermanmd]

More on teclistamab....this time with pomalidomide and daratumumab.
Here we see a signal for very high infection rates, including grade ¾ (despite IVIG).

Questions:
Is this infection risk because of prior therapies increasing risk of infection? Or just longer follow-up?

Is the juice worth the squeeze? ORR is high - 85% overall and even higher in less pretreated patients. 2-year PFS over 50% in early lines.

Does pom dose intensity need to be modulated?
#ASH24 #mmsm

[Ben Derman @bdermanmd]

Subgroup analysis of AURIGA: Dara-Len vs Len for pts with MRD+ post-ASCT.
I like the breakdown re: benefit in high-risk disease (however you want to define it!)
- Dara-R benefit seems to extend to all patients regardless of risk; perhaps particularly so for patients with 1 high-risk abnormality?
- Still a lot of work to be done for patients with 2+ HRCA / ultra-high risk

[Samer Al Hadidi, MD,MS,FACP @HadidiSamer]

#ASH24 #mmsm @ASH_hematology

Oral: amyloidosis

MRD -ve in AL amyloidosis is associated with better outcomes, no correlation between MRD status and cardiac or renal responses (it is important in heme responses) - it may be related to earlier assessment since organ function improvement takes time cc:@rajshekharucms

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

#ASH24 and the best for last! Our fearless US #MMsm consortium leader #DorisHansen presenting the most sophisticated analysis of cilta-cel vs ide-cel in RW practice I’ve ever seen!

Yes, an RCT will be ideal - but will never happen this decade. So what do our current data show?

[Victor H Jimenez-Zepeda @vhugo8762]

BCMA CART for AL Amyloidosis! #ash24

[Ben Derman @bdermanmd]

AQUILA: Daratumumab x 3 years vs. active surveillance for smoldering myeloma
- All patients had advanced imaging (CT/PET/MRI during screening and yearly)
- Primary endpoint: PFS per IMWG SLiM-CRAB criteria
- Secondary endpoints: included OS (see image for stats)
- Only about 40% of patients were considered high-risk by 2/20/20 criteria.
- PFS: significant benefit for daratumumab
- OS: HR 0.52 (95% CI 0.27-0.98) though the study not powered for this. #ASH24