Top 7 ASCO24 abstracts to watch for multiple myeloma by Samer Al Hadidi

Samer Al Hadidi, Assistant professor at UAMS Myeloma Center, shared a post on X:

“My top 7 ASCO24 abstracts to watch for multiple myeloma

Will have more details on those once presented/published- those are initial thoughts that may evolve according to more data

There are more interesting data will highlight during the meeting.

IMROZ: Isa-VRd vs VRd i n transplant-ineligible NDMM patients 

• Follow-up: 5 years
• Median PFS Isa-VRd(NR, estimated 7.5 years!!) vs VRd(4.5 years)
•  Grade 5 TEAE: 2 times higher with Isa-VRd (11% vs 5.5%)

Thoughts on IMROZ

Very important data

• median PFS: 7.5 yrs(estimated)
• Grade IV AEs: higher though compare to: MAIA: Dara-Rd: median F/U <5yrs (shorter median follow up),death related to AEs (10%) in Dara-Rd

Thoughts on IMROZ

baseline characteristics: will be important

For MAIA trial:
– 43% of pts >=75 yrs
– Median PFS:NR was not reached (95% CI 54·8–NR) – at least more than 4.5 years

We will need the complete data.

Thoughts on BENEFIT

• We may not need a quad (usual V dosing) in most transplant in-eligible patients
• Anti-CD38 +Rd is really a great option for most patients
• Will be looking for high risk groups and older pts to see if quad helps this subset of patients.

DREAM-7: BVd vs DVd

•  Median PFS: BVd(3 yrs) vs. DVd (1 yr)
• In high-risk cytogenetic subgroup, PFS was 33 mo with BVd vs 11 mo with DVd
• Ocular AEs more frequent with BVd vs DVd (79% vs 29%) DREAM-8: interesting (N/A-LBA n=8)./abstract/

Thoughts on DREAM-7

• Addition of belantamab mafodotin to PI (V) showed better PFS in randomized trial (anti-CD38 based)
• benefit maintained in high risk disease

AEs (mainly ocular) &censoring will be imp to explore- this requires full data (hopefully soon).

CARTITUDE-4 subgroup analysis/abstract/

Difficult to treat pts(functionally high risk)

• Better PFS with Cilta cel vs SC
• 1-yr PFS for Cilta cel: 77% vs 49%
• Better responses

Thoughts on CARTITUDE-4 subgroup analysis

This subgroup of pts remain with sub-optimal outcomes: Meaning 1 out of 4 pts who got Cilta cel earlier with functionally high risk progressed in <= 1 year

Access to Cilta Cel earlier for this group is imp

PERSEUS MRD data/abstract/

Rates of sustained MRD neg for ≥12 mo were higher for D-VRd vs VRd
– 10-5: 2 out of 3 compared to 1 out of 3
– 10-6: 1 out of 2 compared to 1 out of 5

thoughts on PERSEUS MRD data

Addition of anti-CD38 to induction/maintenance regimen showed improvement with long term sustained disease control

We need to follow patients for >10-15 years in such important studies to better know the long term outcomes.

MRD2STOP/abstract/

•  treatment discontinuation study
• Median follow up after discontinuation: 2.5 years
• ~10% of pts progressed after discontinuation (90% didn’t)
• 3-year PFS was 85%

Thoughts about MRD2STOP

• Many pts didn’t qualify to stop tt (need of MRD -ve), some of those may do well with discontinuation
• Data on high risk will be imp to see.
• Longer follow up and more patients needed.

T cell subsets as predictors of response to BCMA BsAbs/abstract/

79 pts treated with BCMA BsAb
Increased proportion of CD4 cells within the ALC is significantly associated with better response to BCMA targeting bsAb (absolute no. Not imp)

Will be looking forward to meet many colleagues, mentees, mentors and share some other important presentations at ASCO

Make sure you stop by Trainee lounge for important trainees/early career sessions.”

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Source: Samer Al Hadidi/X