Mehak Trehan, Subject Matter Expert at DailyRounds and Marrow, shared on X:
“Turning Pages Tuesday | ASH 2026 edition
10 myeloma abstracts I’m watching from India
With teclistamab (Tec), elranatamab (Elra), talquetamab (Tal) and SC Dara in our toolkit, my questions are about sequencing, duration, safety and access.
1. MonumentAL-6
At 13.4 months’ median follow-up, Tec+Tal vs EPd/PVd: PFS HR 0.11; Tal+Pom also improved PFS/OS. ~80% were anti-CD38-refractory. Watch the planned 26-cycle bispecific cap and immunoglobulin replacement burden.
2. MagnetisMM-5
Elra vs DPd: PFS HR 0.56. Only 5.9% had prior anti-CD38 exposure: important when interpreting this for Dara-refractory relapse.
3. Which bispecific next?
In a retrospective 187-patient series, 136 target-switchers had median PFS ~4 months with the second bispecific. Activity remains possible; the best order is unresolved.
4. Can we stop bispecifics?
43 selected responders stopped; 12-month treatment-free PFS was 85.4%. Relevant to financial and infectious toxicity; selection bias limits conclusions.
5. Infection prevention
Modelled 1-year grade ≥3 infection risk: 21.0% with continuous vs 38.3% with observed immunoglobulin replacement. Supportive care belongs in the budget; replacement was not randomized.
6. Who should receive Tal?
Among 43 IHC-evaluable Tal patients, none of 19 with low/negative GPRC5D responded. Could pretreatment IHC improve selection? Retrospective data need validation.
7. PERSEUS
After ASCT, 236 patients stopped Dara per protocol; lenalidomide continued. Eligibility required ≥24 months maintenance, ≥CR and ≥12 months sustained MRD negativity by serial NGS.
8. AQUILA
In high-risk smoldering MM, 7-year OS: 87.8% vs 78.7% with 3 years of SC Dara vs monitoring. Risk definitions and reliable follow-up are central before treating asymptomatic patients.
9. Belantamab eye monitoring
A 30-patient BelaRd study in newly diagnosed MM tests symptom-guided dosing. Both groups still had eye examinations. A practical implementation question for belantamab.
10. EXCALIBER-RRMM: iberdomide
IberDd vs DVd: 10⁻⁵ flow MRD-negative CR, 41.1% vs 20.7%. PFS results await presentation. A CELMoD future-access watch: 84.3% grade 3/4 neutropenia; anti-CD38-refractory patients excluded.
For MRD, 10⁻⁵ is not 10⁻⁶; matching sensitivity also does not automatically make flow and NGS interchangeable for a trial’s treatment decisions.
These are abstracts to examine closely, with fuller data still to come.”
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