Murali Janakiram, Associate Professor at the Division of Hematological Malignancies, Myeloma, Cellular Immunotherapy and Immune Checkpoints at City of Hope, shared a post on X:
“Top 10 ASH abstracts
1. 2422- Redefining function high-risk (FHR) MM s/p QUAD and ASCT
- Median 2PFS -3.3 mo -FHR12,
- 2.7 mo -FHR18,
- 3.3 mo – FHR24
- 5.8 mo – FHR36.
FHR is the common poor prognostic factor in predictors of early relapse after CART in two separate ASH abstracts, Saad Z. Usmani and Doris Hansen [ID=93]․
2. 367- Ph 2 Tec+ Dara The IFM2021-01 NDMM,
- n=37, median age -73
- grt responses -100% ORR
- 14% Gr 3 infections (usually means admission to hospital)
- MRD neg- 6 months by NGS at 10-6 -51% ITT-100% in 21 evaluable
Not a top abstract but abs 12114- no difference in CRS/ICANS b/w NDMM and RRMM inc. tumor burden -? BCMA is present in normal B cells․
3. 697 – Linvo as monoRx in NDMM
- n=45, age-67
- ORR- 79-86%, 24 MRD Eva. 10^-5 – 92%
- Gr 3 Inf- 19-31%
Comparing this and previous -Early concl. BsAb does most of the work. An increment of? to 10% by adding CD38 and most inf. contributed by BsAb․
4. SMM- AQUILA – Dara in SMM
- long-term PFS benefit across all MWG 2020
- most pronounced benefit in the high-risk subgroup.
- Early Dara tx for high-risk SMM has no detrimental impact on stem cell yield.
How to Rx after progression [my opinion]- CART/ BsAb․
5. 100- Elra + Iber
Iber started in C1/C2
- n=22
- ORR-77.3%, unconfirmed (90%)
- Gr 3/4 Inf. – 4.4% ?? lowest I have seen-need longer f/v
Also watch for 10621- mezi+ elra, very early to say. no tec/tan + era as yet?
6. 8381 – Tec+Tal in EMD
Kudos for selecting True EMD
- n=90
- 12 mo PFS- 55.6%
- 12% died (n=11) 50% due to infections
The 12 mo. PFS is one of the best for ՛true EMD՛, need good ppx for infections. Need to compare with imid or RT combinations, whether they do better․
7. 5322- Trispecific JNJ-5322
- n=36
- ORR-100%, 12 mo PFS- 96%
- 1 patient died due to inf.
- CRS- Gr 1 and 2 -52%
- q4wk dosing
Bi vs Tri- can’t get this soon enough in clinic. Need to know whether this is better in BCMA relapsed MM. Ph 3 planned․
8. 11319 – AZD0120, a BCMA/CD19 dual-targeting CAR T-cell therapy
n=25
- ORR-100%
- no Gr 3 CRS, no ICANS, mostly Gr 1,2
- n=5, MRD eval. -100%
- no HLH, long-term neuro tox
Ciltacel –> Anitocel –> AZD0120. The evolution of safer BCMA CART constructs and one time treatment․
9. 4598 -Short survival with BCMA and GPRC5D dual antigen exposed relapsed myeloma-IMWG immunotherapy consortium
- n=49
- 32.7% did not receive any subsequent LOT and died due to progressive disease.
- 67.3% of patients had progressive MM
- Median PFS1 -1.77 mo
- Median OS – 5.7 mo
Population in need. Need further Rx. Also see abstract 5760- similar conclusions.
10. DH UHR MM- UKMRA RADAR
- N=70
- IsaVRDC*4 -> ASCT –> Isa VRD *4 –> IsaR maintenance
- 66.7% MRD neg 12 mo – results very similar to CONCEPT with IsaKRD
It is very close to our current practice of DVRD/IsaVRD and is easier to adopt.”
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