5 Multiple Myeloma Research Highlights: 2024 International Myeloma Society Meeting | For Patients (https://www.myeloma.org/videos/5-myeloma-research-highlights-2024-ims)
5 Multiple Myeloma Research Highlights: 2024 International Myeloma Society Meeting | For Patients
The International Myeloma Society’s annual meeting in Rio de Janeiro, Brazil, featured groundbreaking research for myeloma patients. IMF Chief Medical Officer Dr. Joseph Mikhael shares his five most impactful takeaways that could shape future treatments for myeloma patients and their families.
In this video, Dr. Mikhael discusses:
1. 4-Drug Treatment (Quadruplet Therapies) Upfront
One of the most significant updates is the Cepheus Trial, which added DARZALEX® (daratumumab) (https://www.myeloma.org/darzalex-faspro-daratumumab-hyaluronidase-fihj) to the standard VRd regimen (Velcade® (bortezomib) (https://www.myeloma.org/velcade-bortezomib) Revlimid® (lenalidomide) (https://www.myeloma.org/revlimid-lenalidomide) and dexamethasone) for patients not undergoing autologous stem cell transplant. This solidifies the role of quadruplet therapies as the new standard of care.
2. Enhanced Consolidation and Maintenance in Frontline Therapy
Deep remission is crucial for myeloma patients. Ongoing studies are exploring more prolonged consolidation strategies and enhanced maintenance therapy. A key study added daratumumab to lenalidomide in the maintenance phase, with promising future applications.
3. MRD-Guided Therapy: A Step Toward a Cure
Minimal Residual Disease (MRD) is becoming a critical tool in guiding therapy. Trials like the MIDAS trial are leveraging MRD to determine the right times to pause or escalate treatment, offering hope for more personalized care.
4. Early Relapse: Blenrep and CAR T-cell Advances
At early relapse, new data on the drug Blenrep® (belantamab mafodotin-blmf) (https://www.myeloma.org/blenrep-belantamab-mafodotin-blmf) showed improved remission and survival rates. In addition, CAR T-cell therapies continue to evolve, with studies demonstrating enhanced safety and efficacy, offering promising real-world applications.
5. The Future of Multiple Myeloma Treatment
Exciting developments are underway, including GPRC5D-targeting CAR T-cell therapy and the possibility of off-the-shelf ALLO CAR T, where T-cells from healthy donors are used to create therapies for myeloma patients. This represents a transformative future for treatment.
New myeloma research was presented at the International Myeloma Society's annual meeting in Rio de Janeiro in Brazil, and today I'm going to briefly summarize the key impactful research that will affect myeloma patients.
Let me give you Dr. Joe's five big highlights. Number one, quadruplet therapies upfront. One of the plenary abstracts was the Cepheus Trial that added Daratumumab to VRd, or Velcade, Revlimid, and dexamethasone, in patients not going to autologous stem cell transplant. This further adds to the evidence that we have more recently of adding isatuximab to VRd that literally all patients should be receiving quadruplet therapies upfront, or at least those who are eligible to receive a quadruplet therapy.
Issue number two, impactful research number two, was more consolidation and maintenance in frontline therapy. What do I mean by that? When patients receive those quadruplets or their frontline therapy, we want to get them to the deepest remission possible, and now we're looking at different strategies of prolonging the consolidation or giving more consolidation after transplant or giving more maintenance after transplant. There was a very good study that presented adding Daratumumab to lenalidomide in maintenance therapy, and we will likely be doing this more so in the future.
Issue number three was MRD-guided therapy. MRD, of course, is minimal residual disease. This is where we can measure down to tiny, tiny amounts of myeloma left within a patient, and we know that that is a step towards a cure and a step towards giving someone a long remission. And so instead of just giving a certain number of cycles or giving therapy until the disease wakes up again, we're starting to use this incredible tool to think about periods of time when we can stop therapy on patients and have it guide whether or not patients get less or more therapy thereafter. One of the clinical trials that was presented, the MIDAS trial, is now built on this platform of MRD guidance.
And then issue number four is what we do at early relapse, at that first relapse, and we saw some really amazing data updating us of that drug blenrep or belantamab, which is an antibody drug conjugate, meaning it's a drug that hooks onto the myeloma cell and drops a toxin into it to be able to help destroy the myeloma cell. We saw combinations with blenrep that really improved not only people's time and remission but even their overall survival, so we're very likely to see blenrep come back to the clinic very soon. And also we saw data with CAR T-cell therapy, real world data or large registry reports of what we can do with CAR T-cell therapy to make it even more effective and in particular, to make it safer for our patients so they're less likely to have the side effects.
Last issue, number five, is really a view into the future of new things that are coming in multiple myeloma. I found this particularly exciting that we have ways of targeting CAR T-cell therapy in different parts of the myeloma cell like GPRC-5D, maybe even doing ALLO CAR T, where we don't have to take T-cells from a patient, we actually just collect T-cells from healthy donors and create a CAR T product that we can directly give to patients and so many other things.
These are really exciting times in multiple myeloma. It's amazing to me how often we can do these updates because the field is changing so much. Make sure you subscribe to our YouTube channel at the International Myeloma Foundation, so you can be up-to-date with all of these amazing changes. Also, we're always available to you at myeloma.org where you can find information there or even be guided by our chatbot, Myelo, as you learn more about multiple myeloma.
Joseph Mikhael, MD, MEd, FRCPC, FACP, FASCO
International Myeloma Foundation Medical Advisor
TGen, City of Hope Cancer Center—Phoenix, AZ, USA
Dr Mikhael is a Professor in the Clinical Genomics and Therapeutics Division at the Translational Genomics Research Institute (TGen), an affiliate of City of Hope Cancer Center. He is also the Director of Myeloma research at the HonorHealth Research Institute in Scottsdale, Arizona. Dr Mikhael specializes clinically in plasma cell disorders, namely multiple myeloma, amyloidosis, and Waldenstrom’s macroglobulinemia. He is the PI of many clinical trials, primarily in relapsed multiple myeloma, and his other clinical research interests include pharmaco-economics, communication skills, and media relations.
Dr. Mikhael recently served as the Chief Medical Officer of the International Myeloma Foundation (IMF) from 2018 to 2026 – he now serves as Medical Advisor to the IMF to provide guidance and strategic input in areas such as patient education, health disparities, collaboration with partners, international research, and publications.
Dr Mikhael has published over 200 peer-reviewed articles in these fields and lectures internationally on a regular basis. Dr. Mikhael is deeply committed to health disparities in myeloma and is the chair of the Diversity, Equity and Inclusion Council at TGen. Dr. Mikhael is heavily involved in training future researchers and mentors junior faculty worldwide. Dr. Mikhael is an active member of the International Myeloma Working Group (IMWG) and recently led the ASCO guidelines in myeloma. Dr. Mikhael also serves as the Treasurer on the executive of the American Society of Hematology.
Dr. Mikhael did his medical training in Canada, including a fellowship in Multiple Myeloma at the Princess Margaret Hospital in Toronto. He also obtained his master’s degree in education from the University of Toronto. He then worked at the Mayo Clinic Arizona as a Hematologist from 2008-2018.
Citations:
Johnson & Johnson Files for US FDA Approval of DARZALEX FASPRO-Based Quadruplet Regimen for Newly Diagnosed Multiple Myeloma Patients for Whom Transplant Is Not Planned." PR Newswire, 1 Oct. 2024, www.prnewswire.com/news-releases/johnson--johnson-files-for-us-fda-approval-of-darzalex-faspro-based-quadruplet-regimen-for-newly-diagnosed-multiple-myeloma-patients-for-whom-transplant-is-not-planned-302263120.html (http://www.prnewswire.com/news-releases/johnson--johnson-files-for-us-fda-approval-of-darzalex-faspro-based-quadruplet-regimen-for-newly-diagnosed-multiple-myeloma-patients-for-whom-transplant-is-not-planned-302263120.html).
Bahlis NJ, Costa LJ, Facon T, Harousseau JL, Manier S, Perrot A, Touzeau C, Mohty M. Current Advances in Multiple Myeloma: A Post International Myeloma Society (IMS 2022) Round Table Debate by the International Academy for Clinical Hematology (IACH). Clin Hematol Int. 2023 Jun;5(2-3):112-121. doi: 10.1007/s44228-023-00036-8. Epub 2023 Apr 15. PMID: 37060392; PMCID: PMC10241743. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241743/ (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241743/)
Poseida Therapeutics Reports Positive Interim Phase 1 Results for Allogeneic CAR-T Therapy P-BCMA-ALLO1 with High Overall Response Rates in Heavily Pretreated Relapsed/Refractory Multiple Myeloma Patients." PR Newswire, 18 Sept. 2024, www.prnewswire.com/news-releases/poseida-therapeutics-reports-positive-interim-phase-1-results-for-allogeneic-car-t-therapy-p-bcma-allo1-with-high-overall-response-rates-in-heavily-pretreated-relapsedrefractory-multiple-myeloma-patients-302261471.html (http://www.prnewswire.com/news-releases/poseida-therapeutics-reports-positive-interim-phase-1-results-for-allogeneic-car-t-therapy-p-bcma-allo1-with-high-overall-response-rates-in-heavily-pretreated-relapsedrefractory-multiple-myeloma-patients-302261471.html).