You are absolutely correct. Show me a non transplant approach that has 84% pfs at 4 years. When the median OS is >15 years for many patients unless there is a cure you won’t see OS benefit in frontline except if access is not equal

The problem with the analysis you describe is that mrd measured at 1 year after the transplant decision made. 2/3 of mrd neg patients were in the transplant arm. Don’t get confused by the data. Transplant offers huge benefit

5-year follow-up from the LEGEND-2 study of cilta-cel
⏳ 5-year PFS 21% and OS 49% (despite variable LD). 3 progressions after 5 years. No plateau!
🧠No delayed neurotox
🩸No 2nd heme malignancies
🏋️T cells persisted >1 year for VGPR+ (1 at 5.6 years!)
jhoonline.biomedcentral.com/articles/10.11…

I love this figure from a recent review of high risk MM by Matthew Rees and Shaji Kumar in AmericanJournalofHematology. Risk is a spectrum that involves so much more than cytogenetics and ISS stage! #mmsm

onlinelibrary.wiley.com/doi/full/10.10…

Dara-KRd and Dara-VRd for transplant-eligible NDMM with high cytogenetic risk. Inferior PFS with both quadruplets with >/= 2 HRCA #mmsm #bmtsm Natalie Callander Plasma Cell Pete Luciano J Costa Blood Cancer Journal nature.com/articles/s4140…

#Myeloma Paper of the Day: Study of immune fitness & teclistamab finds responders had higher baseline total T-cell counts, lower Tregs, fewer T-cells expressing co-inhibitory receptors, less soluble BCMA, and T-cell profile with more cytolytic potential: pubmed.ncbi.nlm.nih.gov/38657201/.

#Myeloma Paper of the Day: Study of RAS/RAF finds 61% of plasma cell dyscrasia patients presented w/ mutations, lower frequencies in pre-symptomatic cases, different mutations vs. solid tumors, & some having mutations in different subclones: pubmed.ncbi.nlm.nih.gov/38643494/.

Imp manuscript from the Mayo group Saurabh Zanwar showing the outcomes of pts w/ suboptimal response to DaraVCd in NDAL. I have traditionally switched to BCL2 inhibition ASAP if t(11;14) but for the rest such a tricky spot! Hopeful for TCE in this popn

nature.com/articles/s4137…

#Myeloma Paper of the Day: Study of real world impact of bridging therapy prior to CAR T finds response showed no significant association with CRS, ICANS rates, or 3-month post-CAR-T response, and median PFS didn’t significantly differ based on response: pubmed.ncbi.nlm.nih.gov/38609386/.

IMF Research Milestone! #ODAC unanimously votes yes on #MRD testing as an accelerated endpoint in #clinicaltrials . A decade of effort by the IMF. Thank you, Dr. Durie and i2TEAMM for paving the way for faster #FDA approvals in #myeloma drug development. myeloma.org/node/10787

Huge win for #myeloma patients today! The ODAC committee approved MRD testing as an early endpoint for MM drugs in trials. This accelerates progress towards new treatments! Thank you all who participated Nikhil C. Munshi, MD C. Ola Landgren, M.D. International Myeloma Foundation + #mmsm myeloma.org/news-events/mu…

#Myeloma Paper of the Day: A preliminary investigation evaluating ChatGPT as an educational resource for patients with multiple myeloma concludes it has 95% accuracy rate in answering key questions: pubmed.ncbi.nlm.nih.gov/38602288/.

Thanks Robert Z. Orlowski for highlighting this brief correspondence on artificial intelligence, which is more common than you would think! #AI #mmsm Ludovic Saba Chakra Chaulagain MD FACP Jack Khouri Faiz Anwer MD Cleveland Clinic MD

It is an honor to collaborate with our colleagues Beth Faiman PhD Faiz Anwer MD Jack Khouri on this project from Cleveland Clinic Florida Maroone Cancer at Cleveland Clinic Florida Ludovic Saba

Thankful for this collaborative effort! Cleveland Clinic MD #CleClinicCancer

Impact of bridging therapy with Ide-cel for myeloma:U.S. Myeloma Immunotherapy Consortium. Blood Cancer Journal. Key takeaway: 'Less is more'; exercise caution with intensified/infusional Cy, if feasible. #myeloma #CAR -T
shorturl.at/eqyZ5

Multiple myeloma patients previously treated with T-cell redirection therapy have significantly low risk of developing CRS with teclistamab ⁦MSK Department of Medicine⁩ #mmsm ashpublications.org/bloodadvances/…

Congratulations to Dr. Matt Kalaycio Cleveland Clinic MD Cleveland Clinic - new chair of National Comprehensive Cancer Network (NCCN) board of directors John Suh Case Comp Cancer Ctr !

38 year old male with h/o residency

FDA Approves Cilta-Cel for R/R Multiple Myeloma Who Have Received at Least One Prior Line of Therapy and Are Refractory to Lenalidomide #mmsm onclive.com/view/fda-appro…