Topline Presentation Points 
MGUS and SMM (0:15-3:17)
  • iStopMM study Iceland (ASH 2021)
    • Prevalence of SMM
    • Impact of screening, work-up, follow-up
Risk stratification in MM (3:17-5:28)
  • Chromosome 1 abnormalities important. (ECOG study E1A11, Schmidt, TM et al. ASH 2021)
    • Gain1q, amp1q, and del1p confer inferior PFS among pts with otherwise standard risk features who are treated with VRd or KRd induction
    • In multivariate analysis, +1q was an independent prognostic factor for poor PFS
    • There were no significant differences in PFS among patients with +1q or del1p based on receipt of VEd or KRd
    • Possible OS benefit for KRd among patients with gain1q, del1p and “ultra high risk”.
    • Classification warrants further review
Newly Diagnosed MM (NDMM) (5:29-10:59)
  • GRIFFIN – Phase 2 study of D-RVd vs RVd in transplant eligible NDMM (Anderson et al, Blood 2021)
    • Response rates for sCR and > CR were greater for D-RVd vs RVd at all points, with the deepest responses occurring after 2 years of maintenance therapy
    • Anticipate Canadian clinicians will add Daratumumab to induction
    • MRD- negativity rates improved throughout DR maintenance period
    • PFS in the ITT Population
  • GMMG-HD7 Phase III Trial – Isatuximab VRD (Goldschmidt et al. ASH 2021)
    • First primary end point, end of induction
    • MRD negativity by NGF 10⁻⁵, was met in ITT analysis
    • Isa-RVd is the first regimen to demonstrate a rapid and statistically significant benefit from treatment by reaching a MRD negativity of 50.1% at the end of induction and to show superiority vs RVd in a Phase 3 trial
  • MASTER Trial – Dara-KRd (Costa, LJ et al. ASH 2021)
    • Very powerful and effective regimen
    • Not as effective in ultra high risk
    • Not available in Canada
Relapsed MM (11:01-23:40)

Treatment for Myeloma is being further disrupted with a number of new agents that show significant activity in heavily pre-treated

CAR T
CARTITUDE-1b/2 – Cilta-cel (Martin et al. ASH 2021)

  • Remarkable efficacy with 98% response rate
  • 2 year PFS 71% for sCR patients and 60.5% all patients
  • 2 year OS 74%, significant for patients who would normally not expect a year

Other CAR-T targeting BCMA -liso-cel 90% response


Bi-specific antibodies (BiTEs) targeting BCM
Teclistamab (most advanced)

  • MajesTEC-1 trial in highly refractory patients
    • 62% ORR, response rapid and MRD negativity of 24.7% at threshold of 10⁻⁵
    • Well tolerated

Tnb383B

  • Higher ORR at 82% with serious AEs occurring in 46% patients

Other – Regn5468, Elranatamab, CC93269, AMG701


‘Off the shelf’ T-Cell engagers
GP3C5D-targeted CAR T

  • Talquetamab a promising target MonumenTAL-1 trial 70% ORR

FcRH5 and CD3

  • Cevostamab a dual targeted BiTE


Other agents
Ven+Bort+Dex (Phase 3 BELLINI trial)

  • PFS was significantly prolonged in Ven+Bd vs Pbo+Bd
  • Greatest PFS improvements observed in patients with t(11;14) or BCL2ʰᶦᵍʰ expression
  • Patients with these translocations 11 and 14 can do well on Ven

Iberdomide – a potent novel CELMoD agent, being developed as a next generation IMiD for rrMM
(Phase 1/2b CC-220-MM-001)

Amyloidosis (23:40-24:38)

ANDROMEDA study update of D-VCd vs VCd

  • At a medium follow-up of 25.8 months, hematological response rates remained higher with D-VCd vs VCd
  • Organ response rates at 18 months remained higher with D-VCd vs VCd