Morie A. Gertz, MD, MACP, Mayo Clinic

Panelists discuss how chimeric antigen receptor (CAR) T-cell therapy in early relapsed multiple myeloma can provide deep and durable responses for eligible patients, though patient selection, timing of referral, manufacturing logistics, and management of adverse effects remain important considerations in optimizing outcomes.

Panelists discuss how the CEPHEUS trial’s demonstration of improved progression-free survival with daratumumab-VRd versus VRd alone in transplant not-preferred NDMM provides compelling evidence for quadruplet therapy in this setting, though considerations of cost, toxicity management, and patient selection remain important factors in implementation.

Panelists discuss how recent clinical trials have demonstrated improved outcomes with antibody-containing regimens and biomarker-driven approaches in patients with transplant not-preferred newly diagnosed multiple myeloma (NDMM).

Panelists discuss how the decision between quadruplet versus triplet therapy depends on multiple factors, including cytogenetic risk status, insurance coverage/drug access, patient fitness to tolerate additional toxicity, and the strength of evidence supporting improved outcomes with 4-drug combinations.

Panelists discuss how patient-specific factors like age, comorbidities, cytogenetic risk status, and personal preferences guide decisions to deviate from standard protocols, with particular attention to frailty scores and organ function when considering treatment intensity.

Panelists discuss how VRd (bortezomib, lenalidomide, dexamethasone) remains the standard frontline regimen for transplant-eligible newly diagnosed multiple myeloma (NDMM) patients, though some now consider adding daratumumab (dara-VRd) in high-risk cases.

Closing out their panel on bispecifics in relapsed/refractory multiple myeloma, key opinion leaders share closing thoughts and hopes for the future treatment landscape.

Expert panelists from Mayo Clinic discuss their approach for the use of BCMA and non-BCMA targeting bispecifics, respectively, in patients with relapsed/refractory multiple myeloma.

Focused discussion on the mSMART guidelines for monitoring and managing adverse events associated with bispecific therapies in patients being treated for relapsed/refractory multiple myeloma.

A panel of key opinion leaders from Mayo Clinic reflect on optimizing use of bispecifics in relapsed/refractory multiple myeloma, reviewing step-up dosing, administration, and followup strategies.

Comprehensive insights from experts in Mayo Clinic on the selection and sequencing of CAR T cell therapy or bispecifics, respectively, in patients with relapsed/refractory multiple myeloma.

Before closing out the panel’s review of clinical data behind bispecifics in relapsed/refractory multiple myeloma, Morie Gertz, MD, highlights use of cevostamab therapy in this setting.

Shared insight from Rafael Fonseca, MD, on data from MonumenTAL-1 and the use of talquetamab therapy in patients with relapsed/refractory multiple myeloma.

Expert perspectives from Joselle Cook, MBBS, on use of elranatamab in relapsed/refractory multiple myeloma based on data from the MagnetisMM-1 trial.

Expert Shaji Kumar, MD, spearheads a review of data from MajesTEC-1 and use of teclistamab therapy in patients with relapsed/refractory multiple myeloma.

Opening the panel’s discussion on multiple myeloma management, Rafael Fonseca, MD, reviews treatment options available to patients at early or late relapse.

Broad discussion on novel therapies, including bispecifics and CAR-T therapies, that are evolving the treatment landscape of multiple myeloma.

Panelists take a broad look at treatment selection and sequencing through multiple lines of therapy in patients with multiple myeloma.

Moving to the last patient case of newly diagnosed multiple myeloma, expert panelists work together to define patient frailty in this setting and discuss how frail patients are treated in practice.

Shared insight on optimizing selection and use of daratumumab-containing regimens in NDMM, with regard for clinical trial readouts in this setting.

Experts review a second patient case wherein transplant-ineligible newly diagnosed multiple myeloma was treated with the daratumumab, lenalidomide and dexamethasone regimen and how updated data from the MAIA trial can be incorporated into clinical practice.

Considerations for assessing eligibility of patients for transplantation for NDMM and how maintenance therapy may be initiated in the post-transplant setting.

Centering discussion on a patient case of transplant-ineligible newly diagnosed multiple myeloma, experts consider how they would approach workup and management.

Comprehensive insight on optimizing newly diagnosed multiple myeloma management, ranging from response assessment to use of consolidation and maintenance therapy.

Shared insight on the GMMG-HD7 study, which utilized a frontline isatuximab-containing quadruplet regimen in patients with newly diagnosed multiple myeloma.

Expert perspectives on frontline daratumumab-containing quadruplet regimens in the context of recent clinical trials in newly diagnosed multiple myeloma.

Concluding their discussion on newly diagnosed multiple myeloma, expert panelists consider treatment options for patients with high-risk disease.

Shared insight on the evolving treatment landscape of transplant-ineligible newly diagnosed multiple myeloma.

After reviewing the case of a patient with transplant-eligible newly-diagnosed multiple myeloma, experts consider optimal selection of first-line treatment.

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