The Multiple Myeloma Hub spoke to Vania Tietsche de Moraes Hungria, Clínica São Germano, São Paolo, BR. We asked, What is the impact of belantamab mafodotin (belamaf) on quality of life (QoL) in patients with multiple myeloma (MM)? 

Hungria provided insights into the mechanism of action of belamaf, its efficacy and safety in heavily pre-treated patients, and the latest findings from the phase III DREAMM-7 (NCT04246047) study. Hungria discussed how belamaf in combination with bortezomib and dexamethasone (BelaVd) impacts disease progression, survival, and patient-reported outcomes compared to daratumumab with Vd (DaraVd). This discussion also evaluated the safety profile of belamaf, including ocular side effects and their impact on QoL.

Key learnings

• Belamaf is an antibody–drug conjugate that targets the B-cell maturation antigen on malignant plasma cells.
• Belamaf has previously demonstrated promising anti-myeloma activity and a manageable safety profile as a sole agent in patients with heavily pre-treated MM.

DREAMM-71,2

• DREAMM-7 is a phase III, randomized study evaluating BelaVd vs DaraVd in patients with relapsed/refractory MM.
• A statistically significant benefit in progression-free survival, overall survival, duration of response, and measurable residual disease negativity were observed with BelaVd.
• Patients reported stable quality of life, physical functioning, fatigue, and disease symptoms, with no significant differences between treatment arms.
• Ocular toxicities were more common during the initial phase of treatment but generally improved as dosing frequency was reduced, highlighting dose modification as an effective strategy to manage these effects.
• Among patients who experienced a clinically meaningful decline in visual acuity, overall QoL remained comparable to those treated with DaraVd.
• BelaVd has a limited impact on health-related QoL, supporting its potential as a new standard of care treatment for relapsed/refractory MM.

This educational resource is independently supported by GSK. All content was developed by SES in collaboration with an expert steering committee; funders are allowed no influence on the content of this resource.

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The Multiple Myeloma Hub spoke with Mohamad Mohty, Hôpital Saint-Antoine and Sorbonne University, Paris, FR. We asked, What is the impact of elranatamab on quality of life (QoL) in relapsed/refractory multiple myeloma (RRMM)?

Mohty discussed the impact of elranatamab on QoL in patients with RRMM, highlighting its benefits in symptom relief, mobility, and overall well-being. Mohty also addressed the associated risk of cytokine release syndrome (CRS), neurotoxicity, and infections, concluding with the latest clinical trial data and emphasizing the need for ongoing research to optimize the role of elranatamab and other bispecific antibodies in patient care.

Key learnings

• Overall, elranatamab has positively impacted QoL in many patients with RRMM by providing rapid symptom relief, reducing bone pain and fatigue, improving mobility, and decreasing healthcare visits.
• Better disease control also contributes to improved psychological well-being.
• These benefits ultimately enhance daily functioning and overall well-being, allowing patients to resume their daily activities.
• Adverse events are a concern; however, the implementation of step-up dosing helps to reduce the risks of severe CRS and neurotoxicities.
• The risk of infections remains significant. However, mitigation strategies such as prophylactic antivirals, antifungals, and intravenous immunoglobulin administration can help preserve QoL.
• Clinical trial data from the MagnetisMM-3 (NCT04649359) trial support these findings, demonstrating improved patient-reported outcomes in global health status, functional ability, and symptom management.
• Ongoing trials aim to further clarify the role of elranatamab and other bispecific antibodies in enhancing QoL.

This educational resource is independently supported by Pfizer. All content was developed by SES in collaboration with an expert steering committee. Funders were allowed no influence on the content of this resource.

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During the European Hematology Association (EHA) 2024 Hybrid Congress, the Lymphoma Hub and Multiple Myeloma Hub held a joint satellite symposium entitled ‘Sequencing immune-based therapies in B-cell malignancies’.

Here the Multiple Myeloma Hub is pleased to share the session: Next wave of immune-based therapies: What you need to know, which focused on relapsed/refractory (R/R) multiple myeloma (MM) and was presented by Krina Patel, MD Anderson Cancer Center, Houston, US.

This activity was supported through an educational grant from Bristol Myers Squibb.

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Ciltacabtagene autoleucel (cilta-cel) is a B-cell maturation antigen (BCMA)-targeting chimeric antigen receptor (CAR) T-cell therapy, which is one of only two U.S. Food and Drug Administration (FDA)-approved CAR T-cell therapies for the treatment of relapsed/refractory multiple myeloma (RRMM). Both approved CAR T-cell agents are indicated in the heavily pre-treated setting after four or more prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody.

However, in February 2024, the European Medicines Agency (EMA) Committee for Medicinal Products for Human Use (CHMP) recommended the approval of cilta-cel after at least one prior line of therapy, including an immunomodulatory agent or proteasome inhibitor, for those who have progressed on the last therapy and are refractory to lenalidomide.

The Multiple Myeloma Hub is pleased to summarize the rationale for and latest data from clinical trials of cilta-cel after one to three lines of therapy for the treatment of MM.

Read the article here: https://multiplemyelomahub.com/medical-information/integrating-cilta-cel-into-earlier-lines-of-therapy-rationale-and-latest-data-from-cartitude-2-and-cartitude-4

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During the 65th American Society of Hematology Annual Meeting and Exposition, Dima presented results from a retrospective analysis to evaluate the real-world safety and efficacy of teclistamab, with a focus on patients who would have been ineligible for the MajesTEC-1 trial. We summarize the key findings in this podcast.

To read this article on the Multiple Myeloma Hub, click here: https://multiplemyelomahub.com/medical-information/teclistamab-real-world-safety-and-efficacy

This educational resource is independently supported by Johnson & Johnson. All content is developed by SES in collaboration with an expert steering committee; funders are allowed no influence on the content of this resource.

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During the Multiple Myeloma Hub Steering Committee Meeting in May 2024, key opinion leaders met to discuss key considerations regarding infections associated with bispecific antibodies. Meral Beksaç​ opened with a presentation reviewing the infectious complications associated with bispecific antibodies, and current treatment algorithms for such infections. Beksaç​ explored an analysis of infections and parameters of humoral immunity in the MonumenTAL-1 study, the clinical management of infections, and regional differences in access to prophylaxis and treatment for infections.

Following her presentation, Beksaç​ chaired a Q&A session featuring Hermann Einsele, Paul Richardson, Heinz Ludwig, María-Victoria Mateos, Elena Zamagni, and Vania Tietsche De Moraes Hungria. Discussions included COVID infections, the need for vaccination in donors of immunoglobulins for IVIG treatment, and the impact of dosing schedules on reducing infectious complications and T‑cell exhaustion.

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During the Multiple Myeloma Hub Steering Committee Meeting in May 2024, key opinion leaders met to discuss the current use of CAR T-cell therapies in clinical practice, with a focus on patient-specific considerations in the development of personalized treatment plans.

To open, Hermann Einsele provides a presentation reviewing the latest data from trials of ciltacabtagene autoleucel (cilta-cel) and idecabtagene vicleucel (ide-cel) in relapsed/refractory multiple myeloma (RRMM), including the KarMMa and CARTITUDE trials. He explores criteria for the identification of patients who may benefit from CAR T-cell therapy, mechanisms of resistance to BCMA CAR T-cell therapy, and the rationale for the earlier application of CAR T-cell therapies in MM. Einsele provides a review of the toxicities associated with immunotherapies, including strategies for prevention and monitoring, management techniques for CRS and ICANS, and infection prophylaxis and management.

Following his presentation, Einsele chaired a Q&A session featuring Paul Richardson, Heinz Ludwig, María-Victoria Mateos, Meral Beksaç, Elena Zamagni, and Vania Tietsche De Moraes Hungria.

Discussions included the implementation of CAR T-cell therapies in earlier lines of therapy, CAR T-cell therapies in high-risk disease, maintenance after CAR T-cell therapies, and toxicities with CAR T-cell therapies and bispecifics.

This educational resource is independently supported by Bristol Myers Squibb. All content is developed by SES in collaboration with an expert steering committee; funders are allowed no influence on the content of this resource.

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