Highlights in Myeloma, GVHD, and NHL From ASH 2024

S. Vincent Rajkumar, MD, of Mayo Clinic; Nosha Farhadfar, MD, of Methodist Physician Practices; and Sonali Smith, MD, of University of Chicago Medicine, sit down with Chandler Park, MD, FACP, to discuss the latest in multiple myeloma, graft-vs-host disease, and non-Hodgkin lymphoma, respectively, from the 2024 ASH Annual Meeting.

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Breaking the News in Myeloma, GVHD, and NHL, With Drs Rajkumar, Farhadfar, and Smith 

, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, 

 covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions.

In today’s episode, we invited experts from across oncology specialties to discuss the abstracts and presentations they are most looking forward to seeing at the 2024 ASCO Annual Meeting.

Stephen Liu, MD, an associate professor of medicine at Georgetown University and the director of Thoracic Oncology and head of Developmental Therapeutics at the Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, highlighted key updates in lung cancer treatment that he is excited to see. 

Sara A. Hurvitz, MD, FACP, a professor, as well as the senior vice president and director of the Clinical Research Division at Fred Hutchinson Cancer Center, as well as the head of the Division of Hematology and Oncology at the University of Washington Department of Medicine in Seattle, previewed breast cancer research she is involved in that will be presented at the meeting. 

S. Vincent Rajkumar, MD, a professor of medicine, a consultant in the Division of Hematology in the Department of Internal Medicine, and a consultant in the Division of Hematopathology in the Department of Laboratory Medicine and Pathology at Mayo Clinic in Rochester, Minnesota, spotlighted several areas of multiple myeloma research where results are anticipated. 

Sumanta Kumar Pal, MD, FASCO, chair of the Kidney and Bladder Cancer Disease Team, codirector of the Kidney Cancer Program, and a professor in the Department of Medical Oncology & Therapeutics Research at City of Hope in Duarte, California, noted the genitourinary cancer data he is looking forward to seeing. 

Finally, Shubham Pant, MD, MBBS, a professor in the Department of Gastrointestinal (GI) Medical Oncology in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston, shared key updates in GI cancer that you won’t want to miss. 

That’s all we have for today! Thank you for listening to this episode of 

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Experts from across oncology specialties discuss the abstracts and presentations they are most looking forward to seeing at the 2024 ASCO Annual Meeting.

Oncology Experts Preview Top Abstracts From the 2024 ASCO Annual Meeting

S. Vincent Rajkumar, MD, discusses highly anticipated abstracts in multiple myeloma that will be presented at the 2024 ASCO Annual Meeting.   

Dr Rajkumar Previews ASCO 2024 Data in Multiple Myeloma

S. Vincent Rajkumar, MD, professor, medicine, Mayo Clinic College of Medicine, chair, Mayo Clinic Myeloma, Amyloidosis, and Dysproteinemia Group, discusses highly anticipated abstracts in multiple myeloma that will be presented at the 2024 ASCO Annual Meeting.

At the 2024 ASCO Annual Meeting, findings from several pivotal randomized controlled trials in multiple myeloma are set to be presented for the first time, promising to provide new insights and potentially alter the treatment paradigm in myeloma, Rajkumar begins. Four key trials are of particular interest, 2 of which focus on the use of isatuximab (Sarclisa)–based regimens in the frontline setting for patients with newly diagnosed transplant-ineligible multiple myeloma, he says. The first is a randomized phase 3 study (NCT04751877) of isatuximab plus lenalidomide (Revlimid) and dexamethasone (Rd) with bortezomib (Velcade; Isa-VRd) vs Isa-Rd alone in patients between 65 and 80 years of age. The second trial, the phase 3 IMROZ study (NCT03319667), will compare Isa-VRd with standard-of-care (SOC) VRd.

Data from the randomized phase 3 DREAMM-8 study (NCT04484623) will also be presented, Rajkumar continues. This study assessed belantamab mafodotin (Blenrep) plus pomalidomide (Pomalyst) and dexamethasone (BPd) vs pomalidomide plus bortezomib and dexamethasone (PVd) in patients with relapsed/refractory multiple myeloma. These data are particularly noteworthy as the marketing authorization for belantamab mafodotin in this patient population was 

 (NCT04162210), which did not meet its primary end point of a progression-free survival (PFS) benefit with BPd vs PVd, Rajkumar notes. However, new data from DREAMM-8 may shed light on the potential advantages of BPd in the relapsed/refractory patient population, Rajkumar says.

Another significant trial being presented is the phase 3 CANOVA study (NCT03539744), which compared venetoclax (Venclexta) plus dexamethasone vs pomalidomide plus dexamethasone in patients with t(11;14)-positive, relapsed/refractory multiple myeloma, Rajkumar details. Despite initial setbacks in the development of venetoclax from the phase 3 BELLINI trial (NCT02755597), there is hope that new data will provide a clearer picture of venetoclax's efficacy and safety, he adds.

In addition to these phase 3 trials, a phase 2 trial on the real-world schedule de-escalation of teclistamab (Tecvayli) in patients with relapsed/refractory multiple myeloma from Memorial Sloan Kettering will be presented, Rajkumar reports. This study aims to address concerns regarding the tolerability of the current teclistamab dosing schedule for this patient population. Additionally, a real-world study comparing the efficacy of the BCMA-targeted therapy linvoseltamab (REGN5458) vs SOC in patients with triple-class exposed relapsed/refractory multiple myeloma in the United States will be discussed, he adds.

Research on predictors of response to BCMA-based CAR T-cell therapy is also advancing, with a study from the University of Arkansas for Medical Sciences investigating T-cell subsets to predict treatment outcomes, Rajkumar says. Lastly, the MRD2STOP study (NCT04108624) from the University of Chicago will explore the feasibility of using minimal residual disease to determine when maintenance therapy can be safely discontinued in patients with multiple myeloma, addressing the ongoing challenge of the increasing cost and duration of treatment in this disease, Rajkumar explains.

These trials, especially those investigating quadruplet regimens in non–transplant eligible patients, will provide valuable data on both efficacy and safety, potentially influencing future clinical practices in the treatment of patients with multiple myeloma, he concludes.

S. Vincent Rajkumar, MD, discusses highly anticipated abstracts in multiple myeloma that will be presented at the 2024 ASCO Annual Meeting. 


S. Vincent Rajkumar, a professor of medicine at the Mayo Clinic, discusses the prevalence of quadruplet regimens in treating patients with multiple myeloma. Choices for patients who experience ≥2 relapses are complicated and quadruplet regimens are stepping in as a viable option for clinicians, says Rajkumar. However, there are considerations to take into account including access to drugs and cost of the therapy.

Promising quadruplet studies include the phase III CASSIOPEIA (MMY3006) trial, which is evaluating the addition of daratumumab (Darzalex) to bortezomib (Velcade), thalidomide (Thalomid), and dexamethasone (VTd) for the treatment of patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplant.

The FDA granted a priority review to DVTd based on findings from part 1 of the CASSIOPEIA trial, in which the stringent complete response (sCR) rate at day 100 post-ASCT was 28.9% in patients who received the daratumumab regimen compared with 20.3% in those who received VTd alone following induction and consolidation therapy (odds ratio [OR], 1.60; 95% CI, 1.21-2.12; 

 =.001). As these data mature, clinicians may see a rise in the use of quadruplet regimens, Rajkumar concludes.

15th International Conference on Malignant Lymphoma

S. Vincent Rajkumar, a professor of Medicine at the Mayo Clinic, Rochester, Minnesota, discusses the prevalence of quadruplet regimens in treating patients with multiple myeloma.

Dr. Rajkumar on Quadruplet Regimens in Multiple Myeloma Treatment

S. Vincent Rajkumar, MD, professor of Medicine at Mayo Clinic, discusses the significance of the phase III SWOG S0777 study, which looked at bortezomib, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone in patients with previously untreated multiple myeloma.

Results of the study showed that the addition of bortezomib to lenalidomide and dexamethasone for induction therapy for patients with previously untreated myeloma led to a statistically significant and clinically meaningful improvement in progression-free and overall survival.

The NCCN has approximately 20 therapy options to recommend for newly diagnosed patients in the frontline setting, Rajkumar explains. These phase III findings, however, provide practitioners with an option that clearly has a survival benefit in patients. The triplet regimen should become a standard of care, he adds. 

S. Vincent Rajkumar, MD, professor of Medicine at Mayo Clinic, discusses the significance of the phase III SWOG S0777 study, which looked at bortezomib, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone in patients with previously untreated multiple myeloma. 


S. Vincent Rajkumar, MD

Articles

Breaking the News in Myeloma, GVHD, and NHL, With Drs Rajkumar, Farhadfar, and Smith

Oncology Experts Preview Top Abstracts From the 2024 ASCO Annual Meeting

Dr Rajkumar Previews ASCO 2024 Data in Multiple Myeloma

Dr. Rajkumar on Quadruplet Regimens in Multiple Myeloma Treatment

Dr. Rajkumar on Significance of SWOG S0777 Study for Multiple Myeloma