From Trials to Practice: What's New and What's Next for Myeloma

In this Editor’s Special Episode of The HemOnc Pulse, Gurbakhash Kaur, MD, Assistant Professor of Medicine, hematology and oncology at Mount Sinai and Danai Dima, MD, Assistant Professor, Clinical Research Division at Fred Hutchinson Cancer Center explore the most promising investigational and newly approved therapies for patients with relapsed/refractory multiple myeloma, including those with high-risk features such as extramedullary disease (EMD).

Among the agents discussed are dual-target CAR T-cell therapies, including a BCMA-CD19 construct presented at the EHA Congress with a median follow-up of 12.4 months. Notably, this therapy demonstrated a manageable safety profile, which experts find encouraging. Also discussed is teclistamab in combination with talquetamab, a bispecific strategy showing exceptional activity in EMD, a historically difficult subtype. This combination is now reflected in the NCCN guidelines for use after at least four prior lines of therapy.

The conversation shifts to newer targets such as GPRC5D. The CAR T product targeting GPRC5D or arlo-cel is currently under evaluation in phase 2 and 3 trials, offering reduced skin and nail toxicities compared to talquetamab. Additional highlights include the recent approval of linvoseltamab (a BCMA x CD3 bispecific antibody) and the monthly-dosed BCMA-targeting bispecific antibody, F182112.

The speakers emphasize the potential return of belantamab mafodotin to clinical use and the exciting prospects of trispecific antibodies. As the field advances, they stress the need for evidence-based sequencing of these novel immunotherapies to optimize outcomes. They close the episode with cautious optimism, citing long-term CARTITUDE-1 results showing one-third of patients alive and disease-free at five years, fueling hope for durable remissions and possibly functional cures.

This forward-looking discussion captures the momentum in myeloma therapy and the real-world challenges of bringing innovation to patients.