Today’s Clinical Trials Define the Next Era in Myeloma

In this Editor’s Special Episode of The HemOnc Pulse, Hira Mian, MD, associate professor, Oncology, McMaster Univeristy, explores the latest clinical trial updates and future directions in the treatment of multiple myeloma, based on updates presented during the 2025 ASCO Annual Meeting.

Dr. Mian begins by examining the evolving role of selinexor, a therapy once challenging due to toxicity concerns, and explains how optimized dosing strategies and improved supportive care have made it a more manageable option in clinical practice. The discussion then shifts to the MonumenTAL-1 study and the progress of talquetamab, the first FDA-approved GPRC5D-targeting bispecific antibody. Dr. Mian highlights its impressive response rates, survival outcomes, and encouraging long-term safety profile—particularly with respect to infection management. She also provides perspective on where talquetamab fits within the bispecific antibody landscape alongside BCMA-directed therapies.

Looking ahead, Dr. Mian outlines the most significant trends shaping myeloma care today: the rise of quadruplet regimens as standard of care, the growing importance of minimal residual disease (MRD) negativity as both a prognostic and therapeutic marker, and the anticipated expansion of bispecific antibody combinations into earlier treatment settings.

Finally, Dr. Mian offers an exciting preview of emerging trispecific antibodies, including J&J-5322, which targets both BCMA and GPRC5D and has shown remarkable depth of response even in heavily pretreated patients.