Friday evening (Eastern time), I attended one of the best symposiums I’ve seen in my 12 years of attending the American Society of Hematology (ASH) Annual Meeting. Sagar Lonial, MD moderated a panel of elite myeloma specialists through five modules of discussion. The panel included Professor Philippe Moreau, MD; Robert Z Orlowski, MD, PhD; Noopur Raje, MD; Paul G. Richardson, MD. The discussion also included real-world clinical questions from six community-based hematologists.
The Modules ran the spectrum from newly diagnosed to what the future holds. The modules were Management of Newly Diagnosed Multiple Myeloma (MM), Integration of Novel Therapies into the Management of Relapsed/Refractory MM, Chimeric Antigen Receptor (CAR) T-Cell Therapy for MM, Bispecific Antibodies for the Treatment of MM, and Other Novel Agents and Strategies Under Investigation for MM.

Each panelist led one of the modules which sparked good conversation and sometimes debate among the group. I can’t include all the items that caught my attention from the two-hour event, but a few key takeaways for me included:

• Quad therapies of Darzalex (daratumumab), Revlimid (lenalidomide), Velcade (bortezomib), and dexamethasone; or Sarclisa (isatuximab), Revlimid (lenalidomide), Velcade (bortezomib), and dexamethasone definitely show benefit and no need to avoid adding the monoclonal antibody to the tried and true Revlimid, Velcade, dex induction therapy. They produce increased response and increased minimal residual disease (MRD) negativity.
• The use of autologous stem cell transplant (ASCT) did not have 100% endorsement from the panelists. Drs. Lonial, Moreau, and Raje continue to see value, while Dr. Orlowski did not favor using it upfront and Dr. Richardson was undecided. What does the future hold for ASCT? Will CAR T-cell therapy take its place in the future? I’ll be listening closely in the abstracts for more information on this topic.
• The use of Xpovio (Selinexor) got favorable reviews from the panel when it was used at lower doses than originally prescribed. Its unique mechanism of action provides a new way to attack myeloma. I used this drug as part of my bridging therapy before my CAR T-cell therapy in 2023. I was wisely advised by the late Jack Aiello on the dosage—which concurs with what was presented in the symposium, and I had a very positive experience with this treatment.
• There was consensus that PET/CT is advised post-CAR T-cell therapy to monitor for extramedullary disease. I questioned the need for this in my last visit with Dr. Lonial and this reason, which was also confirmed by my local hematologist, convinced me of the true need. I have this scheduled for two weeks from now.
• Blenrep (belantamab mafodotin)—the antibody drug conjugate—will be back in the arsenal of FDA-approved treatments. I’ll be looking for additional data from the DREAMM 7 and DREAMM 8 studies over the next couple of days. Given at reduced dosing and spread out over as much as 8-12 weeks, this is showing efficacy without the previously reported difficult ocular side effects.
• Iberdomide and Mezigdomide, which are advances of immunomodulatory agents like Revlimid and Pomalyst, show great promise. There was a discussion that they may even replace Revlimid in the induction therapy regimen in the future.

I’m excited to get started in the Annual Meeting which starts virtually for me this afternoon. Please check out the blogs and tweets on Twitter (X) of the entire ASH 24 team throughout the conference to stay up-to-date on all the promising advancements.

Linda Huguelet, Chattanooga Multiple Myeloma Networking Group

@LindaMYELOMA