IMS 2024 Speakers Look Back on Exciting Myeloma Updates

We spoke with the following global experts who attended the 2024 International Myeloma Society meeting regarding what they believe was the most interesting update in the myeloma space this year:

• Pieter Sonneveld, MD, PhD, professor of hematology at the Erasmus University Medical Center, chairman of the Multiple Myeloma Working Group and European Myeloma Network
• Saad Usmani, MD, MBA, FACP, myeloma specialist and cellular therapist at Memorial Sloan Kettering Cancer Center
• Binod Dhakal, MD, associate professor, division of hematology and oncology, Medical College of Wisconsin

This transcript has been lightly edited for clarity.

Transcript

What update in the myeloma space this year has been the most interesting to you?

Sonneveld: The most interesting update to me is the PERSEUS study, a study using traditional drugs like VRd [bortezomib, lenalidomide, and dexamethasone] and adding the monoclonal antibody daratumumab. This results in a great effect in the frontline setting of treatment for multiple myeloma.

At the same time, we are also aware of new developments like CAR [chimeric antigen receptor] T-cell treatments and treatments with bispecific antibodies.

The organization for which I'm working, The European Myeloma Network [EMN], also coordinates 2 important trials in the frontline setting. One trial is comparing CAR T-cell treatment with standard autologous stem cell transplantation. This trial is ongoing in many countries around the world, coordinated by EMN.

The other trial is about the use of bispecifics in the maintenance setting—in this case, teclistamab, also for a frontline treatment for patients with multiple myeloma. Trials have been done in the relapse setting and we know they are very effective, have very high response rates, and lasting responses of good quality.

We expect that when moving these novel agents from the relapse setting to the frontline setting, the impact on the treatment in terms of response rate, but especially duration of response, will be huge.

We expect that this will be the next step in myeloma treatment that will set the new standard of care and we expect a lot from that. Over the next 5 to 10 years, we will see the developments with these new agents. I think the whole world of myeloma treatment will change with the results of these new trials.

Usmani: The movement from 3-drug combinations to anti-CD38–based quadruplet induction approaches for patients has been a very important step forward for patients. The next important avenue that we have to figure out is what kind of maintenance strategies would suffice for standard-risk patients, what do we need for high-risk patients? We need to look at the duration of therapy. These will be important things to consider for the future research directions.

Dhakal: There are a lot of new CAR T [therapies] being developed, both against BCMA [B-cell maturation antigen] and non-BCMA, like GPRC5D. Under this, it has been pretty encouraging and shows some very good results. In addition, there are small molecules that are being developed, particularly for the protein integrators, BCL-2 inhibitors, and a lot of developments in the bispecific antibodies, but not only for BCMA, but also GPRC5D/FcRH5. More importantly, things are moving earlier in the early-line setting and are showing very impressive efficacy and safety, and this really kind of sets this platform for us to have a very deep, durable response in majority of the patients in the future.