Medscape InDiscussion: Multiple Myeloma Medscape

Drs Joseph Mikhael and Brandon Blue reveal the impact of disparities in multiple myeloma and pave a path forward to culturally competent care.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/964342). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Multiple Myeloma Awareness and African American Disparities https://www.cancer.gov/about-nci/organization/crchd/blog/2017/multiple-myeloma-disparities
Multiple Myeloma https://emedicine.medscape.com/article/204369-overview
International Myeloma Foundation https://www.myeloma.org/
International Myeloma Foundation Launches "M-Power Charlotte" to Improve Outcomes in Multiple Myeloma, a Cancer That Disproportionately Affects African Americans https://www.myeloma.org/international-myeloma-foundation-launches-m-power-charlotte-improve-outcomes-multiple-myeloma
The Tuskegee Timeline https://www.cdc.gov/tuskegee/timeline.htm

Drs Joseph Mikhael and Nina Shah discuss the exciting future in multiple myeloma in which bispecifics, CELMoDs, modakafusp, and easily delivered CAR T-cell therapy all may play a role.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/964340). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
International Myeloma Foundation https://www.myeloma.org/
CAR T-Cell Therapy for Multiple Myeloma https://decisionpoint.medscape.com/oncology/viewarticle/951727
Bispecific Antibodies Versus CAR T-Cells in Multiple Myeloma Treatment: Pros and Cons https://decisionpoint.medscape.com/oncology/viewarticle/967868
Cytokine Release Syndrome https://emedicine.medscape.com/article/2500111-overview
Bispecific Antibodies With Multiple Targets Moving Forward in Multiple Myeloma https://ascopost.com/issues/may-10-2022-supplement-hematologic-oncology-almanac/bispecific-antibodies-with-multiple-targets-moving-forward-in-multiple-myeloma/
Study to Evaluate the Safety and Tolerability of CC-92328 in Participants With Relapsed and/or Refractory Multiple Myeloma https://clinicaltrials.gov/ct2/show/NCT04975399
B-Cell Maturation Antigen (BCMA) in Multiple Myeloma: Rationale for Targeting and Current Therapeutic Approaches https://www.nature.com/articles/s41375-020-0734-z
GPRC5D Is a Target for the Immunotherapy of Multiple Myeloma With Rationally Designed CAR T Cells https://www.science.org/doi/10.1126/scitranslmed.aau7746
Phase I Study of the Anti-FcRH5 Antibody-Drug Conjugate DFRF4539A in Relapsed or Refractory Multiple Myeloma https://www.nature.com/articles/s41408-019-0178-8
belantamab mafodotin https://reference.medscape.com/drug/blenrep-belantamab-mafodotin-4000056
idecabtagene vicleucel https://reference.medscape.com/drug/abecma-idecabtagene-vicleucel-4000133
ciltacabtagene autoleucel https://reference.medscape.com/drug/carvykti-ciltacabtagene-autoleucel-4000224
A Study of Talquetamab in Participants With Relapsed or Refractory Multiple Myeloma https://clinicaltrials.gov/ct2/show/NCT04634552
Dose-Escalation Study of Cevostamab in Participants With Relapsed or Refractory Multiple Myeloma (R/R MM) https://www.clinicaltrials.gov/ct2/show/NCT03275103
Molecular Mechanisms of Cereblon-Interacting Small Molecules in Multiple Myeloma Therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623651/
Open-Label Study Comparing Iberdomide, Daratumumab and Dexamethasone (IberDd) Versus Daratumumab, Bortezomib, and Dexamethasone (DVd) in Participants With Relapsed or Refractory Multiple Myeloma (RRMM) (EXCALIBER-RRMM) https://clinicaltrials.gov/ct2/show/NCT04975997
Modakafusp Alfa (TAK-573), an Immunocytokine, Shows Clinical Activity in Patients with Relapsed/Refractory Multiple Myeloma; Updated Results from a First-in-Human Phase 1 Study https://www.sciencedirect.com/science/article/pii/S0006497121028858
A Phase I Study of MCARH109 and MCARH125 CAR T-Cell Therapy in People With Multiple Myeloma https://www.mskcc.org/cancer-care/clinical-trials/22-052

Joseph Mikhael, MD, and Saad Usmani, MD, discuss options in managing triple-class refractory multiple myeloma including selinexor, belantamab mafodotin, and CAR T-cell therapy.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/964339). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Multiple Myeloma https://emedicine.medscape.com/article/204369-overview
Selinexor Prescribing Information https://www.karyopharm.com/wp-content/uploads/2019/07/NDA-212306-SN-0071-Prescribing-Information-01July2019.pdf
Belantamab Mafodotin Prescribing Information https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Blenrep/pdf/BLENREP-PI-MG.PDF
Cytokine Release Syndrome https://emedicine.medscape.com/article/2500111-overview
Trending Clinical Topic: CAR T-cell Therapy https://reference.medscape.com/viewarticle/965011
Consensus Recommendations for the Clinical Management of Patients With Multiple Myeloma Treated With Selinexor https://www.karyopharm.com/wp-content/uploads/2020/06/Consensus-Recommendations_June2020.pdf
Selinexor, Bortezomib and Dexamethasone: An Effective Salvage Regimen for Heavily Pretreated Myeloma Patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8932935/
Once Weekly Selinexor, Carfilzomib, and Dexamethasone (XKd) in Carfilzomib Nonrefractory Multiple Myeloma (MM) Patients. https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.8038
Ide-cel Prescribing Information https://packageinserts.bms.com/pi/pi_abecma.pdf
Belantamab Mafodotin for Relapsed or Refractory Multiple Myeloma (DREAMM-2): A Two-Arm, Randomised, Open-label, Phase 2 Study https://linkinghub.elsevier.com/retrieve/pii/S1470-2045(19)30788-0
DREAMM Trials https://dreammtrials.com/
Blenrep (Belantamab Mafodotin) REMS https://www.accessdata.fda.gov/scripts/cder/rems/index.cfm?event=IndvRemsDetails.page&REMS=403
Band Keratopathy https://emedicine.medscape.com/article/1194813-overview
Cilta-cel Prescribing Information https://www.fda.gov/media/156560/download
BCMA-Directed CAR T-cell Therapy in Adult Patients With Relapsed and/or Refractory Multiple Myeloma https://clinicaltrials.gov/ct2/show/NCT04318327

Joseph Mikhael, MD, and Ashley Rosko, MD, discuss the role of comorbidities in multiple myeloma and stress the importance of shifting away from the sole use of age-based treatment decisions.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/964338). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Multiple Myeloma https://emedicine.medscape.com/article/204369-overview
International Myeloma Working Group Frailty Score Calculator http://www.myelomafrailtyscorecalculator.net/
R-MCI: Myeloma Comorbidity Index https://www.myelomacomorbidityindex.org/en_calc.html
A Simplified Frailty Scale Predicts Outcomes in Transplant-Ineligible Patients With Newly Diagnosed Multiple Myeloma Treated in the FIRST (MM-020) Trial https://www.nature.com/articles/s41375-019-0539-0
Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline https://ascopubs.org/doi/full/10.1200/JCO.18.02096
Frailty in Older Adults: Evidence for a Phenotype https://academic.oup.com/biomedgerontology/article/56/3/M146/545770
Comprehensive Geriatric Assessment https://www.uptodate.com/contents/comprehensive-geriatric-assessment
Carfilzomib or Bortezomib in Combination With Lenalidomide and Dexamethasone for Patients With Newly Diagnosed Multiple Myeloma Without Intention for Immediate Autologous Stem-Cell Transplantation (ENDURANCE): A Multicentre, Open-Label, Phase 3, Randomised, Controlled Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591827/

Joseph Mikhael, MD, and Peter Voorhees, MD, discuss frontline therapy for multiple myeloma and new options for both transplant-eligible and transplant-ineligible patients.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/964337). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
International Myeloma Foundation https://www.myeloma.org/
Lenalidomide, Bortezomib, and Dexamethasone (RVD) Regimen for Multiple Myeloma https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278911/pdf/i0018-5787-52-1-27.pdf
Carfilzomib, Lenalidomide, and Dexamethasone Plus Transplant in Newly Diagnosed Multiple Myeloma https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714092/
Maintenance With Daratumumab or Observation Following Treatment With Bortezomib, Thalidomide, and Dexamethasone With or Without Daratumumab and Autologous Stem-Cell Transplant in Patients With Newly Diagnosed Multiple Myeloma (CASSIOPEIA): An Open-Label, Randomised, Phase 3 Trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00428-9/fulltext
Daratumumab, Lenalidomide, Bortezomib, and Dexamethasone for Transplant-Eligible Newly Diagnosed Multiple Myeloma: The GRIFFIN Trial https://ashpublications.org/blood/article/136/8/936/454474/Daratumumab-lenalidomide-bortezomib-and
Daratumumab (DARA) Plus Lenalidomide, Bortezomib, and Dexamethasone (RVd) in Patients (Pts) with Transplant-Eligible Newly Diagnosed Multiple Myeloma (NDMM): Updated Analysis of GRIFFIN After 24 Months of Maintenance https://ash.confex.com/ash/2021/webprogram/Paper149024.html
Venetoclax or Placebo in Combination With Bortezomib and Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma (BELLINI): A Randomised, Double-Blind, Multicentre, Phase 3 Trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30525-8/fulltext
Addition of Isatuximab to Lenalidomide, Bortezomib and Dexamethasone As Induction Therapy for Newly-Diagnosed, Transplant-Eligible Multiple Myeloma Patients: The Phase III GMMG-HD7 Trial https://ash.confex.com/ash/2021/webprogram/Paper145097.html
Daratumumab, Carfilzomib, Lenalidomide, and Dexamethasone With Minimal Residual Disease Response-Adapted Therapy in Newly Diagnosed Multiple Myeloma https://ascopubs.org/doi/10.1200/JCO.21.01935
Carfilzomib or Bortezomib in Combination With Lenalidomide and Dexamethasone for Patients With Newly Diagnosed Multiple Myeloma Without Intention for Immediate Autologous Stem-Cell Transplantation (ENDURANCE): A Multicentre, Open-Label, Phase 3, Randomised, Controlled Trial https://www.thelancet.com/article/S1470-2045(20)30452-6/fulltext
Safety and Effectiveness of Weekly Carfilzomib, Lenalidomide, Dexamethasone, and Daratumumab Combination Therapy for Patients With Newly Diagnosed Multiple Myeloma The MANHATTAN Nonrandomized Clinical Trial https://jamanetwork.com/journals/jamaoncology/fullarticle/2778195
Carfilzomib or Bortezomib in Relapsed or Refractory Multiple Myeloma (ENDEAVOR): An Interim Overall Survival Analysis of an Open-Label, Randomised, Phase 3 Trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30578-8/fulltext
Carfilzomib With Cyclophosphamide and Dexamethasone or Lenalidomide and Dexamethasone Plus Autologous Transplantation or Carfilzomib Plus Lenalidomide and Dexamethasone, Followed by Maintenance With Carfilzomib Plus Lenalidomide or Lenalidomide Alone for Patients With Newly Diagnosed Multiple Myeloma (FORTE): A Randomised, Open-Label, Phase 2 Trial https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00535-0/fulltext
Lenalidomide, Bortezomib, and Dexamethasone With Transplantation for Myeloma https://www.nejm.org/doi/full/10.1056/NEJMoa1611750

Joseph Mikhael, MD, and Irene Ghobrial, MD, discuss screening high-risk populations for early-stage multiple myeloma and new techniques to detect it.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/964336). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
Long-Term Follow-up of Monoclonal Gammopathy of Undetermined Significance https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852672/
Prevalence of Monoclonal Gammopathies and Clinical Outcomes in a High-Risk US Population Screened by Mass Spectrometry: A Multicentre Cohort Study https://linkinghub.elsevier.com/retrieve/pii/S2352-3026(22)00069-2
Iceland Screens, Treats, or Prevents Multiple Myeloma (iStopMM): A Population-Based Screening Study for Monoclonal Gammopathy of Undetermined Significance and Randomized Controlled Trial of Follow-up Strategies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128921/
International Myeloma Working Group Updated Criteria for the Diagnosis of Multiple Myeloma https://linkinghub.elsevier.com/retrieve/pii/S1470-2045(14)70442-5
The IMWG 2/20/20 Risk Stratification Model for Smoldering Multiple Myeloma https://multiplemyelomahub.com/medical-information/the-imwg-22020-risk-stratification-model-for-smoldering-multiple-myeloma