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4/💃Quads are taking center stage in NDMM
Let’s look @ the📈 on quad tx
PERSEUS ~🔑trial: SQ dara➕VRd➡️↑outcomes in TE pts
👉↑PFS @ 48m 84.3 v 67.7%; HR: 0.42; P<0.001
👉↑MRD- rate 75.2 v 47.5%; P<0.001
👉↑CR rate 87.9 v 70.1%; P<0.001
🎉🆕#SOC ~ quad instead of triplet🎉
5/PERSEUS #ASCO25: sustMRD- in pts on quad maint @ median f/u 47.5m
↑ sustMRD- @ ≥24m w DVRd v VRd: 55.8 v 22.6%
👉Pts w ≥12m sustMRD-: ↑48m PFS, regardless of tx
👉Only 3.1% progressn @ 18m w DVRd v 6.8% VRd
🔑DVRd➡️2.5x⬆️≥24m sustMRD- & ½progressn risk@≤18m tx
@mbeksac56
6/🙋🏻What about replacing dara- with isa- in a quad?
GMMG-HD7
IsaVRd v VRd induction➡️isa-len v len maintenance in TE NDMM
👉↑ MRD- rate 50% v 36%; p =0.00017
👉IsaVRd had ↓AE rates & ↓d/c rates v RVd
🎉🆕SOC
👉Results➡️addition of IsaVRd as induction regimen for TE NDMM
7/⚡️GMMG-HD7 #ASCO25 update w/ PFS benefit in all quad recipients
↑CR 43.5% w IsaVRd v 34% w VRd
↑MRD- rate 66.2% w quad v 47.7% w triplet
👉PFS at 3yr benefit: 83% v 75% w/ IsaVRd v VRd
↑MRD- regardless of maint v MRD (HR 0.61; P=0.002)
🔮Maint w Isa-len v len is on-going
8/🔬Exciting news for #mmsm
Quad tx as🆕SOC for #NDMM
Current @EHA_Hematology/@EMN_EuMMnet (1st optn) & @NCCN (pref,cat 1) regimens for TE pts w/NDMM:
🎯DaraVRd➡️SCT➡️len maint
🎯IsaVRd SCT➡️len maint
👏to quad as 1L for TE pts👏
…but what about pts who are TIE /SCT-deferred?
10/ CEPHEUS🔑trial in TIE & SCT-deferrd pts
DVRd➡️deeper, more durable MRD- rate
TIE cohort:
👉Overall MRD- 63.2 v 41.4%
👉SustMRD @ ≥12m 48.7 v 26.3%; P<0.0001
👉CR 81.2 v 61.6%; P<0.0001
👉HR 0.57, 95% CI 0.41-0.79; P=0.0005
↓D/C rate w quad
🎉DVRd new SOC for TIE NDMM🎉
11/#MMSM Do results w isa show similar trends?
IMROZ🔑trial
IsaVRd➡️IsaRd v VRd➡️Rd in TIE pts w NDMM
👉IsaVRd ➡️↓time to MRD-: 14.7 v 32.8m
👉↑ PFS @ 60m: 63.2 v 45.2%; HR: 0.60; P<0.001
👉↑ CR: 74.7% v 64.1%; P=0.01
IMROZ results support IsaVRd as 🎉🆕SOC for TIE #NDMM pts
12/BENEFIT eval'd wkly bortezomib (V) in TIE NDMM
IsaVRd➡️IsaVR➡️IsaR v IsaRd➡️IsaR➡️IsaR
↑MRD- rate at
12mo 51% v 21%; OR: 3.88; 95%CI: 2.27-6.62;P<0.0001
18mo 53% v 26%; OR: 3.16; 95%CI: 1.89-5.28;P<0.0001
🔑Wkly V in IsaRd=deep responses
Supports IsaVRd as🆕SOC for TIE NDMM
14/Unfortunately, pts w high-risk (HR) #NDMM have 👎poorer prognosis & shorter survival rates vs standard-risk
Based on results of GMMG-CONCEPT presented at #ASCO2025, which treatment strategy should be used for pts w/ HR NDMM?
🔑Key:
🔸MRD- = Treat to MRD-
#mmsm#OncTwitter
15/👏if you chose to treat to MRD- & cont maint
GMMG-CONCEPT, largest cohort to eval MRD- in TE & TIE HRNDMM
IsaKRd inductn & consolidatn➡️IsaKR maint➡️
↑MRD- rate: 67.7% in TE & 54.2% in TIE
Sustained ≥1yr: 62.6% in TE & 46.2% in TIE
🎉IsaKRd➡️↑deep remissions
@Mohty_EBMT
17/ADVANCE🔑trial demonstrating dara standard KRd ➡️↑outcomes in NDMM independent of TE
↑MRD- rate: 59% v 36%, adjOR = 2.5; P<0.0007➡️ 2.5x ↑MRD- rate w/DKRd
👉No new safety concerns
❓Impact on EFS, PFS & OS TBD
DKRd👉1L for all pts on KRd backbone regardless of TE status
18/ Looking across trials... e.g.
🔬CEPHEUS
🔬IMROZ
🔬GMMG-CONCEPT
🔬ADVANCE…
🥅MRD negativity emerges as benchmark to create a level playing field
Across🔬, regimens and now✅FDA approved as a clinical trial endpt as of April ‘25
#MMSM#OncTwitter#OncX#MedTwitter#MedX
19/MIDAS eval’d MRD-guided consolidatn post 1L IsaKRd in TE NDMM
Post 1L, no🔼in MRD- rates for all pts
Tailoring tx to MRD post 1L may not➡️MRD-
If respond to 1L tx may not need tandem SCT to reach MRD-; cont anti-CD38 &PI
🤔High # pts w t(11;14): impact time to MRD- results?
20/🔑1L in TE & TIE for NDMM SUMMARY🔑
🎯Triplet WAS standard approach, but quad is🆕SOC
🎉Quad is preferred 1L for TE NDMM v triplet
🆕SOC: IsaRVd for TIE NDMM🎉
🎯MRD- emerging as a benchmark in🔬 & clin decision making
👏Great news for pts
#MMSM NEXT answer Qs & claim #CME👇