Grateful to @BloodJournal, co-authors, and @SWOG for making this #downwithdex piece possible! Dex 40mg weekly in #MMsm induction: 1️⃣ Not practical even for trial-enrolled patients 2️⃣ Does not improve PFS vs ⬇️ dex Twitter 🧵 once I’m back from #IMS24! ashpublications.org/blood/ar…

CONGRESS | #EHA2026 | PRESENTATION Peter Voorhees presents results from the phase III MonumenTAL-3 study evaluating talquetamab plus daratumumab ± pomalidomide (TalDP; TalD), versus daratumumab plus pomalidomide, and dexamethasone (DPd) for the treatment of RRMM. TalDP and TalD was associated with improved PFS vs DPd, corresponding to a reduced the risk of progression or death by 72% (HR, 0.28; P < 0.0001) and 67% (HR, 0.33; P < 0.0001), respectively. At 24 months, PFS rates were 81.3% with TalDP, 77.6% with TalD, and 51.2% with DPd. TalDp/TalD were also associated with higher ORR, ≥CR, and MRD-negative CR rates vs DPd. Safety findings were consistent with the known profiles of the individual agents. Follow our live feed for more updates: loom.ly/CXccZxs Intended for HCPs only. This congress coverage is independently supported by pharmaceutical companies, who are allowed no influence on the content; a full list of supporters can be found on our website. #MultipleMyeloma #myeloma #mmsm #MedEd

I’ve looked at this #EHA2026 slide 100x but it still always makes me pause. Unexpected early relapses so scary for patients with myeloma, and historically post-PD OS in FHRMM ≤ 2 years no matter what we do. Here, off-the-shelf Tx boosted 3-yr PFS from 0% to 77%. Giving these pts a fighting chance for deep & durable remissions 🥹

MajesTEC-9 at #EHA26 #EHA2026 #mmsm

#mmsm #EHA26 MajesTEC-3 high risk post hoc analysis @RahulBanerjeeMD Tec-Dara worked well in patients with 2HRCA or more as well as functionally high risk Really good results in hard to treat patients

Congratulations! Great result and another new landmark SOC at relapse

CONGRESS | #EHA2026 | PRESENTATION Rahul Banerjee presents results from an analysis of the phase III MajesTEC-3 study evaluating teclistamab plus daratumumab (Tec-Dara) in patients with RRMM, stratified by cytogenetic and functional risk. Tec-Dara improved PFS versus DPd/DVd across all cytogenetic and functional risk groups. In patients with prespecified HR cytogenetics, median PFS was not reached with Tec-Dara versus 14.4 months with DPd/DVd (HR, 0.15), while estimated 36-month PFS rates were 77.7% versus 11.5%, respectively. Tec-Dara also increased MRD-negative ≥CR rates across risk groups, including among patients with functional high-risk disease (42.9% vs 5.6% at 10⁻⁵sensitivity; OR, 12.75). Follow our live feed for more updates: loom.ly/CXccZxs Intended for HCPs only. This congress coverage is independently supported by pharmaceutical companies, who are allowed no influence on the content; a full list of supporters can be found on our website. #MultipleMyeloma #myeloma #mmsm #MedEd @RahulBanerjeeMD

High risk nearly eliminated or redefined

Phenomenal presentation by @RahulBanerjeeMD here at @EHA_Hematology #EHA2026! Drop the 🎤 moment with the high risk data! @End_myeloma and @mvmateos broke the MajesTEC-3 data at #ASH25 and these data provide important information for 2L high risk patients. #MyCompany

GLP1 is likely going to change landscape of many disease ; I think in a positive way over the next many decades usmedicine.com/clinical-topi….

Not a plateau in whole cohort, but do the authors have info about MRD -ve VS. ve? Probably there we can see a plateau. @RahulBanerjeeMD

Excellent #EHA2026 🧵- Something we continue to learn about as we use GPRC5D more in myeloma. We’ll overestimate incidence at first (e.g., dizziness from orthostatic hypotension from wt loss, 1st noted by @AjaiChari ) … but more research & unified AE term will go a long way!

3. Uncover the pathophysiology through translational science 4. Incorporate this in prospective clinical trials 5. Develop guidance for clinicians on early identification and prevention, rechallenge 6.GPRC5D is an important therapeutic target

2. Understand the syndrome, its variations, risk factors. In the IMWG we are undertaking a co-ordinated effort to collect the clinical course of these patients. Specifically- onset, CNS signs/symptoms, resolution, imaging. This is a syndrome and should not be considered symptom in isolation. If talq is continued the whole syndrome will develop. Also imperative to stress is reversibility which we have seen in the real world experience

What should we do in the field 1. Common terminology- we can't call it ataxia/balance disorder, other selected neurotoxicity (CART) , cerebellar syndrome. We need to name it as GPRC5D related ataxia/balance disorder across trials and RWE -This is important so that non specific symptoms like dizziness or balance disorders which has other causes are not attributed wrongly

Lets consolidate -ataxia/balance disorder, dizziness early symptom -occurs with GPRC5D CART and Bispecific -increasing incidence over time, hence needs vigilance What's not known -why the wide variance -pathophysiology [seperate tweet] -syndrome -who is at risk, reversibility -prevention/treatment

Now lets look at MONUMENTAL-3- Table S19 -captured ataxia and balance disorders -12.4 &14.5%, 2.9 & 2.2% Grade 3 -8% dose delays/skips -time to onset- 73 wks -81 wks -earliest is 3 and 24 days -quite different/delayed to what we are seeing in RWE -10-16% resolution, 68-88% no resolution -low in cycle 1 (0.4% ), increased during cycles 2-6 (4.7%, 2.6%), and highest from cycle 7 (10.9%. 10.2% ).

Second report from @Phhersh in real-world They put together a series of 6 patients and named it vestibular syndrome Wide variation in onset but notice improvement and reversibility

What happens in real world. I noticed this in some of my patients treated with talq and put together a case series with our group Notice the relatively early onset and reversibility Named this as dizziness-ataxia syndrome

With Tal-Dara published and concerns about ataxia/ balance disorders lets take a deep dive on GPRC5D ataxia syndrome -> The first report of a cerebellar syndrome from GPRC5D came from MCARH019 reported by Mailankody et al -2/17 (12%) Grd 3 cerebellar syndrome -6.5 and 8.4 mo's after infusion -was a DLT at 450*10^6

Thx for reading this on GPRC5D ataxia, more to come. @HiraSMian @VincentRK @myelomaMD @TomMartinMD @DoctorAKrishnan @RobertoMinaMD @HadidiSamer @Mohty_EBMT @TheIACH @AjaiChari @NBahlis @RahulBanerjeeMD @NikhilMunshiMD @NoopurRajeMD Sham Mailakondy @YiLinMDPhD Vania Hungria Peter Voorheese @End_myeloma Torsten Steinbaumm Hermann Einsele