myeloma doc @UMRogelCancer. immunity, microbiome, aging, infections, alum @MSKCancerCenter & @columbiamedres, #GoBlue

Joined November 2008
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Excited to see this work out there and to have had a part in leading this exciting trial @UMRogelCancer @umichmedicine offering potent BCMA-sparing combinations in early relapsed MM. Congratulations to the rest of study team in bringing these options closer to our MM patients in need. nejm.org/doi/full/10.1056/NE…
MonumenTAL-3 is out in NEJM 🍾 nejm.org/doi/full/10.1056/NE… Tal-dara-pom and Tal-dara offer superior PFS and OS over DPd. Tal-based combos are a new SOC in 2line RRMM Congrats to the study team and the co-authors! @PlasmaCellPete @mbeksac56 @gdnsvl @paurotero @mvmateos
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Matthew Pianko, MD retweeted
Every myeloma eventually stops responding to a proteasome inhibitor. Some after years, some after a few months. What you reach for next is half of what we actually do in clinic ? The Anderson lab's new Blood paper (Du, Fang et al, DFCI) goes somewhere different with that problem. Instead of another 20S inhibitor — bortezomib → carfilzomib → ixazomib → marizomib, two decades of the same engine — they go upstream to the 19S regulatory particle. Specifically PSMD1, the scaffold subunit that lets 19S dock to 20S. At first sounded like yah this would make sense... The biology is clean: • PSMD1 overexpressed in MM • Knockdown → K48 polyubiquitin piles up despite intact 20S catalytic activity — the 26S can't assemble • ER stress, G0/G1 arrest, caspase 3/9 cleavage, p53-independent • Active in carfilzomib and bortezomib samples— routes around PI resistance entirely • Kills CD138 patient cells, spares CD138-neg cells and healthy PBMCs The immune piece is the little surprising to me. PSMD1 depletion turns on IFN-α/γ, activates cGAS-STING, flips calreticulin to the surface (immunogenic cell death), and bumps MHC I/II. Patient CD4 /CD8 T cells activate in coculture. So you're not only killing tumor — you're potentially re-priming the BM at the same time !! I looked back on what has happened when folks tried targeting - PSMD4 and ADRM1 and both have failed. PSMD1 sits upstream of both — knock it out and PSMD4/ADRM1 fall with it, but not vice versa. The hierarchy explains why the earlier attempts stalled. Authors explore delivery with LNP-siRNA, same chemistry as patisiran --> in NSG xenograft shows response and synergy wtih Pom. Interesting thought from my knowledee on LNP; their biodistribution favors liver and BM. We have seen that siRNA durability in heme has been a sticky problem. Look forward to were it goes next. If you take down the assembly platform of the 26S instead of the catalytic core, you stop chasing 20S mutations and start with a clean resistance slate. The immune activation suggests this could layer with a bispecific rather than compete. @BloodJournal @JanakiramMurali @bhemato @mpianko @nihrardesai89 @GKaurMD #Myeloma #mmsm #HemOnc @NikhilMunshiMD @DanaFarber
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Matthew Pianko, MD retweeted
New in Blood (April 2, 2026): "Genomic mechanisms of resistance to venetoclax in t(11;14) myeloma" — Kaddoura, Kumar, Maura, Baughn et al. We know venetoclax works in t(11;14) myeloma. What we haven't understood well is why some t(11;14) patients don't respond — or respond then progress quickly. This paper starts to answer that with whole-genome/exome sequencing of 34 patients. Study link: doi.org/10.1182/blood.202502…
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Matthew Pianko, MD retweeted
⭐🩸 @syed_abutalibmd & @mpianko highlight major advances in T-cell–redirecting therapies for relapsed/refractory #multiplemyeloma from #ASH25: MajesTEC-3, RedirecTT-1, and inMMyCAR Read their highlights from these featured abstracts ➡️ ascopost.com/news/february-2…
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Matthew Pianko, MD retweeted
MajesTEC-3 ASH LBA Best result ever in a RRMM randomized trial. It will transform how we approach myeloma. Congratulations to authors and @JNJNews meetings-api.hematology.org/…

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Matthew Pianko, MD retweeted
Congratulations to the @Regeneron team. Disappointed we cannot use earlier in the course of the disease. Would gladly use for first relapse in many patients with advanced age. Attrition erodes success.
FDA grants accelerated approval to a treatment for relapsed or refractory multiple myeloma. fda.gov/drugs/resources-info…
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🩸 Hem/Onc physicians, including community practitioners, fellows & faculty — join us for the Fall 2025 Hematologic Malignancies Symposium at @UMichMedicine! 📅 Sat, Oct 11 | ⏰ 9 AM–3:30 PM 📍 The Kensington Hotel, Ann Arbor, MI 💵 No cost to attend 💡 Focus on myeloma, lymphoma, leukemia & CAR-T Register: sites.google.com/umich.edu/m… Agenda: sites.google.com/umich.edu/m… #HemOnc #mmsm #Lymphoma #Leukemia #CAR_T #MedEd #UMich @UMRogelCancer @umichFFMI
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Matthew Pianko, MD retweeted
28 Jun 2023
Many oncologists dismiss nutrition as part of a patients overall cancer care plan since they don’t get nutrition training. I discuss nutrition in oncology with Dr Tracy Cushing and Dr Eden English on their podcast. Hope this episode changes your mind. tinyurl.com/y373sz9u 1/3
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Matthew Pianko, MD retweeted
Calling all physicians/advanced practice providers seeing pts with multiple myeloma! We invite you to participate in a quick survey on "Clinician Perspectives on Smoldering Myeloma." Led by @bdermanmd @rajshekharucms @Eddie_Cliff Survey link: bit.ly/smolderingMM #mmsm

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Matthew Pianko, MD retweeted
30 Mar 2023
Our comprehensive review on dietary and microbiome evidence in plasma cell disorders @richaparikh36 @LesokhinMD Francesca Castro and Matteo Bellone @MSK_DeptOfMed @LeukemiaJnl #mmsm #microbiome #nutrition #diet rdcu.be/c8JFV
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waiting patiently for @BCBSM to approve Teclistamab for my patient in great need of this drug. Apparently ‘urgent’ means a 10-14 day review time. Unreasonable prior authorization times are dangerous and irresponsible. What can be done to stop this madness? #mmsm
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Any way @BCBSM can help me address this and get the patient what they need?
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Update: Someone from BCBSM reached out to us directly to help, which is very appreciated. Since it seems no PA is actually required yet for Tecvayli, Part of the issue here may be related to PA for tocilizumab(Actemra) which is essential for safe management of Tecvayli-related cytokine release syndrome. Getting fast auth for both of these drugs is another important issue for getting tecvayli started in a timely manner
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Matthew Pianko, MD retweeted
waiting patiently for @BCBSM to approve Teclistamab for my patient in great need of this drug. Apparently ‘urgent’ means a 10-14 day review time. Unreasonable prior authorization times are dangerous and irresponsible. What can be done to stop this madness? #mmsm
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EMERSE was instrumental to this project evaluating PJP risk and use of PJP prophylaxis in autoHSCT recipients at UM 2001-2019. Thanks @informaticsGeek for creating this great resource for clinical research. @UMIntMed @BMTjournal
28 Feb 2023
EMERSE helped "ensure that even rarely mentioned events are detected" for the study "Pneumocystis jirovecii Infection in autologous hematopoietic stem cell transplant recipients", published in Bone Marrow Transplantation. @kevingreggmd @mpianko www-nature-com.proxy.lib.umi…
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Matthew Pianko, MD retweeted
#ASH22 @HiraSMian from @McMasterU presents an interim analysis and data from the prospective MFRAIL clinical study, evaluating the association of frailty assessments at at baseline and longitudinally with clinical outcomes in patients with MM #mmsm #MYELOMA
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