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style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27250%27%20height=%27250%27/%3e"/></span><img alt="Don M. Benson, MD, PhD, James Cancer Hospital" title="Don M. Benson, MD, PhD, James Cancer Hospital" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" class="object-cover w-full h-full" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover"/><noscript><img alt="Don M. Benson, MD, PhD, James Cancer Hospital" title="Don M. Benson, MD, PhD, James Cancer Hospital" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6c4eacfe9c992d1f7ea48bbb7606ade7b9a0b9cf-1920x1080.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=256&q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6c4eacfe9c992d1f7ea48bbb7606ade7b9a0b9cf-1920x1080.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6c4eacfe9c992d1f7ea48bbb7606ade7b9a0b9cf-1920x1080.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" class="object-cover w-full h-full" loading="lazy"/></noscript></span></div></a><div class="col-span-3 space-y-1"><a class="font-bold text-md md:text-lg" href="/view/balancing-life-and-myeloma-a-patient-centered-approach">Balancing Life and Myeloma: A Patient-Centered Approach</a><div><span class="text-md "><span class="mr-1 italic">By </span><a class="mr-1 text-sky-800 hover:text-primary" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></span></div><p class="text-sm text-gray-500">November 22nd 2024</p><p class="text-md block">In this second part of our discussion with Don M. Benson, MD, PhD, from our recent Institute for Value-Based Medicine® event in Cleveland, Ohio, he explains how his ultimate goal for his patients is for them to live as long and as well as possible.</p></div></div><div class="grid grid-cols-4 gap-3 mt-3 "><a href="/view/elevating-value-in-cancer-care-with-innovations-accessibility-equity"><div class="w-full aspect-square overflow-hidden rounded-bl-[10%]"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27250%27%20height=%27250%27/%3e"/></span><img alt="Elevating Value in Cancer Care With Innovations, Accessibility, Equity" title="Elevating Value in Cancer Care With Innovations, Accessibility, Equity" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" class="object-cover w-full h-full" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:"/><noscript><img alt="Elevating Value in Cancer Care With Innovations, Accessibility, Equity" title="Elevating Value in Cancer Care With Innovations, Accessibility, Equity" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fc93bf646d31467af3bf1146ded1ddb1b32755d08-2022x645.png%3Ffit%3Dcrop%26auto%3Dformat&w=256&q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fc93bf646d31467af3bf1146ded1ddb1b32755d08-2022x645.png%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fc93bf646d31467af3bf1146ded1ddb1b32755d08-2022x645.png%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:" class="object-cover w-full h-full" loading="lazy"/></noscript></span></div></a><div class="col-span-3 space-y-1"><a class="font-bold text-md md:text-lg" href="/view/elevating-value-in-cancer-care-with-innovations-accessibility-equity">Elevating Value in Cancer Care With Innovations, Accessibility, Equity</a><div><span class="text-md "><span class="mr-1 italic">By </span><a class="mr-1 text-sky-800 hover:text-primary" href="/authors/cameron-santoro">Cameron Santoro</a></span></div><p class="text-sm text-gray-500">November 21st 2024</p><p class="text-md hidden">Coverage from the IVBM Regional event in Denver, Colorado.</p></div></div><div class="grid grid-cols-4 gap-3 mt-3 "><a href="/view/os-better-with-belantamab-mafodotin-triplet-vs-daratumumab-in-r-r-mm"><div class="w-full aspect-square overflow-hidden rounded-bl-[10%]"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27250%27%20height=%27250%27/%3e"/></span><img alt="Multiple Myeloma | Image Credit: © Dzmitry-stock.adobe.com" title="Multiple Myeloma | Image Credit: © Dzmitry-stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" class="object-cover w-full h-full" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:"/><noscript><img alt="Multiple Myeloma | Image Credit: © Dzmitry-stock.adobe.com" title="Multiple Myeloma | Image Credit: © Dzmitry-stock.adobe.com" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F80e6c85b19f91f7e54b4708b48cf74f795adc108-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=256&q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F80e6c85b19f91f7e54b4708b48cf74f795adc108-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F80e6c85b19f91f7e54b4708b48cf74f795adc108-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:" class="object-cover w-full h-full" loading="lazy"/></noscript></span></div></a><div class="col-span-3 space-y-1"><a class="font-bold text-md md:text-lg" href="/view/os-better-with-belantamab-mafodotin-triplet-vs-daratumumab-in-r-r-mm">OS Better With Belantamab Mafodotin Triplet vs Daratumumab in R/R MM</a><div><span class="text-md "><span class="mr-1 italic">By </span><a class="mr-1 text-sky-800 hover:text-primary" href="/authors/jordyn-sava">Jordyn Sava</a></span></div><p class="text-sm text-gray-500">November 19th 2024</p><p class="text-md hidden">The key secondary end point of overall survival (OS) was met in the DREAMM-7 trial of belantamab mafodotin (Blenrep; GSK) for the treatment of patients with relapsed/refractory multiple myeloma (R/R MM).</p></div></div><div class="grid grid-cols-4 gap-3 mt-3 "><a href="/view/elevating-myeloma-care-amidst-complex-treatment-choices"><div class="w-full aspect-square overflow-hidden rounded-bl-[10%]"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27250%27%20height=%27250%27/%3e"/></span><img alt="Don M. Benson, MD, PhD, James Cancer Hospital" title="Don M. Benson, MD, PhD, James Cancer Hospital" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" class="object-cover w-full h-full" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:"/><noscript><img alt="Don M. Benson, MD, PhD, James Cancer Hospital" title="Don M. Benson, MD, PhD, James Cancer Hospital" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F9b9874b28b21d52d6b1aa78689e72d7eb07fb979-1200x677.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=256&q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F9b9874b28b21d52d6b1aa78689e72d7eb07fb979-1200x677.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F9b9874b28b21d52d6b1aa78689e72d7eb07fb979-1200x677.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:" class="object-cover w-full h-full" loading="lazy"/></noscript></span></div></a><div class="col-span-3 space-y-1"><a class="font-bold text-md md:text-lg" href="/view/elevating-myeloma-care-amidst-complex-treatment-choices">Elevating Myeloma Care Amidst Complex Treatment Choices</a><div><span class="text-md "><span class="mr-1 italic">By </span><a class="mr-1 text-sky-800 hover:text-primary" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></span></div><p class="text-sm text-gray-500">November 15th 2024</p><p class="text-md hidden">Don M. Benson, MD, PhD, has cared for patients at James Cancer Hospital in Ohio for 22 years, where he and his team see approximately 10,000 patient visits each year.</p></div></div><div class="grid grid-cols-4 gap-3 mt-3 "><a href="/view/eque-cel-car-t-shows-strong-results-for-multiple-myeloma"><div class="w-full aspect-square overflow-hidden rounded-bl-[10%]"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27250%27%20height=%27250%27/%3e"/></span><img alt="Neon CAR T graphic | Image Credit: © kalpis-stock.adobe.com" title="Neon CAR T graphic | Image Credit: © kalpis-stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" class="object-cover w-full h-full" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:"/><noscript><img alt="Neon CAR T graphic | Image Credit: © kalpis-stock.adobe.com" title="Neon CAR T graphic | Image Credit: © kalpis-stock.adobe.com" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fd6cda65715e52774e2cab34d922cdd302167b243-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=256&q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fd6cda65715e52774e2cab34d922cdd302167b243-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fd6cda65715e52774e2cab34d922cdd302167b243-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:" class="object-cover w-full h-full" loading="lazy"/></noscript></span></div></a><div class="col-span-3 space-y-1"><a class="font-bold text-md md:text-lg" href="/view/eque-cel-car-t-shows-strong-results-for-multiple-myeloma">Eque-Cel CAR T Shows Strong Results for Multiple Myeloma</a><div><span class="text-md "><span class="mr-1 italic">By </span><a class="mr-1 text-sky-800 hover:text-primary" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></span></div><p class="text-sm text-gray-500">November 7th 2024</p><p class="text-md hidden">Multiple myeloma is the second most common hematologic malignancy, but there is a treatment gap for patients with disease progression following standard-of-care therapies that include immunomodulatory agents, proteasome inhibitors, and anti-CD38 antibodies.</p></div></div></div></div><div class="py-8 border-b-[2px] border-[#EEE]"><div class="relative w-full h-full max-w-[984px] rounded-md mx-auto"><div class="flex flex-col-reverse lg:flex-row items-center justify-center mx-auto rounded-md"><div class="w-full lg:w-[610px] xl:w-3/4 h-[280px] xs:h-[260px] sm:h-[250px] lg:h-[243px] xl:h-[311px] pb-[90px] pt-2 sm:pt-4 lg:pt-3 xl:pt-4 pl-3 xs:pl-4 sm:pl-6 pr-3 rounded-tl-none lg:rounded-tl-md rounded-bl-md rounded-br-md lg:rounded-br-none" style="background:var(--primary)"><h2 class="text-md sm:text-lg xl:text-xl leading-tight lg:leading-none xl:sleading-tight text-white font-bold font-lora my-2">EHA 2024: Highlights in Multiple Myeloma</h2><p class=" font-light font-rubik text-white text-xs xl:text-sm">Joseph Mikhael, MD, shares insights surrounding key updates in multiple myeloma management as presented at EHA 2024.</p><div style="color:var(--primary)"><a class="font-bold font-rubik text-xs flex items-center gap-2 mt-2.5 xs:mt-4 lg:mt-2.5 xl:mt-3.5 py-2 px-3 cursor-pointer max-w-fit bg-white hover:bg-gray-300 rounded-md" href="https://bit.ly/4cuqjYm">Visit Now</a></div></div><div class="w-full max-h-[385px] lg:max-h-[243px] xl:max-h-[311px] overflow-hidden flex justify-center items-center rounded-br-none rounded-tr-md rounded-tl-md lg:rounded-r-md lg:rounded-tl-none pointer-events-none"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27959%27%20height=%27539.5%27/%3e"/></span><img alt="Joseph Mikhael, MD, shares insights surrounding key updates in multiple myeloma management as presented at EHA 2024." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Joseph Mikhael, MD, shares insights surrounding key updates in multiple myeloma 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But this is like the iceberg: you can detect something on the surface, then you do a bone marrow [test and] you can detect something under the surface. But we know that even with those techniques, a lot of disease was left behind that they were just not sensitive enough to detect. So, MRD, or minimal residual disease, testing is just a more sensitive technique to detect disease that cannot be detected by conventional technologies.","_key":"4b3feb5ff4ea0","_type":"span"}],"_type":"block","style":"normal","_key":"42663d1d89af"},{"style":"normal","_key":"d5c4a53f535f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"963bac9bb6f30"}],"_type":"block"},{"style":"normal","_key":"9cd8bd26c74c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"There's a couple of ways to do it by our current methodologies. Both of them right now rely on bone marrow testing: next-generation flow cytometry, which is an advanced flow cytometry to [provide a] more sensitive way of detection, or next-generation sequencing that detects the clone in myeloma at the time of diagnosis or relapse and tracks that clone through sequencing of the VDJ region in the plasma cell and just tracks that one clone to detect it at a very low level.","_key":"8f9de165a7cc0"}],"_type":"block"},{"_type":"block","style":"normal","_key":"10f739c2a94b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"bcb4ac9e5d860"}]},{"_type":"block","style":"normal","_key":"005a8ef2b630","markDefs":[],"children":[{"_key":"38d06ac96fe20","_type":"span","marks":[],"text":"It's just a sensitive way to detect disease that we couldn't previously detect. And what this tells us is that if you have low-level disease that we cannot detect by MRD—it doesn't mean there's no disease, just that these techniques cannot detect—those patients do better. We've seen that historically."}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"e40841cfd7a60"}],"_type":"block","style":"normal","_key":"cf90ac37678c"},{"children":[{"text":"Now, the FDA ODAC [Oncologic Drugs Advisory Committee] came out ","_key":"54b2dae43cf80","_type":"span","marks":[]},{"_type":"span","marks":["17839c83ace1"],"text":"with a decision","_key":"54b2dae43cf81"},{"text":" that MRD will be used as a surrogate end point. They're open to that as a surrogate end point for drug approval. So, I think the field is moving in that direction. 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This results in a great effect in the frontline setting of treatment for multiple myeloma."}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"45e024e269ba0"}],"_type":"block","style":"normal","_key":"00472c80195a"},{"children":[{"_type":"span","marks":[],"text":"At the same time, we are also aware of new developments like CAR [chimeric antigen receptor] T-cell treatments and treatments with bispecific antibodies.","_key":"542a2e47377b0"}],"_type":"block","style":"normal","_key":"4f659b993f62","markDefs":[]},{"_type":"block","style":"normal","_key":"6659f5c3e0a4","markDefs":[],"children":[{"text":"","_key":"f456171e3d8c0","_type":"span","marks":[]}]},{"children":[{"_type":"span","marks":[],"text":"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.","_key":"6c8862d0afd30"}],"_type":"block","style":"normal","_key":"b53aaf0fb805","markDefs":[]},{"_key":"306dac0fb23e","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ce37f7ff812d0"}],"_type":"block","style":"normal"},{"style":"normal","_key":"25f3bbc12420","markDefs":[],"children":[{"_type":"span","marks":[],"text":"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.","_key":"4703da37a2820"}],"_type":"block"},{"style":"normal","_key":"d58d43cba6ea","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"3da478fac5c10"}],"_type":"block"},{"_type":"block","style":"normal","_key":"48e5ff43a8c4","markDefs":[],"children":[{"marks":[],"text":"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.","_key":"feccf4e2f14d0","_type":"span"}]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"5ac4d28ffae00","_type":"span"}],"_type":"block","style":"normal","_key":"6ba987eb24c5"},{"children":[{"_type":"span","marks":[],"text":"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. 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Although newer CAR T-cell therapies are expected to be more effective based on less T-cell exhaustion, he expressed concerns regarding infectious complications and the unmet need for specialized centers that are equipped to treat CAR T-cell therapies."}],"_type":"block","style":"normal"},{"_key":"e88b91739c27","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"02e2f039893e"}],"_type":"block","style":"normal"},{"markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://clinicaltrials.gov/study/NCT04923893","_key":"51836a73e689"}],"children":[{"_type":"span","marks":[],"text":"The ","_key":"83574bfa980b0"},{"_key":"83574bfa980b1","_type":"span","marks":["51836a73e689"],"text":"CARTITUDE-5 study"},{"_type":"span","marks":[],"text":" is comparing the efficacy of bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (VRd) induction followed by a single administration of ciltacabtagene autoleucel (cilta-cel) vs VRd induction followed by lenalidomide and dexamethasone maintenance in newly diagnosed patients with multiple myeloma.","_key":"83574bfa980b2"}],"_type":"block","style":"normal","_key":"cac7b08d0157"},{"children":[{"_type":"span","marks":[],"text":"","_key":"c9918a1be4e80"}],"_type":"block","style":"normal","_key":"dddaf339b189","markDefs":[]},{"markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://clinicaltrials.gov/study/NCT05257083","_key":"6a267c6d9669"}],"children":[{"text":"Banerjee also addressed the ","_key":"774674be57ef0","_type":"span","marks":[]},{"_key":"774674be57ef1","_type":"span","marks":["6a267c6d9669"],"text":"CARTITUDE-6 study"},{"_type":"span","marks":[],"text":" that is comparing the efficacy of daratumumab, bortezomib, lenalidomide, and dexamethasone (DVRd) followed by cilta-cel vs DVRd followed by autologous stem cell transplant in newly diagnosed patients with multiple myeloma.","_key":"774674be57ef2"}],"_type":"block","style":"normal","_key":"3c533929ed22"},{"children":[{"_type":"span","marks":[],"text":"","_key":"7404ddff69d20"}],"_type":"block","style":"normal","_key":"3f74f5cb7312","markDefs":[]},{"children":[{"marks":[],"text":"\"Bispecifics are also being explored in the front-line setting. There are several studies that have been looking at this; ","_key":"87a59d2302ff0","_type":"span"},{"_type":"span","marks":["5f0064ee00eb"],"text":"MajesTEC-7","_key":"87a59d2302ff1"},{"marks":[],"text":" comes to mind.\"","_key":"87a59d2302ff2","_type":"span"}],"_type":"block","style":"normal","_key":"b2e64e806882","markDefs":[{"_type":"link","href":"https://clinicaltrials.gov/study/NCT05552222","_key":"5f0064ee00eb","nofollow":true,"blank":true}]},{"_type":"block","style":"normal","_key":"0864143ad372","markDefs":[],"children":[{"marks":[],"text":"","_key":"39a33d70bbec0","_type":"span"}]},{"_type":"block","style":"normal","_key":"8124e4de41e8","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Banerjee explains the purpose of MajesTEC-7 was to compare the efficacy of teclistamab in combination with daratumumab and lenalidomide and talquetamab in combination with daratumumab and lenalidomide vs daratumumab, lenalidomide, and dexamethasone.","_key":"059640affc600"}]},{"style":"normal","_key":"e49c915ff5ca","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"d9eacc94e100"}],"_type":"block"},{"style":"normal","_key":"976b06638dbc","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00466-6/abstract","_key":"4c843eeb0f89"}],"children":[{"marks":[],"text":"Additionally, he mentions the ","_key":"b0d684a351620","_type":"span"},{"_type":"span","marks":["4c843eeb0f89"],"text":"MAIA study","_key":"b0d684a351621"},{"_type":"span","marks":[],"text":" as an example where bispecifics were explored in a front-line setting. Banerjee states that although the study results thus far have shown some success, the risk of infections was found to be greater than he would like them to be, and he suggests the safety profiles of the drugs should be examined further.","_key":"b0d684a351622"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"","_key":"cbce38a7848f0"}],"_type":"block","style":"normal","_key":"82a01628945e","markDefs":[]},{"_key":"014401dcbb2a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"\"Even if tomorrow, teclistamab were to be approved for front-line therapy in any subset of patients, I would hazard a guess that 90% of Americans do not live within 30 minutes of a bispecific-capable 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This gathering will bring together leading experts in the field to discuss the latest advancements in myeloma research, covering fundamental, preclinical, and clinical aspects of the disease.\n","_key":"a98f93c5e1a42"}],"_type":"block"},{"markDefs":[{"_type":"link","href":"https://www.ajmc.com/compendium/multiple-myeloma","_key":"15fb77974f47","nofollow":false,"blank":true}],"children":[{"marks":[],"text":"Anant Madabhushi, PhD, executive director for the Emory Empathetic AI for Health Institute, proposes using AI to address disparities in ","_key":"1108eff9e41c0","_type":"span"},{"_key":"f088e1ce541c","_type":"span","marks":["15fb77974f47"],"text":"multiple myeloma"},{"_key":"864dbe5dac2c","_type":"span","marks":[],"text":" care. He argues that systemic racism contributes significantly to these disparities, but there may also be subtle phenotypic differences between populations that can be identified to develop more tailored treatment approaches."}],"_type":"block","style":"normal","_key":"53c17d5757f7"},{"children":[{"_type":"span","marks":[],"text":"","_key":"ce9cc94aed4b"}],"_type":"block","style":"normal","_key":"b1a9ae95941e","markDefs":[]},{"_type":"block","style":"normal","_key":"2335b8176cbd","markDefs":[],"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity.","_key":"769a338eb5770"}]},{"_type":"block","style":"normal","_key":"3f173340cb04","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"d0e7e9787911"}]},{"markDefs":[],"children":[{"text":"Transcript","_key":"54bbe7c7b5ac0","_type":"span","marks":["strong","underline"]}],"_type":"block","style":"normal","_key":"6b46ee6339b3"},{"style":"normal","_key":"27e27c896cae","markDefs":[],"children":[{"text":"","_key":"c6e67eaa3420","_type":"span","marks":[]}],"_type":"block"},{"style":"normal","_key":"2f92b3120dc4","markDefs":[],"children":[{"_key":"85210111e6fa0","_type":"span","marks":["strong"],"text":"How can AI help address disparities in multiple myeloma care and outcomes?"}],"_type":"block"},{"_key":"04f32e0dfea7","markDefs":[],"children":[{"_key":"548faa8a9993","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"I will react by saying that the issue of disparities in cancer care is well established. We know that there are several different reasons for the disparities that we observe across different populations in the context of cancer care. Let's call out the 800-pound gorilla in the room. A lot of it has been the issue of systemic racism that has caused significant disparities in access and subsequently outcomes for different populations, particularly populations of color. As we look to better understand the disease, and we're seeing this in other cancers and other diseases, that beyond the social determinants of health and beyond the socioeconomic factors and access, we also are starting to acknowledge that there are subtle differences in the phenotype of the disease across different populations. And our work in prostate cancer and endometrial cancer has shown that using technologies like AI, we can start to tease out very subtle differences in the appearance of the disease across different populations. For instance, in prostate cancer and endometrial cancer, our work has revealed that there are cellular-level differences in the pathology images of, say, Black patients and White patients in the context of endometrial cancer and prostate cancer.","_key":"70260210740c0"}],"_type":"block","style":"normal","_key":"c28ee0147ae6"},{"style":"normal","_key":"0b4194fdb87c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"0a521e9fdba00"}],"_type":"block"},{"markDefs":[],"children":[{"text":"Again, I will repeat what I initially said. I know very little about multiple myeloma and I'm looking to learn at this particular meeting but I think that there's an opportunity to really use powerful technologies like AI to start to dive into understanding phenotypic differences between populations. I'm not suggesting that there are necessarily differences, but if there are differences, then we need to be cognizant of those differences and try to start accounting for that, potentially in starting to create more tailored AI models.","_key":"98c04f43b1950","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"3bfeca32011f"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"2bd9a88cbc0d0"}],"_type":"block","style":"normal","_key":"04db5b94f6da"},{"markDefs":[],"children":[{"text":"One of the things that AI has been accused of, quite rightly, is the fact that it is very prone to bias. It is very prone to exacerbating inequity and the only way to really address that is to be intentional about the way we develop the AI. To do that, we have to look at these approaches to try to understand, first and foremost, are there differences in the appearance of the disease across different populations? 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"},{"_type":"span","marks":["em"],"text":"The American Journal of Managed Care","_key":"386447259e9a"},{"_type":"span","marks":["superscript"],"text":"®","_key":"4a87c97f9a02"},{"marks":[],"text":" spoke to him ahead of the IMS meeting.\n","_key":"c215ccbe12de","_type":"span"}],"_type":"block","style":"normal","_key":"4b544b81ccd4"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"10b9cb1106c70"}],"_type":"block","style":"normal","_key":"473224fa551f"},{"markDefs":[],"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity.","_key":"b1873f815b3c0"}],"_type":"block","style":"normal","_key":"8910aee89676"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ef4aee0a2750"}],"_type":"block","style":"normal","_key":"fa675e4aea00"},{"_key":"a64f54c70608","markDefs":[],"children":[{"marks":["strong","underline"],"text":"Transcript","_key":"30888a7799c70","_type":"span"}],"_type":"block","style":"normal"},{"style":"normal","_key":"58a46c3847b8","markDefs":[],"children":[{"marks":[],"text":"","_key":"9b6415a2ed40","_type":"span"}],"_type":"block"},{"style":"normal","_key":"0f629f1216b3","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"How is MRD assessment being used to guide treatment decisions and monitor response in multiple myeloma? What are the implications of MRD negativity for long-term outcomes?","_key":"eaa69ebb97900"}],"_type":"block"},{"children":[{"_type":"span","marks":["strong"],"text":"Banerjee:","_key":"c1513af828290"},{"_type":"span","marks":[],"text":" I would separate this question by clinical trials vs individual patients sitting in front of me. For clinical trials, we all were very excited earlier this year when the FDA approved, or at least gave its endorsement at an ODAC [Oncologic Drugs Advisory Committee] meeting to MRD being a primary end point for studies.","_key":"c1513af828291"},{"_type":"span","marks":["superscript"],"text":"1 ","_key":"1bfd5575b68c"},{"_type":"span","marks":[],"text":"To familiarize the audience, the idea behind MRD is that it basically gives us the best tools in 2024 to look for any residual myeloma cells hiding behind, not [just] myeloma cells, even MGUS [monoclonal gammopathy of undetermined significance]–like cells, anything that's clonally abnormal, lurking underneath the scenes here.","_key":"3c0cd8304f7e"}],"_type":"block","style":"normal","_key":"32a884464755","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"One of the tests, the next-generation sequencing test [or] the clonality assay, can pick up 1 in a million cells, typically even more than that, if you have more than a million cells that are collected from the bone marrow, from the first pill aspirate. This is wonderful.","_key":"5895f7fb50920"}],"_type":"block","style":"normal","_key":"d112283ed200"},{"_type":"block","style":"normal","_key":"8139b2aca138","markDefs":[],"children":[{"marks":[],"text":"MRD negativity is amazing as an end point for trials because it reads out very quickly. With CAR [chimeric antigen receptor] T therapy, you're often able to see pretty quickly, within 28 days, that some patients who are going to do well are the ones who are MRD negative. A good example is the BENEFIT study that was presented at the American Society of Clinical Oncology [annual meeting] and recently published in ","_key":"ea1527b128f80","_type":"span"},{"_type":"span","marks":["em"],"text":"Nature Medicine","_key":"ea1527b128f81"},{"_type":"span","marks":[],"text":".","_key":"ea1527b128f82"},{"_key":"b66f519f0980","_type":"span","marks":["superscript"],"text":"2 "},{"_type":"span","marks":[],"text":"That was looking, for example, at Isa-VRd [isatuximab plus the triplet bortezomib, lenalidomide, and dexamethasone] vs Isa-Rd in newly diagnosed patients.","_key":"b7b6c644a15d"}]},{"markDefs":[],"children":[{"marks":[],"text":"The primary end point there was MRD negativity at 18 months and it worked. Isa-VRd [isatuximab plus bortezomib, lenalidomide, and dexamethasone] beat Isa-Rd [isatuximab plus lenalidomide and dexamethasone]. It's worth noting that that was actually, I would argue, pretty practice changing for me because I had no doubt that Isa-VRd would beat VRd. Actually, the CEPHEUS study being presented at IMS will show that Dara-VRd was up from VRd in transplant-ineligible patients.","_key":"44ac7f64d3fc0","_type":"span"},{"_type":"span","marks":["superscript"],"text":"3","_key":"49c8b8e18543"}],"_type":"block","style":"normal","_key":"9024dc0b9405"},{"children":[{"text":"The question would be for transplant-ineligible patients, we typically use the MAIA regimen,","_key":"7c258599b02e0","_type":"span","marks":[]},{"_type":"span","marks":["superscript"],"text":"4","_key":"35452435fd99"},{"_key":"434322bcc6be","_type":"span","marks":[],"text":" which is dara-Rd [daratumumab plus lenalidomide and dexamethasone] or a CD38 plus [lenalidomide] plus [dexamethasone], \"does adding bortezomib once a week add on to that?\" Here, they actually found a substantial 18-month benefit and MRD negativity. Interestingly, if you look even at 12 months, there was a significant difference between the curve. Even at the 12-month mark, you're able to see that we're using MRD negativity, that there's a difference between these 2 [regimens]. Isa-VRd is better than Isa-Rd and that's been changing my management. Right now, I'm considering quadruplets for maybe some more of my patients that might have been more borderline for transplant eligibility vs not."}],"_type":"block","style":"normal","_key":"ed17c90668cb","markDefs":[]},{"_type":"block","style":"normal","_key":"71f9a5d5e147","markDefs":[],"children":[{"_type":"span","marks":[],"text":"If we had to wait for PFS [progression-free survival], that would have taken 4 to 5 years. The MAIA regimen, like Dara-Rd, or in this case, Isa-Rd, works very well. Medium PFS would have easily been 5 years, so MRD is great from that perspective, I'm so happy to see the FDA gave us blessing to [use] MRD as an end point here.","_key":"4b66568ac6830"}]},{"_key":"6cca8acae872","markDefs":[],"children":[{"_type":"span","marks":[],"text":"For the individual patient sitting in front of me, if they achieve MRD negativity, great, because that means that we can't even see 1 in a million cells left behind. Does that mean they're cured? Probably not, because even patients who achieve MRD negativity after CAR T, for example, I've had many who then go on to relapse years and years later.","_key":"7a82346f210c0"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"The tricky part is if someone is MRD positive, it doesn't necessarily mean that the myeloma is about to come back. There are studies showing that, for example...25% of patients who have MRD resurgence, where their bone marrow goes from negative to positive low level MRD, never had a relapse, despite living for years and years thereafter.","_key":"bdf085484c1a0"}],"_type":"block","style":"normal","_key":"ecc38a915392","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"I've had one patient who is now 9 years after transplant, still on maintenance, doing great, I checked MRD and she's still MRD positive. How is that possible? MRD will just tell you that the cells are abnormal, not that they're cancerous. There's this idea of an MGUS-like phenotype, MGUS is the pre-cancer condition, monoclonal gammopathy of undetermined significance, where you have the precancerous cells producing a protein. I can't say that these patients have MGUS, because MGUS is precancer and they're post-cancer, but it's MGUS-like. Just because these cells are there doesn't mean that they know how to cause kidney damage by cast nephropathy, doesn't mean that they know how to chew holes into the bones, etc.","_key":"fd6e634ee5b10"}],"_type":"block","style":"normal","_key":"5791b70c9baa","markDefs":[]},{"style":"normal","_key":"30de5598cf30","markDefs":[],"children":[{"_type":"span","marks":[],"text":"MRD positivity is not a death sentence by any means. Unfortunately, in the field I feel we've hyped it a lot. There was a nice British study last year showing that they actually interviewed patients before and after their bone marrow biopsy, and the patients who were MRD positive were so disappointed. Honestly, that's on us as a field that we've hyped MRD negativity too much for individual patients.","_key":"6b8f62597abb0"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"I make it very clear for patients for MRD assessments that it's great to see if it's MRD negative, wonderful, if it's MRD positive, I'm not going to escalate your treatment, I'm not going to freak out, I'm not going to do anything differently. We don't know what to do differently for these patients. For MRD-positive patients, I would never escalate therapy or try to force them to become MRD negative, because we don't know that that will make them live better or live longer.","_key":"079d2f2c11ed0"}],"_type":"block","style":"normal","_key":"8c73f7816853","markDefs":[]},{"style":"normal","_key":"8141313d589f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"For patients who are MRD negative, if they have sustained MRD negativity on more than one check, they've been MRD negative twice, [if] MRI is negative, those are patients where I may talk about stopping maintenance therapy entirely in the frontline setting. To be clear, if someone's having toxicities from frontline maintenance, like from lenalidomide, or financial toxicity, you should address that earlier or change therapies or try something different. Don't wait for MRD negativity if someone's having toxicities but the absence of that, I do think it's reasonable, based on the data from the master study showing that in the absence of 2 or more higher cytogenetics, for the patients who had 0 or 0 to 1 high-risk cytogenetic features, discontinuation of all therapy if they achieve sustained MRD negativity at 10-5 worked for those patients is great to see.","_key":"8a74c08c0aa70"}],"_type":"block"},{"_key":"e1cd24a200ee","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The study alluded to earlier looking at daratumumab plus lenalidomide vs lenalidomide maintenance after transplant, had the second randomization, where of patients who achieve sustained MRD negativity after 2 years, do we continue all treatment, or do we stop all treatment?","_key":"571282d101210"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":[],"text":"That would be really interesting. That is the kind of data that I'm really looking for, randomized data, not of MRD as an end point, but of MRD as a middle point of basically helping us decide what to do. Should we continue therapy or stop there for some MRD negative? That I think will be really interesting to see.","_key":"0248a73ea4310","_type":"span"}],"_type":"block","style":"normal","_key":"c4b6b9ee56dc"},{"_type":"block","style":"normal","_key":"7ac70d9afe7a","markDefs":[],"children":[{"marks":["strong"],"text":"References","_key":"e0aeab60c0bc0","_type":"span"}]},{"listItem":"number","markDefs":[{"href":"https://www.onclive.com/view/fda-s-odac-recognizes-mrd-as-an-accepted-end-point-for-accelerated-approval-in-multiple-myeloma","_key":"7f704111b286","_type":"link"}],"children":[{"_key":"5f4089e027c40","_type":"span","marks":[],"text":"Seymour C. FDA’s ODAC recognizes MRD as an accepted end point for accelerated approval in multiple myeloma. OncLive. April 12, 2024. Accessed October 15, 2024. "},{"_type":"span","marks":["7f704111b286"],"text":"https://www.onclive.com/view/fda-s-odac-recognizes-mrd-as-an-accepted-end-point-for-accelerated-approval-in-multiple-myeloma","_key":"5f4089e027c41"}],"level":1,"_type":"block","style":"normal","_key":"ca254d855587"},{"style":"normal","_key":"5aa534bd3424","listItem":"number","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Leleu X, Hulin C, Lambert J, et al Isatuximab, lenalidomide, dexamethasone and bortezomib in transplant-ineligible multiple myeloma: the randomized phase 3 BENEFIT trial. ","_key":"ff8aff3eb2b80"},{"_type":"span","marks":["em"],"text":"Nat Med.","_key":"ff8aff3eb2b81"},{"_type":"span","marks":[],"text":" 2024;30(8):2235-2241. doi: 10.1038/s41591-024-03050-2.","_key":"ff8aff3eb2b82"}],"level":1,"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Usmani S. Daratumumab + bortezomib/lenalidomide/dexamethasone in patients with transplant-ineligible or transplant-deferred newly diagnosed multiple myeloma: Results of the phase 3 CEPHEUS study. Presented at: International Myeloma Society 21st Annual Meeting \u0026 Exposition; Rio de Janiero, Brazil; September 25-28, 2024. Abstract OA – 63.","_key":"a001af32d6440"}],"level":1,"_type":"block","style":"normal","_key":"e06bb688d3c3","listItem":"number"},{"_type":"block","style":"normal","_key":"3e659ab91b3e","listItem":"number","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Facon T, Kumar S, Plesner T, Orlowski R, et al. for the MAIA trial investigators. Daratumumab plus lenalidomide and dexamethasone for untreated myeloma. ","_key":"6ade04a79e450"},{"_type":"span","marks":["em"],"text":"N Engl J Med.","_key":"6ade04a79e451"},{"_type":"span","marks":[],"text":" 2019;380(22):2104-2115. 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","seoTag":["multiple myeloma","BAFF receptors","BAFF CAR T clinical trial","University Hospitals Seidman Cancer Center ","triple receptor"],"factCheckAuthorMapping":null,"published":"2024-08-24T14:00:00.000Z","_id":"74459e26-49c4-433f-b31c-0721073ae54f","body":[{"source":"brightcove","_key":"d6518178a3fe","videoObject":{"thumbnail":{"_type":"image","asset":{"_ref":"image-cda4a66773ecad35c99e0b776bda873d8dda6f50-1200x675-jpg","_type":"reference"}},"videoDuration":"PT2M40S","videoDescription":"Interview with Leland Metheny, MD","_type":"videoDetails","videoTitle":"New CAR T Trial in MM Aims for Triple Receptor Targeting"},"_type":"video","caption":"Leland Metheny, MD, University Hospitals Seidman Cancer Center ","videoID":"6360884167112","disableAutoPlayVideo":false},{"_key":"53f21349bd44","markDefs":[],"children":[{"_key":"a8cabfa46b070","_type":"span","marks":[],"text":"The phase 1 BAFF CAR T clinical trial is investigating a new way to deliver chimeric antigen receptor (CAR) T-cell therapy to its intended targets on 2 fronts: by targeting 3 cell receptors—BAFF receptors, B-cell maturation antigen (BCMA), and transmembrane activator and CAML interactor (TACI)—vs the typical single receptor (CD19) and using electroporation instead of lentiviral vector delivery. "},{"_key":"a8cabfa46b071","_type":"span","marks":["em"],"text":"The American Journal of Managed Care® "},{"_type":"span","marks":[],"text":"spoke with lead investigator Leland Metheny, MD, about the trial goals and how targeting 3 receptors compared with 1 receptor works.","_key":"a8cabfa46b072"}],"_type":"block","style":"normal"},{"style":"normal","_key":"012c7e443c87","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"1840f6256cd40"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"Metheny is a hematologist-oncologist at University Hospitals Seidman Cancer Center and assistant professor of medicine at Case Western Reserve University School of Medicine in Cleveland, Ohio.","_key":"d797cd78412d0"}],"_type":"block","style":"normal","_key":"e952d6427d6b","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"e08b04bbb46e0"}],"_type":"block","style":"normal","_key":"05f3d09fa973"},{"_key":"5b4ca0af8621","markDefs":[],"children":[{"text":"Transcript","_key":"398b573f746d0","_type":"span","marks":["strong","underline"]}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"1888af2d708b","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"What are your primary and secondary outcomes of interest in the BAFF CAR T clinical trial?","_key":"931dc48333110"}]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"3460bf03f2610","_type":"span"}],"_type":"block","style":"normal","_key":"3d8ec22fc985"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The BAFF CAR T phase 1 clinical trial, of course, is a phase 1 trial. We're looking at safety, that's the primary outcome. In addition to that, we want to look at effectivity and the length of effectivity, meaning how long can we affect a progression-free survival in patients with multiple myeloma. And there are some correlative outcomes that we are looking at: integration of the DNA, persistence of the CAR T cells in patients, and immune-kind of end points, focusing on how long people are immunosuppressed and things like that.","_key":"f19bad2c58470"}],"_type":"block","style":"normal","_key":"072a09c801c4"},{"markDefs":[],"children":[{"text":"","_key":"13696926069f0","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"6ceca6880295"},{"children":[{"_type":"span","marks":["strong"],"text":"Can you explain how your triple target approach works?","_key":"aa9887e8073f0"}],"_type":"block","style":"normal","_key":"7f9c6602b795","markDefs":[]},{"_key":"b03ab975c7bd","markDefs":[],"children":[{"marks":[],"text":"","_key":"3039cd5658e40","_type":"span"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"e001361f100a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"This CAR T cell is targeting 3 receptors on mature B cells and plasma cells. The typical CAR T cell will recognize 1. One of the most common is CD19, and that's used for the treatment of certain lymphomas. Another receptor that's being used in multiple myeloma is BCMA; that's a target for many CAR T cells for multiple myeloma.","_key":"e8c4f67eef340"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"dfe7bc78720e0"}],"_type":"block","style":"normal","_key":"eabe158833ed"},{"children":[{"_type":"span","marks":[],"text":"This target is a ligand-based target, meaning there are receptors on the cell surface that attach to ligands, and this CAR T cell acts as kind of a fake ligand and will attach to 3 receptors on cell surfaces. One is the BAFF receptor, one is BCMA, and one is TACI. The benefit of being able to recognize and attach and then, therefore, attack the cells that have those receptors is that it's much harder for a cancer cell that has those 3 receptors—like certain types of lymphomas and myeloma—to downregulate all 3 receptors rather than just one. 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