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Updates in BCMA-directed therapies in multiple myeloma from ASH 2024

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    Faculty & Disclosures
    Prof. Katja Weisel

    University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Prof. Katja Weisel is deputy director and associate professor at the University Medical Center Hamburg-Eppendorf (Oncology, Hematology and BMT with the Department of Pneumology), Hamburg, Germany. She is also co-director of the University Cancer Center Hamburg, Germany, and is head of the myeloma programme. read more

    Prof. Weisel’s myeloma research interests focus on treatment optimization for high-risk myeloma, renally impaired myeloma patients, refractory myeloma patients and radiographic methods to monitor myeloma disease. She is a member of the steering committee of the German-speaking Multiple Myeloma Group (GMMG) where she is lead investigator of GMMG trials. Prof. Weisel has more than 100 publications on multiple myeloma treatment and biology.

    Prof. Katja Weisel discloses: Advisory board or panel fees from AbbVie, Amgen, BeiGene, BMS/Celgene, GSK, Janssen, Karyopharm, Oncopeptides, Pfizer, Regeneron, Roche Pharma, Sanofi, Stemline/Menarini and Takeda. Consultant fees from AbbVie, Adaptive Biotech, Amgen, AstraZeneca, BeiGene, BMS/Celgene, GSK, Janssen, Karyopharm, Novartis, Oncopeptides, Pfizer, Regeneron, Roche Pharma, Sanofi, Stemline/Menarini and Takeda. Grants/research support from AbbVie, Amgen, BMS/Celgene, GSK and Sanofi.

    Dr Nisha Joseph

    Emory University School of Medicine, Atlanta, GA, USA

    Dr Nisha Joseph is an associate professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine, Atlanta, GA, USA. She is board certified in haematology and medical oncology, specializing in plasma cell disorders and bone marrow transplant. Dr Joseph was named the first H.J. Khoury Fellowship in Leukemia and Bone Marrow Transplantation. read more

    Dr Joseph received her medical degree from the Ohio State University School of Medicine in Columbus, OH, USA. She completed both her residency in internal medicine and her fellowship in haematology and medical oncology at Emory University, where she served as chief fellow in her final year.

    Dr Nisha Joseph discloses: Advisory board or panel fees from BMS, GSK, Johnson & Johnson Oncology and Legend Biotech. Consultant fees from BMS and Johnson & Johnson Oncology. Grants/research support from AbbVie, BMS, Genentech, GSK, Johnson & Johnson Oncology and Sanofi.
    Prof. Roman Hájek

    University Hospital Ostrava, Ostrava, Czech Republic

    Prof. Roman Hájek is professor of oncology in the Faculty of Medicine at the University of Ostrava, and is head of the Department of Haematooncology in the University Hospital Ostrava, in the Czech Republic. Prof Hájek is also head of the Blood Cancer Research Group – international research team. read more

    Prof. Hájek has published over 600 scientific articles and book chapters, and is an editor of the European Journal of Hematology. His research interests include multiple myeloma and other monoclonal gammopathies, bone marrow transplantation and immunotherapy. Prof. Hájek is chairman and a founding member of the Czech Myeloma Group and is an investigator on more than 70 clinical trials (across phases I to III) in multiple myeloma, including some investigating experimental immunotherapy.

    Prof. Roman Hájek discloses: Advisory board or panel fees from Amgen, BMS, Janssen, Sanofi and Takeda. Consultant fees from AbbVie, Amgen, BMS/Celgene, Janssen, Novartis, PharmaMar and Takeda. Grants/research support from Amgen, Celgene, Janssen, Novartis and Takeda.
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    What characteristic do you think is most important for future BCMA-targeted agents?

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    Reduced neurotoxicity
       
    Efficacy in high-risk patient populations
       
    Less frequent/more convenient dosing schedules
       
    Other
       

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    Which potential future application of BCMA-targeted therapy most interests you?

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    In combination therapy for relapsed/refractory MM
       
    Transplant-ineligible newly diagnosed MM
       
    Induction therapy in newly diagnosed MM
       
    Maintenance therapy following ASCT
       

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    What is the most important factor you consider when prescribing BCMA-targeted agents?

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    Age/frailty of patient
       
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    Dosing/ease of administration
       
     
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    touchCONGRESS
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    Updates in BCMA-directed therapies in multiple myeloma from ASH 2024

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    Learning Objectives

    After watching this activity, participants should be better able to:

    • Discuss how the latest data may impact the current use of BCMA-targeting therapies for patients with multiple myeloma
    • Outline the potential role of BCMA-targeting therapies earlier in the treatment pathway and in combination with other agents
    • Evaluate the latest evidence for emerging BCMA-targeting therapies in the treatment of multiple myeloma
    Overview

    In this activity, myeloma expert Prof. Katja Weisel reviews key data for BCMA-targeting agents in the treatment of multiple myeloma presented at the 66th American Society of Hematology (ASH) Annual Meeting and Exposition. Dr Nisha Joseph and Prof. Roman Hájek then join Prof. Weisel to discuss how these data may apply in clinical practice.

    This activity was filmed following the 66th ASH Annual Meeting and Exposition (7–10 December 2024, San Diego, CA, USA).

    This activity is provided by touchIME. touchIME is an EBAC®accredited provider. read more

    Target Audience

    This activity has been designed to meet the educational needs of haematologists, including haemato-oncologists, and oncologists involved in the management of multiple myeloma.

    Faculty

    Prof. Katja Weisel discloses: Advisory board or panel fees from AbbVie, Amgen, BeiGene, BMS/Celgene, GSK, Janssen, Karyopharm, Oncopeptides, Pfizer, Regeneron, Roche Pharma, Sanofi, Stemline/Menarini and Takeda. Consultant fees from AbbVie, Adaptive Biotech, Amgen, AstraZeneca, BeiGene, BMS/Celgene, GSK, Janssen, Karyopharm, Novartis, Oncopeptides, Pfizer, Regeneron, Roche Pharma, Sanofi, Stemline/Menarini and Takeda. Grants/research support from AbbVie, Amgen, BMS/Celgene, GSK and Sanofi.

    Dr Nisha Joseph discloses: Advisory board or panel fees from BMS, GSK, Johnson & Johnson Oncology and Legend Biotech. Consultant fees from BMS and Johnson & Johnson Oncology. Grants/research support from AbbVie, BMS, Genentech, GSK, Johnson & Johnson Oncology and Sanofi.

    Prof. Roman Hájek discloses: Advisory board or panel fees from Amgen, BMS, Janssen, Sanofi and Takeda. Consultant fees from AbbVie, Amgen, BMS/Celgene, Janssen, Novartis, PharmaMar and Takeda. Grants/research support from Amgen, Celgene, Janssen, Novartis and Takeda.

    Touch Medical Contributors

    Hannah Fisher and Christina Mackins-Crabtree have no financial interests/relationships or affiliations in relation to this activity.

    EBAC® Accreditation

    touchIME is an EBAC® accredited provider since 2023.

    This programme is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) for 1.25 hours of effective education time.

    EBAC® holds an agreement on mutual recognition of substantive equivalency with the US Accreditation Council for CME (ACCME) and the Royal College of Physicians and Surgeons of Canada, respectively.

    Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) and the American Medical Association, physicians may convert EBAC® External CME credits to AMA PRA Category 1 Credits™. Information on the process to convert EBAC® credit to AMA credit can be found on the AMA website. Other health care professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 Credit™.

    EBAC® is a member of the International Academy for CPD Accreditation (IACPDA) and a partner member of the International Association of Medical Regulatory Authorities (IAMRA).

    Faculty Disclosure Statement / Conflict of Interest Policy

    In compliance with EBAC® guidelines, all speakers/chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event have been mitigated and declared to the audience prior to the CME activities.

    Requirements for Successful Completion

    Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC® CE credit certificate. EBAC® grants 1 CE credit for every hour of education completed.

    Date of original release: 6 February 2025. Date credits expire: 6 February 2027.

    Time to Complete: 1 hour 15 minutes

    If you have any questions regarding the EBAC® credits, please contact accreditation@touchime.org

    This activity is CE/CME accredited

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    This Activity Is Funded By:

    An independent medical education grant from GSK.

    This activity is provided by touchIME. touchIME is an EBAC® accredited provider.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    EBAC® 

    touchIME is an EBAC® accredited provider since 2023.

    In compliance with EBAC® guidelines, all speakers/chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME activities. touchIME accepts no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 6 February 2025. Date credits expire: 6 February 2027.

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    touchCONGRESS
    Updates in BCMA-directed therapies in multiple myeloma from ASH 2024
    1.25 CE/CME credit
    Question 1/5
    After attending ASH 2024, you are updating your colleagues about key findings from the US Multiple Myeloma Immunotherapy Consortium on teclistamab real-world use in the management of relapsed/refractory multiple myeloma. How might you advise your colleagues in terms of potential implications of these data on clinical practice?

    BCMA, B-cell maturation antigen; CR, complete response; ORR, objective response rate; PFS, progression-free survival; VGPR, very good partial response.

    Data from the US Multiple Myeloma Immunotherapy Consortium presented at ASH 2024 assessed real-world outcomes with teclistamab stratified by prior BCMA-directed therapy. Determining optimal interval between last exposure to BCMA-targeting therapy and teclistamab initiation showed waiting >8.7 months vs <8.7 months yielded a significant difference in PFS (8.1 months vs 2.5 months; p=0.001, respectively).

    Abbreviations

    BCMA, B-cell maturation antigen; PFS, progression-free survival.

    Reference

    Dima D, et al. Presented at: 66th ASH Annual Meeting, San Diego, CA, USA. 7–10 December 2024. Abstr 897.

    Question 2/5
    Which of the following statements best reflects findings from a multicentre retrospective study comparing ciltacabtagene autoleucel (cilta-cel) and idecabtagene vicleucel (ide-cel) in the standard-of-care setting for the treatment of relapsed/refractory multiple myeloma?

    AML, acute myeloid leukaemia; ICANS, immune effector cell-associated neurotoxicity syndrome; MDS, myelodysplastic syndrome.

    Data from the US Multiple Myeloma Immunotherapy Consortium comparing ciltacabtagene autoleucel (cilta-cel) and idecabtagene vicleucel (ide-cel) in the standard-of-care setting showed that, compared with ide-cel, cilta-cel was associated with a significantly increased risk of delayed neurotoxicities (OR 20.07, 95% CI 4.46–90.20; p<0.001) and grade ≥3 cytokine release syndrome (OR 6.80, 95% CI 2.28–20.33; p<0.001).

    Abbreviations

    CI, confidence interval; CRS, cytokine release syndrome; OR, odds ratio.

    Reference

    Hansen DK, et al. Presented at: 66th ASH Annual Meeting, San Diego, CA, USA. 7–10 December 2024. Abstr 936.

    Question 3/5
    Which of the following statements best summarizes the latest DREAMM-7 data presented at ASH 2024?

    B, belantamab mafodotin; d, dexamethasone; D, daratumumab; DOR, duration of response; MRD, minimal residual disease; OS, overall survival; V, bortezomib.

    Updated DREAMM-7 data presented at ASH 2024 reported that BVd (n=243) achieved significant OS benefits compared with DVd (n=251) (36-month OS rates: 74% vs 60%); median OS was not reached in either arm (BVd vs DVd: HR 0.58, 95% CI 0.43–0.79; p=0.00023). Favourable DOR and MRD-negativity benefits were also seen with BVd vs DVd (DOR: 40.8 months vs 17.8 months; ≥VGPR and MRD negativity: 39% vs 18%, respectively).

    Abbreviations

    B, belantamab mafodotin; CI, confidence interval; d, dexamethasone; D, daratumumab; DOR, duration of response; HR, hazard ratio; MRD, minimal residual disease; OS, overall survival; V, bortezomib; VGPR, very good partial response.

    Reference

    Hungria V, et al. Presented at: 66th ASH Annual Meeting, San Diego, CA, USA. 7–10 December 2024. Abstr 772.

    Question 4/5
    Your 63-year-old patient is about to initiate teclistamab-based maintenance therapy for newly diagnosed multiple myeloma as part of a clinical trial at your centre. Based on data presented at ASH 2024, which of the following would you consider to optimize side-effect management in this patient?

    Ig, immunoglobulin; Q6W, every 6 weeks.

    The MajesTEC-4 trial evaluated maintenance therapy in newly diagnosed multiple myeloma with Q4W teclistamab plus lenalidomide (with or without QW teclistamab step-up dosing; cohorts 1 and 2, each n=32), or Q4W teclistamab alone (cohort 3, n=30). Grade 3/4 infections were reported in 20% to 38% of patients across cohorts. All patients received ≥1 dose of Ig either intravenously or subcutaneously, and the study authors strongly recommended infection prophylaxis, including Ig replacement.

    Abbreviations

    Ig, immunoglobulin; QW, once weekly; Q4W, every 4 weeks. 

    Reference

    Zamagni E, et al. Presented at: 66th ASH Annual Meeting, San Diego, CA, USA. 7–10 December 2024. Abstr 494.

    Question 5/5
    Your patient with relapsed/refractory multiple myeloma is enrolling in a clinical trial evaluating anitocabtagene autoleucel. They express concerns regarding neurological side effects with CAR T-cell therapies they have read about on patient online forums. Based on preliminary data from the iMMagine-1 study presented at ASH 2024, how would you counsel your patient?

    CAR, chimeric antigen receptor; ICANS, immune effector cell-associated neurotoxicity syndrome.

    In the phase II registrational iMMagine-1 study evaluating anitocabtagene autoleucel in patients with relapsed/refractory multiple myeloma, no delayed or non-ICANS neurotoxicities (including no incidences of Guillain-Barré syndrome nor Parkinsonism) were reported. ICANS of any grade occurred in 9% (n/N=9/98) of patients.

    Abbreviation

    ICANS, immune effector cell-associated neurotoxicity syndrome.

    Reference

    Freeman CL, et al. Presented at: 66th ASH Annual Meeting, San Diego, CA, USA. 7–10 December 2024. Abstr 1031.

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    This Activity Is Funded By:

    An independent medical education grant from GSK.

    This activity is provided by touchIME. touchIME is an EBAC® accredited provider.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgement of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    EBAC® 

    touchIME is an EBAC® accredited provider since 2023.

    In compliance with EBAC® guidelines, all speakers/chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME activities. touchIME accepts no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 6 February 2025. Date credits expire: 6 February 2027.

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