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Targeting BCMA in multiple myeloma: Insights from COMy and EHA 2024

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Poll

How do you see BCMA-targeted therapy being used in high-risk newly diagnosed MM?

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Considered only after first-line treatment failure
   
Incorporated earlier in the treatment algorithm
   
Reserved for clinical trials or special cases
   
Not yet considering BCMA-targeted therapies for first-line treatment
   

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Poll

What is your main barrier to using BCMA-targeted therapies for patients with MM?

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Limited access to therapy or centres offering CAR T-cell therapy
   
Lack of familiarity with managing BCMA-associated adverse events
   
Uncertain of optimal sequencing of BCMA agents after other treatments
   
No barriers
   

Tutorial

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Poll

How often are you prescribing BCMA-targeted therapies for your patients with RRMM?

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Regularly for eligible patients
   
Occasionally, depending on prior therapies
   
Rarely; only in special cases
   
I have not yet prescribed BCMA-targeted therapies
   
 
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Our faculty interpret key data from the congress, complimented by an expert panel discussing what has been presented. Close

Targeting BCMA in multiple myeloma: Insights from COMy and EHA 2024

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Learning Objectives

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

  • Evaluate the latest evidence for current BCMA-targeting therapies for patients with multiple myeloma
  • Review emerging BCMA-targeting therapies being evaluated in clinical trials for patients with multiple myeloma
  • Discuss the impact of the latest data for current and emerging BCMA-targeting agents on the future management of patients with multiple myeloma
Overview

In this activity, an expert in multiple myeloma reviews key data for BCMA-targeting agents in the treatment of multiple myeloma presented at the international Controversies in Multiple Myeloma (COMy) and European Hematology Association (EHA) 2024 congresses. Two further experts then join to discuss how these data may apply in clinical practice.

This activity was filmed following the 10th COMy World Congress (Paris, France and online; 23–26 May 2024) and 29th EHA2024 Hybrid Congress (Madrid, Spain; 13–16 June).

This activity is provided by touchIME. 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.

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 upto 1.25 hours of effective education time. Each participant should claim only time that has been spent in the educational activity.

The Accreditation Council for Continuing Medical Education (ACCME®), and the Royal College of Physicians and Surgeons of Canada hold an agreement on mutual recognition on substantive equivalency of accreditation systems with EBAC®.

Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals and the American Medical Association (AMA), physicians may convert EBAC® CE credits to AMA PRA Category 1 CreditTM. 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 CreditTM.

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.

Faculty

Prof. María-Victoria Mateos discloses: Advisory board, panel and/or speaker bureau fees from AbbVie, Amgen, Celgene, GSK, Janssen, Kite, Oncopeptides, Pfizer, Regeneron, Roche, Sanofi, Stemline and Takeda.

Dr Rakesh Popat discloses: Advisory board or panel fees from GSK, Johnson & Johnson, Roche and Sanofi. Consultant fees from GSK and Regeneron. Grants/research support from GSK and Pfizer. Other financial or material support (royalties, patent, etc) from AbbVie, BMS, GSK, Johnson & Johnson and Pfizer. Speaker Bureau fees from Pfizer.

Prof. Evangelos Terpos discloses: Employee or independent contractor fees from Amgen, Antengene, AstraZeneca, BMS, GSK, Janssen, Pfizer, Sanofi, Swixx Biopharma and Takeda. Advisory board or panel fees from BMS, GSK, Janssen, Pfizer and Swixx Biopharma. Grants/research support from GSK, Janssen, Sanofi and Takeda.

Touch Medical Contributors

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

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: 10 October 2024. Date credits expire: 10 October 2025.

Time to Complete: 55 minutes

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

This activity is CE/CME accredited

To obtain the credit(s) from this activity, please complete this post-activity test.

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Course Modules

  • Select in the video player controls bar to choose subtitle language. Subtitles available in English, French, German, Italian, Portuguese, Spanish.
  • A practice aid is available for this activity in the Toolkit
  • Downloads including slides are available for this activity in the Toolkit

Topics covered in this activity

Myeloma
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touchCONGRESS
Targeting BCMA in multiple myeloma: Insights from COMy and EHA 2024
1.25 CE/CME credit

Question 1/5
Your patient is a 67-year-old woman with relapsed/refractory multiple myeloma who has been receiving weekly teclistamab for 9 months. At follow-up, a complete response has been achieved and maintained for the past 6 months. However, whilst on teclistamab, she has experienced repeated serious respiratory infections including COVID-19 and pneumonia. Based on long-term follow-up data from the phase I/II MajesTEC-1 trial, which of the following might you consider to manage infection risk in this patient?

Long-term data from the MajesTEC-1 trial showed that the onset of new grade ≥3 infections with teclistamab treatment in patients with relapsed/refractory multiple myeloma generally declined over time. Transitioning to fortnightly dosing and increasing use of immunoglobulin replacement may have contributed to this trend.1 Patients achieving a complete response or better after 6 months of treatment may be switched to fortnightly dosing of teclistimab.2 Based on the infection profile of BCMA-targeted bispecific antibodies, it is recommended that clinicians and patients remain vigilant for a range of infection types during treatment.3 Immunoglobulin replacement to address hypogammaglobulinemia and infection should be considered per local protocols during teclistamab therapy.2

References

  1. Oriol A, et al. Presented at: EHA2024, Madrid, Spain, 13–16 June 2024. Abstr. P942.
  2. EMA. Teclistamab SmPC. 2024. Available at: http://www.ema.europa.eu/en/medicines (accessed 05 September 2024).
  3. Nooka AK, et al. Cancer. 2024;130:886–900.
Question 2/5
Your patient is a 63-year-old man with multiple myeloma harbouring the t(4;14) cytogenetic abnormality. He has relapsed 12 months after starting lenalidomide maintenance therapy. During a multidisciplinary team meeting discussing his case, you are considering initiating ciltacabtagene autoleucel (cilta-cel). Based on a subgroup analysis of the CARTITUDE-4 study, how might you advise your colleagues in terms of possible implications of the patient’s high-risk status on initiating cilta-cel?

ICANS, immune effector cell-associated neurotoxicity syndrome; MRD, minimal residual disease; SOC, standard of care.

In a subgroup analysis of the CARTITUDE-4 study in multiple myeloma, cilta-cel achieved consistently higher rates of MRD negativity vs SOC in patients with one prior line of therapy (63.2% [n=68] vs 19.1% [n=68]), and in those with one prior line of therapy and functionally high-risk disease (65.0% [n=40] vs 10.3% [n=39]). No incidents of grade 3/4 ICANS or peripheral neuropathy were reported in functionally high-risk patients with one prior line of therapy. 

Abbreviations

ICANS, immune effector cell-associated neurotoxicity syndrome; MRD, minimal residual disease; SOC, standard of care.

Reference

Weisel K, et al. Presented at: EHA2024, Madrid, Spain, 13–16 June 2024. Abstr. P959.

Question 3/5
Your patient with relapsed/refractory multiple myeloma is interested in enrolling in a trial at your hospital evaluating anitocabtagene autoleucel (anito-cel). They ask you about possible side effects with this therapy. How would you respond?

Phase I data for anito-cel in patients with relapsed/refractory multiple myeloma (N=38) showed grade 3 immune effector cell-associated neurotoxicity syndrome occurred in 2 patients, with no incidence of delayed neurotoxicities, Guillan-Barré syndrome, cranial nerve palsies or parkinsonian-like syndromes during the follow-up period (26.5 months’ median follow-up).

Reference

Frigault M, et al. Presented at: EHA2024, Madrid, Spain, 13–16 June 2024. Abstr. S207.

Question 4/5
Which of the following statements reflect the clinical implications of cohort 2b of the KarMMa-2 trial, investigating ide-cel?

ASCT, autologous stem cell transplant; ide-cel; idecabtagene vicleucel; LEN, lenalidomide; MM, multiple myeloma; RRMM; relapsed/refractory MM; SOC, standard of care.

The KarMMa-2 trial is evaluating ide-cel in patients with RRMM and functional high-risk MM. Cohort 2b included patients with high-risk MM who had experienced early relapse after frontline treatment, not including ASCT (n=35). The ORR was 94%, with a complete response rate of 71%. The favourable risk–benefit profile in these patients, highlights the potential for ide-cel in earlier lines of treatment.

Abbreviations

ASCT, autologous stem cell transplant; ide-cel; idecabtagene vicleucel; MM, multiple myeloma; ORR, overall response rate; RRMM; relapsed/refractory MM.

Reference

Leleu X, et al. Presented at: EHA2024, Madrid, Spain, 13–16 June 2024. Abstr. S208.

Question 5/5
Your patient with relapsed/refractory multiple myeloma is entering a clinical trial evaluating a belantamab mafodotin-based regimen. How would you advise this patient regarding concerns of known ocular side effects with this regimen?

BCVA, best-corrected visual acuity

The DREAMM-7 and DREAMM-8 studies provided insights into ocular safety with belantamab mafodotin-based regimens in relapsed/refractory multiple myeloma. In DREAMM-8, among patients treated with belantamab mafodotin (n=150), 34% experienced a bilateral BCVA worsening of 20/50 or worse, and 1% of 20/200 or worse. Resolution of first event to normal baseline was achieved in 84% and 50% of patients, respectively. Visual acuity changes that could affect daily living were reversible in most patients. Treatment discontinuation due to ocular adverse events occurred in 9% of patients in both the DREAMM-7 and DREAMM-8 studies.

Abbreviation

BCVA, best-corrected visual acuity.

References

  1. Mateos MV, et al. Presented at: EHA2024, Madrid, Spain, 13–16 June 2024. Abstr. S214.
  2. Dimopoulos MA, et al. Presented at: EHA2024, Madrid, Spain, 13–16 June 2024. Abstr. LB3440.
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