Day three of IMS 2025 brought into focus three transformative trends reshaping multiple myeloma care: emerging effective strategies for early relapse, making powerful treatments more accessible to patients, and bringing later-line therapies to earlier stages of treatment.

Here, the MMRF recaps what stood out from today’s sessions.

Experts Highlight Strategies for Managing Early Relapse

The first plenary session of the day brought several myeloma experts together to outline key considerations for managing early relapse.

• Patients and their care teams should keep a close eye on myeloma markers in the blood (like M protein levels), and, where possible, access testing for minimal residual disease in the bone marrow. Don’t wait for other symptoms to reappear. To optimize outcomes, patients should begin treatment when these biochemical markers begin to rise again.
• Quadruplet therapies and combination maintenance therapy are key to helping patients with a high risk of relapsing.
• When deciding what is next after relapse, patients and providers must consider treatment logistics and access. With so many options now available in early relapse—from triplet therapies to immunotherapies like CAR T—shared decision-making is more important than ever whereby patients and their care teams evaluate the potential benefits and risks of available options.
  
• In the next few years, bispecific therapies will continue to make their way into clinical trials as earlier lines of treatment, even in high-risk newly diagnosed patients. The MMRF’s Horizon II platform is helping to lead this initiative.

These discussions signal a future where earlier intervention, innovative therapies, and collaborative decision-making can significantly improve outcomes for patients facing relapse.

Expanding Access to Bispecifics

Bispecific antibody therapies are typically given in hospital settings because they come with the risk of complications like cytokine release syndrome (CRS), a common, flu-like side effect of T cell-engaging treatments that can cause fevers, chills, and low blood pressure. Because of this, access to these powerful treatments is more limited.

We were excited to hear data at IMS showing that bispecific antibody therapies can safely be given in the community setting, without requiring a hospital stay, enabling more patients to greater access.

• Several studies, including a large real-world study of more than 200 patients, found that step-up dosing of Tecvalyi (teclistamab) and Talvey (talquetamab) can be safely given in outpatient or community clinics. Step-up dosing means slowly increasing the dose to help lower the risk of serious side effects like CRS. With careful monitoring and a clear care plan, side effects in outpatient settings were comparable to those in the hospital—showing that CRS can be managed safely by an outpatient team outside the hospital.
• Equally as exciting was another real-world study showing that relapsed/refractory patients who had a strong response to bispecific antibody therapy—targeting BCMA, GPRC5D, or both—were able to stop continuous treatment. The study analyzed 78 patients who had stopped treatment (not because of disease worsening) and were closely monitored. Nearly 70% of these patients stayed in remission for at least two years. Factors that lead to high risk of relapse included presence of extramedullary disease (myeloma outside the bone marrow) and a higher number of previous therapies.

Bringing Later Line Therapies Upfront

With numerous promising treatments now available for multiple myeloma, determining the optimal timing and sequence of therapies has become increasingly important to improve outcomes and patients’ quality of life. This has been a research focus at the MMRF through our innovative Horizon Clinical Trials Program conducted in collaboration with 14 leading cancer centers.

We were excited to hear and share research updates from our colleagues who are similarly examining the potential of giving treatments to newly diagnosed patients or patients with precursor disease that have been shown to be highly effective in relapsed/refractory patients.

• A Phase I clinical trial of 37 newly-diagnosed patients showed that a combination of the bispecific Elrexfio (elranatamab), Revlimid +/-Daralex may be effective for those not eligible for a stem cell transplant. In this study, 97% responded to the treatment, and most had deep responses within just a few months. Side effects like low blood counts and infections were common but manageable, and most cases of CRS were mild.
• A Phase 2 trial of 74 newly-diagnosed patients who are ineligible for a transplant may benefit from Sarclisa and Velcade, Revlimid, and dexamethasone (Isa SC-VRd). Isa SC is unique in that it is delivered beneath the skin through a special a device worn on the belly. The Isa SC treatment regimen that has shown already promise in clinical trials patients with relapsed/refractory myeloma. After eight months, 88% of patients who received Isa SC-VRd had a very good response or better, with 24% achieving complete remission, and 35% showing no detectable disease.
• Lastly, the newly approved bispecific treatment Lynozyfic (Linvoseltamab) was recently tested in high-risk smoldering multiple myeloma patients. While this study was small (only 19 patients who completed at least one treatment cycle), all of them responded and have not progressed to active myeloma. Side effects (such as infections and CRS) were manageable and did not lead to any treatment discontinuations.

Updates on New Treatments for Patients with Relapsed/Refractory Myeloma

We conclude by sharing exciting updates on arlo-cel, a type of CAR T-cell therapy that targets GPRC5D. We shared promising results from a phase 1 study on the first day of IMS. Today, researchers presented data from a second study that showed similarly encouraging results. In this phase 1 study of 31 relapsed/refractory patients who had received one to three prior lines of therapy, 96% responded to arlo-cel. Side effects—including CRS, loss of taste, and nerve-related symptoms—were common but mostly mild and resolved on their own.

Day three’s presentations demonstrate how myeloma care is evolving to become more accessible and strategically timed—bringing us closer to more personalized strategies that maximize both effectiveness and patients’ quality of life.

Saturday marks the final day of the IMS 2025 meeting. Stay tuned for highlights from the concluding sessions.

MMRF continues to drive the critical global research collaborations that lead to scientific breakthroughs and improved patient outcomes

Norwalk, Conn., September 20, 2025 – Today, the Multiple Myeloma Research Foundation® (MMRF) announced that data generated from several MMRF initiatives were presented at the prestigious 22nd International Myeloma Society (IMS) Annual Meeting. The MMRF team presented five posters, while new findings from its Immune Atlas and CoMMpass℠ programs underpinned 18 additional presentations, reflecting the organization’s unique ability to drive key discoveries, collaborative research, and innovative clinical trials in multiple myeloma.

“Year after year, the MMRF leads research that accelerates the pace of discovery and directly translates into better treatments for patients with multiple myeloma,” said MMRF Chief Scientific Officer George Mulligan, PhD. “Insights from MMRF-led programs are powered by our large clinical and genomic datasets as well as our innovative clinical trial platforms. These demonstrate how our collaborative, data-driven approach is fueling discoveries to deepen our understanding of multiple myeloma.”

The novel MMRF-led research presented at IMS 2025 demonstrates the impact of the foundation’s flagship programs and illustrates how the MMRF’s approach to integrating research within trials addresses key questions that other trials cannot. Among the highlights:

• New reports from the Immune Atlas program include a podium presentation describing how the immune system changes during multiple myeloma treatment.
• The MyDRUG℠ study—a precision medicine trial that selected treatment to match patients’ specific tumor mutations—showed how quadruplet therapy, including daratumumab, reshapes T cell populations in the bone marrow. This highlights the importance of immune function for current therapies.

In addition, the MMRF presented two reports highlighting the positive impact of the organization’s patient education and navigation programs. These initiatives empower people diagnosed with multiple myeloma to optimize their care, better communicate with their healthcare teams, and improve their outcomes.

Abstracts Presented by MMRF
Title: Daratumumab-based Quadruplet Therapy in Functional High-risk Relapse/Refractory Multiple Myeloma Patients Induces Changes Associated with CD8 T Cell Activation and Expansion in the Immune Microenvironment
Abstract: PA-204

Title: CoMMpass Explorer: An Interactive Platform to Explore Clinico-Genomic Data from Newly Diagnosed Multiple Myeloma Patients from the CoMMpass Observational Trial
Abstract: PA-205

Title: Exploration of Tumor Immune Gene Expression to Stratify Progression Risk in Newly Diagnosed Multiple Myeloma Patients from CoMMpass With 1q Cytogenetic Abnormality
Abstract: PA-230

Title: Assessing Positive Behavioral Change in Myeloma Care: An MMRF Longitudinal Study
Abstract: PA-111

Title: Navigating Myeloma: Behavioral and Emotional Outcomes from a Patient-Centered Navigation Resource
Abstract: PA-112

Abstracts on MMRF Immune Atlas Program
Title: Longitudinal Multi-Omic Profiling Uncovers Immune Escape and Predictors of Response in Multiple Myeloma
Abstract: OA-73

Title: Integrating Microenvironment with Tumor Multi-Omic using Unsupervised Machine Learning to Model Heterogeneity Refines Multiple Myeloma Subtypes and Reveals Immune-Based Clusters with Prognostic Impact
Abstract: PA-234

Title: Ancestry-Associated Dysregulation of the Bone Marrow T Cell Compartment in Multiple Myeloma Revealed via scRNA-seq and CyTOF Profiling
Abstract: PA-254

Title: Multi-hit Cytogenetics Risk Events Associated with IFN-I Suppression across TME of NDMM Patients and Poor Outcomes
Abstract: PA-255

Title: Elevated Levels of Circulating Tumor Cells (CTCs) in Newly-Diagnosed Multiple Myeloma (NDMM) Patients Reflect a Highly Proliferative and Genomically Complex Profile
Abstract: PA-231

About Multiple Myeloma
Multiple myeloma is a cancer of the plasma cells that develops in bone marrow. This year, an estimated 35,750 new cases of multiple myeloma will be diagnosed—making it the second-most common blood cancer in the U.S.—and 12,590 people will die from the disease. New targeted agents and therapies have resulted in better outcomes, but most multiple myeloma patients eventually relapse.

About the Multiple Myeloma Research Foundation (MMRF)
The Multiple Myeloma Research Foundation (MMRF) is the largest nonprofit in the world solely focused on accelerating a cure for each and every multiple myeloma patient. We drive the development and delivery of next-generation therapies, leverage data to identify optimal and more personalized treatment approaches, and empower myeloma patients and the broader community with information and resources to extend their lives. Central to our mission is our commitment to advancing access so that all myeloma patients can benefit from the scientific and clinical advances we pursue. Since our inception, the MMRF has raised over $600 million for research, opened nearly 100 clinical trials, and helped bring 15+ FDA-approved therapies to market, which have tripled the life expectancy of myeloma patients. To learn more, visit www.themmrf.org.

Media Contact:
Adam Silverstein, Scient PR: [email protected]

Day two of IMS 2025 reinforced a central theme: Innovation in multiple myeloma treatment is expanding at every stage of the patient journey. From new options for newly diagnosed patients to groundbreaking multi-target CAR T therapies for those facing relapsed disease, researchers are pushing the boundaries of what’s possible while never losing sight of the ultimate goal—delivering safe and effective new treatments to every patient who needs them. 

Today’s presentations highlighted both the potential of emerging therapies and the critical importance of understanding their real-world impact on patients’ lives.  

Here MMRF highlights the latest developments. 

New Treatments for Newly Diagnosed Patients 

• Iberdomide belongs to a new class of oral myeloma drugs called CELMoDs. The CELMoDs work similarly to immune-based therapies like Revlimid but are more powerful. Doctors are studying CELMoDs in many clinical trials, including as an early treatment for people newly diagnosed with multiple myeloma.  

One recent study looked at Iberdomide combined with two other medicines: Darzalex (an antibody treatment) and dexamethasone (a steroid). This was tested in 77 patients who were unable to have a stem cell transplant. The results were very promising: More than 90% of patients responded to the treatment and nearly 80% of patients had their disease stay under control for at least a year. Only three patients discontinued treatment due to adverse effects. 

Researchers will continue following these patients to see how long the benefits last and to better understand how well this treatment works over time.  

Multi-Target CAR T-Cell Therapies 

New CAR T-cell therapies are being designed to attack more than one target on myeloma cells. This may help prevent myeloma from becoming resistant to treatment. Today’s presentations highlighted two unique ways of reaching this goal: 

• TriPRIL is a type of CAR T that targets two proteins on myeloma cells:
  BCMA and TACI. In a small study of 10 participants with relapsed/refractory myeloma, eight responded to TriPRIL. Importantly, this included four patients who did not respond to previous CAR T therapy. 

• In another phase 1 study, two different sets of CAR T-cells that target BCMA and GPRC5D were delivered at the same time to patients who had received at least three prior lines of therapy. 87% of the 19 patients responded to the dual CAR T-cell therapies, including those who received the BCMA CAR T therapy alone.  

In both studies, side effects were manageable, with no serious long-term neurological problems. 

Weighing the Risk/Benefits of Currently Approved CAR T-Cell Therapies  

Abecma, also known as ide-cel, and Carvykti, also known as cilta-cel, are the first CAR T-cell therapies approved for relapsed/refractory multiple myeloma. They work by targeting a protein called BCMA on myeloma cells. Both therapies continue to draw attention as potent treatment options, though many patients can experience significant side effects from either of them. 

Two important studies presented at IMS provided valuable insights for patients and providers weighing CAR T treatment decisions: 

• Researchers analyzed patient outcomes from ide-cel and cilta-cel in more than 1,500 patients with relapsed/refractory myeloma who had at least six prior lines of therapy. While cilta-cel demonstrated higher response rates, deeper remissions, and longer progression-free and overall survival, it also carried a higher risk of delayed neurologic toxicities and slightly increased treatment-related mortality. Although ide-cel and cilta-cel haven’t been directly compared in clinical trials, studies using real-world data like this can help patients and their doctors weigh the potential benefits and risks of each.  

• In a separate analysis, researchers interviewed 38 patients who had received cilta-cel treatment and remained treatment-free for at least six months. Patients described this treatment-free period as profoundly meaningful, highlighting improved quality of life, increased energy, freedom from side effects, and the ability to return to normal routines and family activities.  

Together, these studies reinforce that making the decision to have CAR T-cell therapy requires weighing not only clinical outcomes and safety concerns but also understanding how the therapy can affect patients’ quality of life and long-term well-being. 

As we continue our coverage from Toronto, we’re encouraged by the depth of innovation happening across the myeloma research community and the field’s commitment to balancing clinical effectiveness, safety, and the patient experience. 

Stay tuned for tomorrow’s highlights and more updates from IMS 2025 all meeting long. 

This week, the International Myeloma Society (IMS) is hosting its 22nd Annual Meeting—the world’s largest gathering of multiple myeloma researchers and clinicians. The MMRF team is on the ground in Toronto attending scientific sessions, connecting with experts, and bringing you real-time coverage of the latest breakthroughs.

Over the next four days, we’ll highlight the most promising research and key insights shaping the future of myeloma treatment. Much of the science being presented is closely aligned with MMRF’s strategic research priorities and addresses critical unmet needs in patient care, including:

• New therapies for patients at all stages of the disease
• New therapies for patients with high-risk disease
• Expanding bispecific antibody treatment from hospital to community settings
• Optimizing CAR T-cell therapy approaches
• Understanding markers that predict risk and may inform treatment decisions

Here’s what captured our attention on day one.

New Treatments on the Horizon for Relapsed/Refractory Patients

Data from early-phase studies of several new treatments were very encouraging, particularly for groups of patients who have exhausted current treatment options. Here are three with exciting potential:

• Cevostamab is a new bispecific antibody that goes after a different target on myeloma cells (called FcRH5) compared to the other available bispecific treatments. In a phase 1 study of 32 relapsed/refractory patients—most relapsing after two prior therapies—response rates were 86% with low-dose cevostamab plus Pomalyst/dexamethasone and 88% with the higher dose. Side effects such as infections did occur but were treatable and did not lead to anyone stopping treatment.
• ISB 2001 is a new trispecific antibody that is designed to more strongly bind to myeloma cells and destroy them. In a phase 1 study of 35 relapsed/refractory patients, about 74% responded to ISB 2001, many of whom (43%) already had a prior CAR T or bispecific treatment. Patients experienced deep, lasting benefits at about six months of follow-up. In the study, ISB 2001 was given by injection once a week, but may eventually be given monthly due to how long it lasts in the body.
• Arlo-cel is a new CAR T-cell therapy that targets GPRC5D, the same protein targeted by the bispecific therapy Talvey. In a phase 1 study of 86 relapsed/refractory patients, more than 90% of patients responded to the treatment. At least 45% of these patients had already tried bispecific or CAR T therapies, so this treatment could offer hope for people who are running out of options. We’ll share more on arlo-cel in the days to come, so stay tuned.

While the results of these studies are promising, more work is needed to figure out how well they compare to currently approved myeloma treatments.

Treatments for Patients with High-Risk Disease

Patients with high-risk multiple myeloma face a more aggressive and treatment-resistant form of the disease, so they often have a worse prognosis. Research is needed to find and improve effective strategies for newly diagnosed and relapsed patients who fall into this high-risk category.

Several abstracts highlighted encouraging progress in this area. One standout study looked at the combination of Talvey (talquetamab) and Tecvayli (teclistamab) in patients with relapsed/refractory multiple myeloma and extramedullary disease—a group of patients who have myeloma in other organs of the body beyond the bone marrow. Nearly 80% of patients responded to this combination of bispecifics.

Importantly, the combination of Talvey and Tecvayli worked better for patients than either drug by itself. In fact, about twice as many people improved with the combination compared to just one of the treatments.

We are encouraged by these developments and will continue to monitor advancements in this important area of research.

Stay tuned for more daily highlights and expert perspectives from the conference this week.

Several presentations at the 2025 American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) Annual Meetings introduced new and updated study data in multiple myeloma (MM), along with potentially significant advancements in therapy. Data presented at the meetings included the following:

• Quads as gold standard for high-risk newly diagnosed MM (NDMM)
• Novel treatment combinations for NDMM
• Using minimal residual disease (MRD) results as a clinical decision point
• New frontiers for relapsed/refractory MM (RRMM)
• New prognostic indicators

Data Reinforces Daratumumab Quads as a Gold Standard in NDMM

Data from the CEPHEUS, PERSEUS, and ADVANCE trials confirm daratumumab-based quadruplet regimens as the new frontline standard for NDMM, delivering superior MRD negativity and survival benefits regardless of transplant eligibility.

Phase 3 CEPHEUS trial: dara-VRd

• Intervention: VRd ± daratumumab
• Patient population: 289 non–transplant-eligible (TNE) post hoc analysis
• Efficacy: The overall MRD negativity rate (10^-5) for DVRd vs VRd was 60.4% vs 39.3% (odds ratio [OR] 2.37; 95% confidence interval [CI] 1.47–3.80; P=0.0004)
  • Sustained MRD negativity rate (10^-5 ) for DVRd vs VRd at ≥12 months and ≥24 months was 47.2% vs 28.3% (OR 2.28; 95% CI 1.40–3.72; P=0.0010) and 40.3% vs 22.8% (OR 2.30; 95% CI 1.3–3.83; P=0.0015)
  • The overall rate of complete response or better (≥CR) for DVRd vs VRd was 80.6% vs 61.4% (OR 2.73; 95% CI 1.71–4.34; P<0.0001)
  • At 58.7-mo median follow-up, median progression-free survival (PFS) was not reported (NR) for DVRd and 49.6 mo for VRd
  • Overall survival (OS) favored DVRd vs VRd (hazard ratio [HR] 0.66; 95% CI 0.42–1.03)
• Safety: No unexpected adverse events (AEs) were detected
• Takeaway: Results reinforce the strong efficacy of DVRd in the TNE NDMM population

Phase 3 PERSEUS trial: dara-VRd with dara-len maintenance

• Intervention: Daratumumab + bortezomib + lenalidomide + dex (D-VRd) induction/consolidation followed by DR maintenance or VRd induction/consolidation followed by R maintenance
• Patient population: 709 TE patients
• Efficacy: At 47.5-mo median follow-up, ≥12-month sustained MRD negativity rates were higher with D-VRd (64.8%) vs VRd (29.7%) overall and across clinically relevant subgroups (age ≥65 years and high-risk cytogenetics). Sustained (≥24-month) MRD negativity rates were also higher with D-VRd (55.8%) vs VRd (22.6%). DVRd vs VRd reduced functionally high risk (FHR) rates (3.1% vs 6.8%), and rates of FHR or pre-progression deaths were lower (5.4% vs 11.0%) in the first 18 months
• Safety: NR
• Takeaway: Findings support D-VRd as the standard of care for transplant-eligible (TE) NDMM

Phase 2 ADVANCE trial: dara-KRd

• Intervention: KRd ± daratumumab (autologous stem cell transplant [ASCT] offered to patients who were MRD+ after 8 cycles) followed by lenalidomide maintenance
• Patient population: 306 NDMM patients
• Efficacy: MRD negativity rate (next-generation sequencing [NGS], 10^-5) after up to 8 cycles (primary end point) was significantly higher in patients receiving D-KRd than in those receiving only KRd (59% vs 36%, adjusted OR = 2.5, 95% CI: 1.5–4.2; P<0.0007)
• Safety: AEs of interest (DKRd vs KRd) included cardiac AEs (13% vs 16%), infections (61% vs 53%), and acute kidney injury (1% vs 4%). Serious AEs occurring in >1% of patients (DKRd vs KRd) included pyrexia (5% vs 2%), chest pain (0% vs 3%), pneumonia (3% vs 10%), and acute kidney injury (0% vs 3%)
• Takeaway: DKRd demonstrated a statistically significant, 2.5-fold higher MRD-negativity rate compared to KRd.

Isatuximab Quads Break New Ground in High-Risk Myeloma

Isatuximab-based quadruplet regimens significantly deepen MRD negativity in high-risk patients, offering new hope for improved long-term outcomes.

Phase 2 GMMG-CONCEPT trial: isa-KRd

• Intervention: Isatuximab + carfilzomib + lenalidomide + dexamethasone (dex; isa-KRd)
  • Isa-KRd induction (6 cycles)
  • ASCT in the TE arm or 2 cycles Isa-KRd in the TNE arm
  • Isa-KRd consolidation (4 cycles)
  • 2 years Isa-KR maintenance
  • A switch to carfilzomib administration from twice weekly to once weekly implemented in 2021
• Patient population: 219 TE and 26 TNE patients with high-risk NDMM, defined as ≥1 high-risk cytogenetic aberration—del(17p), t(4;14), t(14;16), ≥3 copies 1q21—in combination with International Staging System (ISS) stage II/III
• Efficacy: MRD negativity rate (next-generation flow cytometry [NGF] 10^-5) after consolidation (primary end point) was 73.2%
  • Overall, 58.4% reached MRD negativity, ≥CR
  • ≥1- and ≥2-year-sustained MRD negativity was achieved in 64.8% and 40.6% of patients, respectively
  • Reaching and remaining in an MRD-negative state led to a significant PFS benefit (HR 0.15 [0.07−0.29]; P<0.0001)
• Safety: Carfilzomib once weekly resulted in fewer discontinuations than twice-weekly dosing (0.6% and 4.8%, TE pts), with more dose reductions in the once-weekly dosing group (9.5% and 5.5%, TE pts)
• Takeaway: Isa-KRd resulted in unprecedented rates of MRD negativity, sustained MRD negativity, and survival, thus supporting the use of isa-KRd as a standard-of-care regimen in a high-risk MM population

Phase 3 IMROZ study: isa-VRd

• Intervention: Isatuximab + bortezomib + lenalidomide + dex (isa-VRd) followed by isatuximab + lenalidomide + dex (isa-Rd) vs bortezomib + lenalidomide + dex (VRd) followed by lenalidomide + dex (Rd)
• Patient population: 446 NDMM patients with 1q21+ chromosomal status (36% [isa-VRd arm];39% [VRd arm] of patients)
• Efficacy: Treatment with isa-VRd significantly prolonged PFS vs VRd in patients with 1q21 (with or without high-risk chromosomal abnormalities) and in patients with isolated 1q21+ and led to higher rates of CR and MRD negativity. MRD-negative CR and sustained MRD negativity (≥12 months) were also greater with isa-VRd vs VRd treatment in patients with 1q21+ or isolated 1q21+
• Safety: NR
• Takeaways: Consistent PFS benefit with isa-VRd vs VRd regardless of 1q21 status

Phase 3 IsKia trial: isa-KRd

• Intervention: KRd ± isatuximab
  • Isa-KRd patients received full-dose induction (4 cycles) followed by ASCT and full-dose isa-KRd consolidation (4 cycles) and, thereafter, 12 28-day light consolidation cycles
  • Patients in the KRd arm received the same KRd schedule used in the other arm
• Patient population: 302 TE patients
• Efficacy: The rates of MRD negativity at the 10^-6 cutoff (by NGS) after full-dose consolidation were 67% with isa-KRd vs 48% with KRd (OR 2.29; P<0.001); the rates of 10^-6 1-year sustained MRD negativity after light consolidation were 52% with Isa-KRd vs 38% with KRd (OR 1.82; P=0.012). The 10^-6 1-year sustained MRD negativity advantage with Isa-KRd vs KRd was retained in all subgroups, such as patients with ≥2 high-risk cytogenetic abnormalities and Revised 2-ISS III/IV
• Safety: In the isa-KRd vs KRd arms:
  • The main grade 3–4 hematologic AEs during light consolidation were neutropenia (17% vs 18%) and thrombocytopenia (2% vs 3%); the main grade 3–4 nonhematologic AEs included infections (8% vs 5%), gastrointestinal (4% vs 4%), and vascular AEs (3% vs 1%)
  • Discontinuations occurred in 3% vs 2%, respectively
  • There were 2 treatment-related deaths (1 cerebral ischemia, 1 pulmonary embolism) in the isa-KRd group vs 0 in the KRd group
• Takeaway: Isa-KRd significantly increased the rate of 10^-6 sustained MRD negativity relative to what was seen with KRd, including in patients with high-risk disease

MRD-Guided Strategies Show Promise

Rather than trying to achieve universal MRD negativity, the MIDAS and PREDATOR trials demonstrate that MRD status informs key treatment decisions—such as whether to proceed with or defer stem cell transplantation or intervene early upon MRD recurrence—enabling more individualized strategies for patients.

Phase 3 MIDAS trial: isa-KRd

• Intervention: KRd ± isatuximab
  • Patients achieving postinduction MRD negativity (NGS 10^-5) following isa-KRd induction were randomized to receive either 6 additional cycles of isa-KRd (Arm A) or ASCT followed by 2 cycles of isa-KRd (Arm B) followed by lenalidomide maintenance
  • MRD-positive patients after induction (≥10^-5) were randomized to either single ASCT + 2 cycles of Isa-KRd (Arm C) or tandem ASCT (Arm D) followed by isatuximab-iberdomide maintenance
• Patient population: 485 MRD-negative and 233 MRD-positive TE patients
• Efficacy: The premaintenance MRD negativity rates at 10^-6 (primary end point) were 84% in Arm A and 86% in Arm B (OR 1.17, 95% CI 0.64–2.76, P=0.64)
• Safety: No new safety signals were identified beyond what was observed in the induction phase
• Takeaway: MRD negativity rates at 10^-6 before maintenance were not significantly different between the ASCT-based approach and isa-KRd consolidation alone; in patients who did not achieve MRD negativity (10^-5), tandem ASCT did not significantly improve MRD negativity rates at 10^-6 before maintenance. The similar rates of sustained MRD negativity suggest that up-front ASCT may not be necessary. This study, published in the New England Journal of Medicine, is ongoing to collect sustained MRD negativity rates and PFS data

Phase 2 PREDATOR-MRD trial: daratumumab or observation for MRD reappearance

• Intervention: Eligible patients were followed for MRD status (≥10^-5) in the bone marrow with regular 4-month intervals for a maximum of 2 years; patients who became MRD-positive were randomized for observation or daratumumab treatment
• Patient population: 54 MM patients who completed 1 or 2 prior lines of therapy achieved CR with MRD-negativity and were not receiving any antimyeloma treatment
• Efficacy: MRD re-emerged in 29 patients (median time to MRD reappearance: 11.3 months, range, 0–23.8). MRD-positive patients without signs of significant paraprotein relapse or clinical progression (n=24) were randomized to daratumumab (n=12) or the observation arm (n=12)
  • After a median follow-up of 17.9 months, median event-free survival was not reached in the daratumumab arm vs 9.5 mos in the observation arm (HR=0.20, 95% CI: 0.05−0.76; P=0.0097)
  • After initiating daratumumab treatment, 7 of 12 patients (58.3%) achieved MRD negativity
• Safety: No patients died during the study. The most common AEs with daratumumab (vs observation) were infection (58% vs 16%) and pain (33% vs 8%)
• Takeaway: Early intervention with daratumumab in MM patients experiencing MRD relapse delays clinical progression and can restore MRD negativity in a significant proportion

Investigating Elranatamab For Transplant-Ineligible NDMM

Use of elranatamab for TIE NDMM patients highlights the expanding arsenal of next-generation therapies aiming to improve outcomes and personalize care for patients.

Phase 3 MagnetisMM-6 trial: elranatamab-DR

• Intervention: Elranatamab + lenalidomide (ER) + daratumumab vs daratumumab + lenalidomide + dex (DRd)
• Patient population: 37 patients with TIE MM
• Efficacy: At the median follow-up of 4.6 months, treatment was ongoing in 33 patients. The confirmed ORR (95% CI) was 91.9% (78.1–98.3)
• Safety: Cytokine release syndrome (CRS) occurred in 62.2%, all grade ≤2; 1 case of grade 2 immune effector cell-associated neurotoxicity syndrome (ICANS) was reported. Infections occurred in 64.9% (grade 3/4, 18.9%). Hematological treatment-emergent AEs (TEAEs) occurred in 78.4% (grade 3/4, 70.3%)
• Takeaway: In patients with TIE NDMM, elranatamab in combination with daratumumab and lenalidomide demonstrated a manageable safety profile consistent with the known toxicities of components and a high and early response rate. Enrollment in other dose levels is ongoing

Relapsed MM Immunotherapies: Progress in Early and Late Disease

In early relapse, belamaf and isatuximab (via subcutaneous administration) demonstrate significant value. Late-relapse patients benefit from advances in bispecific antibodies—linvoseltamab and talquetamab—and CAR T-cell therapies. Notably, long-term data from CARTITUDE-1 on the use of ciltacabtagene autoleucel (cilta-cel), now published in the Journal of Clinical Oncology, marks a major milestone in long-term outcomes for late-relapse treatment.

Phase 3 DREAMM-8 trial: belamaf-Pd vs PVd

• Intervention: Belamaf + pomalidomide + dex (Belamaf-Pd) or pomalidomide + bortezomib + dex (PVd)
• Patient population: 302 patients who received ≥1 prior line of treatment including lenalidomide
• Efficacy: Patients treated with belamaf-Pd achieved a 5-fold improvement in CR-based MRD negativity vs PVd (24% vs 5%). Patients who did not achieve CR-based MRD negativity had a clinically meaningful benefit in PFS with BPd vs PVd
• Safety: NA
• Takeaway: MRD negativity was associated with a robust benefit in PFS and OS. Patients treated with BPd achieved a higher CR-based MRD negativity than did those receiving PVd

Phase 3 IRAKLIA study: pomalidomide + dex + isatuximab (SC or IV)

• Intervention: Isa subcutaneous (SC) on-body delivery system (OBDS), an investigational wearable bolus injector, versus isa IV + pomalidomide + dexamethasone (Pd)
• Patient population: 531 patients who had received ≥1 prior line of therapy
• Efficacy: After a median follow-up of 12 months, ORR was 71.1% in the SC OBDS arm and 70.5% in the IV arm (relative risk 1.008, 95% CI=0.903–1.126)
• Safety: Grade ≥3 TEAEs occurred in 82% of patients in the SC OBDS arm and 76% of patients in the IV arm with treatment discontinuation rates of 8% and 9%, respectively. Injection site reactions occurred in 4% of patients in the SC arm and 0.4% of patients in the SC arm; all were of Grade 1–2. 99% of OBDS injections were completed without interruption
• Takeaway: Results showed noninferiority of isa SC OBDS relative to what was seen with isa IV, supporting the potential use of isa SC delivered via the OBDS to improve patient experience and practice efficiency. These results are published in the Journal of Clinical Oncology

Phase 1b LINKER-MM2 trial: linvoseltamab + bortezomib or linvoseltamab + carfilzomib

• Intervention: Linvoseltamab + carfilzomib (linvo-cfz) or linvo + bortezomib (linvo-btz)
• Patient population: 42 RRMM patients who had progressed after ≥3 lines of therapy, or ≥2 lines of therapy if either triple-class exposed or double-class refractory. Prior btz or cfz was allowed if previously tolerated and ≥6 months had elapsed since last exposure
• Efficacy:
  • Linvo-btz ORR was 85%; the 6-month PFS rate was 78% (95% CI 52–91)
  • Linvo-cfz ORR was 91% at dose level (DL)1 (linvo 100 mg) and 100% at DL1b (linvo 150 mg) before the start of before initiation of cfz. For DL1, the PFS rate was 99% (95% CI 71–99) at 6 months and 83% (95% CI 55–94) at 12 months
• Safety:
  • Linvo-btz: common TEAEs were neutropenia (any grade 54.2%; G3–4 50%), thrombocytopenia (54.2%; 37.5%), and CRS (58.3%; 0%). ICANS was reported in 4 pts (all Gr 1–2). Infections were reported in 75% (G3–4 37.5%); 2 patients died of infection
  • Linvo-cfz: Most common TEAEs were neutropenia (any grade 78%; G3-4, 61%), thrombocytopenia (61%; 39%), and CRS (61%; 0%). One patient experienced ICANS (G1). Infections were reported in 89% of patients (G≥3 44%)
• Takeaway: Both linvo combinations induced high response rates with a safety profile consistent with the individual drugs, supporting further development

Phase 1b TRIMM-3 study: talquetamab + cetrelimab

• Intervention: Cetrelimab (cet), a programmed cell death receptor-1 (PD-1) monoclonal antibody, combined with talquetamab (tal)
• Patient population: 44 RRMM patients
• Efficacy: ORR was 70% and 6-month duration of response (DOR) and PFS rates were 93% and 72%, respectively. In patients with prior CD3 redirecting antibody therapy, ORR was 68% and 6-month DOR and PFS rates were 92% and 65%, respectively
• Safety: GPRC5D-related AEs were common (taste changes 82% [39% G1/43% G2]; nail 75% [all G1/2]; skin 73% [all G1/2]; and rash 39% [mostly G1/2]). PD-1-related AEs occurred in 7 pts. Grade 3/4 AEs occurred in 82% of patients (commonly neutropenia [41%] and anemia [39%]). CRS occurred in 61% of patients (all G1/2). ICANS occurred in 1 pt (G1). Infections and hypogammaglobulinemia occurred in 80% (27% G3/4) and 57% of patients. One death occurred (pneumonia)
• Takeaway: Tal-cet showed deep and durable responses in patients with RRMM and prior CD3-redirecting antibody therapy. These proof-of-concept data are encouraging for PD-1 inhibition in RRMM and further support tal as a versatile combination partner

Phase 2 IMMAGINE-1 study of anito-cel

• Intervention: Anitocabtagene autoleucel (anito-cel), an autologous anti-BCMA CAR T-cell therapy with a novel D-domain binder
• Patient population: 86 RRMM patients triple-class exposed who had progressed after ≥3 lines of therapy had measurable disease and were refractory to their last line of therapy
• Efficacy: Investigator-assessed ORR was 97% with a CR rate of 62%; 93.1% evaluable patients achieved MRD negativity (10^-5). At 12 months, the DOR, PFS, and OS rates were 75.6%, 78.5%, and 96.5%, respectively
• Safety: The most common grade ≥3 TEAEs were cytopenias: 54% neutropenia, 22% anemia, and 20% thrombocytopenia. Any-grade CRS was observed in 81 pts (83%), with 67 (68%) Grade 1, 13 (13%) Grade 2, and 1 (1%) Grade 5. ICANS was observed in 9 pts (9%)
• Takeaway: Ongoing preliminary results demonstrate deep and durable efficacy and manageable safety (with notable low incidence of ICANS considering rates of neurotoxicity observed for cilta-cel and ide-cel are 21% and 18%, respectively) for anito-cel in RRMM

Long-Term Results From CARTITUDE-1 Redefining Outcomes in Late-Relapse Myeloma

• Intervention: Cilta-cel (single injection)
• Patient population: 97 patients with heavily pretreated RRMM who historically have an expected median PFS of <6 months and median OS of ~1 year
• Efficacy: Of treated patients, 32 (33.0%) remain alive and progression free for ≥5 years. Compared with patients who had progressive disease within 5 years, biomarkers that were significantly associated with ≥5 years of progression-free status included a higher fraction of naive T cells in the drug product, lower neutrophil-to-T-cell ratio, higher hemoglobin and platelets at baseline, and higher effector-to-target ratio. Overall, at 60.3 months median follow-up, the median OS was 60.6 months
• Safety: No new cases of movement and neurocognitive disorders were reported
• Takeaway: First evidence that cilta-cel achieves deep responses that are long lasting in heavily pretreated patients

Trispecific Antibodies Reveal the Next Frontier for RRMM

First-in-human phase 1 data for two novel trispecific antibodies demonstrated impressive response rates and manageable safety profiles in heavily pretreated RRMM.

Phase 1 first-in-human dose-escalation study of ISB 2001

• Intervention: ISB 2001, a first-in-class trispecific BCMA×CD38×CD3-targeting T-cell engager. Patients received 8 dose levels (5–1,800 µg/kg)
• Patient population: 35 RRMM patients exposed to immunomodulatory drugs, proteasome inhibitors, and anti-CD38 therapies and refractory or intolerant to established therapies. Prior BCMA-targeted and/or T-cell-directed therapies were allowed
• Efficacy: ORR was 74% across all 8 doses (79% at doses ≥50 µg/kg), including a stringent CR of 17%. The median time to response was 36 days
• Safety: No dose-limiting toxicity or deaths occurred. Serious AEs were reported in 8 patients. CRS was reported in 24 (69%, G1/2). One patient with ICANS (G1); no other neurologic AEs
• Takeaway: ISB 2001 was well tolerated with manageable CRS, no ICANS, and robust antimyeloma activity regardless of prior CAR T, T-cell engagers, BCMA therapies, CD38-refractoriness, extramedullary disease, or high-risk cytogenetics, thus representing a potential therapy for late-relapse patients.

Phase 1 first-in-human study of JNJ-79635322

• Intervention: JNJ-79635322 (JNJ-5322), a next-generation trispecific antibody dually targeting BCMA and GPRC5D via T-cell redirection. Patients received JNJ-5322 as fixed Q2W or Q4W SC doses (0.4-300 mg), including 100 mg Q4W, the putative RP2D
• Patient population: 126 RRMM patients previously exposed to a proteasome inhibitor, immunomodulatory drug, and anti-CD38 monoclonal antibody
• Efficacy: After a follow-up of 8.2 months, the ORR was 86% at the RP2D (n=36), and 73% overall (n=124). ORR was 100% at the RP2D among patients naïve to anti-BCMA/-GPRC5D therapies (n=27). The median time to first response was 1.2 months
• Safety: The most common AEs included CRS (59%, G1/2); 2% experienced ICANS (all grade 1), and the following AEs were also observed: nail AEs (56%, G1/2), taste AEs (56%, G1/2), neutropenia (48%; 41%, G3/4), and nonrash skin AEs (47%; 1% G3/4). Infection was detected in 75% (28% G3/4). 5 patients had dose-limiting toxicities and 4 died due to AEs
• Takeaway: JNJ-5322 offers high ORRs, especially for BCMA/GPRC5D treatment-naive patients

CTCs as an Independent Risk Factor

One study assessed the independent prognostic value of circulating tumor cells (CTCs) and determined their applicability to clinical practice. Investigators collected data from 2,446 NDMM patients from multiple centers in Europe. High CTC levels (≥1%) were strongly correlated to inferior PFS (HR 1.18, 95% CI 1.12−1.24, P<0.001). The study showed that CTCs are an independent risk factor in NDMM and that a cutoff in the range of 0.01−0.1% is useful in categorizing progression risk.

Jointly provided by the MMRF and RedMedEd.

Support for this activity has been provided through sponsorships from Legend Biotech USA Inc., Pfizer Inc., and Sanofi and by educational grants from AbbVie Inc. and Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC.

If you or a loved one has been exploring treatment options for relapsed or refractory multiple myeloma, you may have heard of CAR T-cell therapy—a highly effective treatment option that reprograms your own immune system to fight cancer.

In a pivotal move, the FDA recently removed the Risk Evaluation and Mitigation Strategy (REMS) requirements for CAR T-cell therapies used in multiple myeloma. REMS are specialized safety programs that CAR T centers must follow to minimize the risk associated with the treatment. Other treatments for multiple myeloma have REMS programs in place.

This decision marks a major shift in how these therapies can be delivered—and it’s one that could open doors for patients who were previously unable to benefit from CAR T.

Removing REMS Means Removing Roadblocks

Limited treatment centers, burdensome pre-approvals, and strict inpatient administration rules have made CAR T difficult to access for many patients and providers. By removing REMS, the FDA has helped streamline the pathway to treatment.

One of the most promising effects of this change?

Reaching patients who’ve been historically underserved.

Right now, only about 20% of eligible myeloma patients receive CAR T therapy, largely due to where they live. Patients in rural or underserved areas often face long-distance travel and financial hurdles that put CAR T out of reach. Without REMS, more treatment centers can begin offering CAR T, potentially improving access in these regions and allowing more patients to receive timely care.

Paving the Way for Progress

As CAR T becomes more accessible, the MMRF sees even greater opportunities on the horizon. This momentum is essential in our mission to accelerate precision medicine and improve outcomes for all myeloma patients.

A Vote of Confidence in the Myeloma Community

The FDA’s decision is more than a policy shift. It’s a signal of trust in the hematology/oncology community. It shows that providers have demonstrated the knowledge and experience needed to manage the risks associated with CAR T, such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), without the need for special certifications or safety checks.

What This Means for Patients

If CAR T isn’t an option for you because of where you live, this change could be the turning point. Now is the time to speak with your care team about whether CAR T is a fit for you, and to revisit clinical trial opportunities that may have been previously out of reach.

You can ask your doctor:

• Am I eligible for CAR T therapy?
• What do I need to prepare for CAR T?
• What side effects will I have on CAR T?
• Where is the nearest CAR T center?
• Is there a clinical trial I can enroll in?

For more support and guidance, the MMRF Patient Navigation Center is here to help you understand your options, connect to care, and navigate the next steps in your myeloma journey.