IMS 2025: Day 3 Sessions Highlight Efforts to Expand Access and Optimize Multiple Myeloma Care

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.