Keypoints:

1. AQUILA: Explore the impact of early intervention using daratumumab for smoldering myeloma, which showed improved progression-free survival (PFS) and overall survival (OS).
2. Dara Based Quad Therapy: We discuss a meta-analysis reaffirming the use of quadruplet therapy with anti-CD38 for newly diagnosed multiple myeloma as the standard of care.
3. CARTITUDE-4: study highlights the benefits of CAR-T therapy in earlier lines of treatment for patients with lenalidomide-refractory disease.
4. Role of IVIG with BCMA Bispecific Antibodies: Discover how IVIG can reduce infection rates and improve overall survival when used alongside BCMA-targeted therapies.
In this episode of the Oncology Brothers podcast, Drs. Rahul & Rohit Gosain had the pleasure of speaking with Dr. Robert Orlowski from MD Anderson Cancer Center. We delved into several key studies presented at ASH 2024 that are shaping the landscape of multiple myeloma treatment.
We kicked off our discussion with the AQUILA study, which focused on early intervention using daratumumab for patients with high-risk smoldering myeloma. Dr. Orlowski highlighted that this study demonstrated a significant improvement in progression-free survival (PFS) and a trend towards better overall survival (OS) for patients receiving daratumumab compared to those under active monitoring. This raises important questions about the ethics of treatment versus monitoring in this patient population.
Next, we explored the first-line treatment for newly diagnosed multiple myeloma, emphasizing the benefits of quadruplet therapy that includes an anti-CD38 antibody. Dr. Orlowski discussed a meta-analysis that reaffirmed the superiority of quadruplet therapy over triplet therapy, particularly in terms of overall survival. He addressed common concerns among community doctors about using all available therapies upfront, emphasizing that the data supports the use of these effective combinations.
We then shifted our focus to the CAR-T therapy landscape, specifically the CAR-T4 trial, which examined the use of BCMA-targeted CAR-T cells in lenalidomide-refractory patients. Dr. Orlowski shared impressive results showing high rates of minimal residual disease (MRD) negativity with CAR-T therapy, which correlates with better patient outcomes.
Finally, we discussed the role of intravenous immunoglobulin (IVIG) in managing infections associated with CAR-T and bispecific antibody therapies. Dr. Orlowski presented compelling data indicating that IVIG not only reduces the risk of major infections but also improves overall survival, reinforcing the importance of supportive care in these treatment regimens.
In summary, this episode provided valuable insights into the evolving treatment strategies for multiple myeloma, highlighting the importance of early intervention, the efficacy of quadruplet therapy, the promise of CAR-T therapies, and the critical role of supportive care.
We hope our listeners find this information helpful as they navigate the complexities of treating multiple myeloma. Thank you for joining us, and be sure to check out our discussions on CLL, myeloma, and lymphoma from ASH 2024. We are the Oncology Brothers.