The latest version of the ASCO Multiple Myeloma Living Guideline is out!
All published phase 3 data is reviewed every 8 weeks and recommendations are updated in real-time.
We are continuing to refine algorithms for relapsed/refractory myeloma as time goes on.
ascopubs.org/guidelines/tre…
All published phase 3 data is reviewed every 8 weeks and recommendations are updated in real-time.
We are continuing to refine algorithms for relapsed/refractory myeloma as time goes on.
ascopubs.org/guidelines/tre…
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A great study idea from Zachary Avigan and the Mount Sinai group:
What does it mean when deep responding patients have MRD 'positivity' below the limit of detection on clonoSEQ?
Not all results are the same!
Unique sequences with disease detected below LOD (typically <1 celigh risk of relapse
Less-unique sequences with disease detected below LOD: no difference from 'true' MRD negativity.
What does it mean when deep responding patients have MRD 'positivity' below the limit of detection on clonoSEQ?
Not all results are the same!
Unique sequences with disease detected below LOD (typically <1 celigh risk of relapse
Less-unique sequences with disease detected below LOD: no difference from 'true' MRD negativity.
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It has been a real delight to have had @UCCancerCenter be a part of the anito-cel journey. Now we await the results of the phase 2 and the PDUFA date - December 23!
In a phase 1 study of anito-cel, a CAR T-cell therapy, for relapsed or refractory myeloma, all 38 patients had a response. Severe cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome were rare. Full study results: nej.md/4ArvK6r
Science -cel for Multiple Myeloma nej.md/4hF5Gxj
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Ben Derman retweeted
In a phase 1 study of anito-cel, a CAR T-cell therapy, for relapsed or refractory myeloma, all 38 patients had a response. Severe cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome were rare. Full study results: nej.md/4ArvK6r
Science -cel for Multiple Myeloma nej.md/4hF5Gxj
Science -cel for Multiple Myeloma nej.md/4hF5Gxj
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Ben Derman retweeted
#MyelomaTips: I have seen several referrals recently for myeloma based on isolated incidental finding of hypercalcemia.
➡️Isolated hypercalcemia is rarely myeloma.
➡️If hypercalcemia is the only abnormal finding with no anemia, renal impairment, or bone lesions; myeloma is an ➡️In iStopMM (n=2,546 MGUS pts), only 3% with persistent hypercalcemia had MM and every single one also had bone lesions/other CRAB features (Blood 2022;140:10099)
➡️Look elsewhere before anchoring on MM.
#MedTwitter #MultipleMyeloma #MMSM #MedEd
➡️Isolated hypercalcemia is rarely myeloma.
➡️If hypercalcemia is the only abnormal finding with no anemia, renal impairment, or bone lesions; myeloma is an ➡️In iStopMM (n=2,546 MGUS pts), only 3% with persistent hypercalcemia had MM and every single one also had bone lesions/other CRAB features (Blood 2022;140:10099)
➡️Look elsewhere before anchoring on MM.
#MedTwitter #MultipleMyeloma #MMSM #MedEd
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Ben Derman retweeted
Drs. Tarek H. Mouhieddine and Kenneth C. Anderson summarize treatment for multiple myeloma, highlighting four-drug induction therapy, evolving transplantation strategies, tailored maintenance therapy, and in relapse, earlier use of BCMA-directed immunotherapy.
Read the Review sions in Multiple Myeloma”: nej.md/4cDwLOF
Read the Review sions in Multiple Myeloma”: nej.md/4cDwLOF
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Ben Derman retweeted
Profound sorry that my mentor, friend, and colleague, the legend Bob Kyle passed away. His contributions to patients, medicine, myeloma, @IMFmyeloma @MayoClinic myeloma group, and the institution are monumental. A role model who will be remembered for his integrity and commitment areer to him. He leaves behind a legacy of experts at Mayo Clinic as well as world over who were influenced greatly by him.
See thread for links to a video an article on him that I wrote for @MayoProceedings
Post your memories below.
See thread for links to a video an article on him that I wrote for @MayoProceedings
Post your memories below.
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Ben Derman retweeted
Multiple Myeloma EHA and ASCO® 2026 Highlights and Controversies: How Do MonumenTAL-3 and Other New Data Reshape CAR T and Bispecific Use at Early Relapse? vumedi.com/video/multiple… via @VuMedi a chat with @DrOlaLandgren Dr. Ken Shain and @bdermanmd
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Ben Derman retweeted
Prognostic Significance of Cell-Free DNA Derived 5-Hydroxymethylcytosine Signatures in Newly Diagnosed Multiple Myeloma. Co-authored by @bdermanmd.
Read the full article. bit.ly/4fFGAw4
Read the full article. bit.ly/4fFGAw4
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Congratulations to the ENDURANCE investigators on an impactful trial - they should be applauded for running a successful cooperative group phase 3 trial with two randomizations! My thoughts below...
ENDURANCE enrolled patients without high-risk disease and without intention for ASCT.
The 1st randomization evaluated KRd vs. VRd (no difference in PFS).
The 2nd randomization evaluated 2 years vs indefinite lenalidomide maintenance with OS as the primary endpoint. After 9 years of follow-up, there is no difference in OS!
Let's dive in and take a closer look...
nejm.org/doi/full/10.10…
ENDURANCE enrolled patients without high-risk disease and without intention for ASCT.
The 1st randomization evaluated KRd vs. VRd (no difference in PFS).
The 2nd randomization evaluated 2 years vs indefinite lenalidomide maintenance with OS as the primary endpoint. After 9 years of follow-up, there is no difference in OS!
Let's dive in and take a closer look...
nejm.org/doi/full/10.10…
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Patients in the indefinite arm certainly had more cumulative lenalidomide exposure, though 44% of patients in indefinite arm had less than or equal to 24 months of therapy.
There is also an interesting phenomenon of nominal PFS difference in the VRd subgroup but not the KRd y, no differences in second cancers between groups.
There is also an interesting phenomenon of nominal PFS difference in the VRd subgroup but not the KRd y, no differences in second cancers between groups.
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All in all, my take is that this study provides some evidence that indefinite maintenance therapy in patients with standard risk disease who did not receive a transplant may not extend survival.
I want to believe this is true for all patients....but...
There are some systematic issues inherent to the complexities of large cooperative group trials that we must acknowledge too.
For now, I will continue to use sustained MRD negativity to trigger discussion regarding discontinuation of therapy.
I want to believe this is true for all patients....but...
There are some systematic issues inherent to the complexities of large cooperative group trials that we must acknowledge too.
For now, I will continue to use sustained MRD negativity to trigger discussion regarding discontinuation of therapy.
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Ben Derman retweeted
Happy to present results from one of the projects I worked on during my time at the University of Chicago at #EHA2026 in Stockholm. Grateful for the opportunity—special thanks to Ben Derman for his support and mentorship.
@bdermanmd
@bdermanmd
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Additions from the LINKER-AL2 presentation:
Rapid reduction of FLC, VGPR+ rate 100%, CR rate 90%, no progression events (!) and high rates of renal and cardiac responses.
Rapid reduction of FLC, VGPR+ rate 100%, CR rate 90%, no progression events (!) and high rates of renal and cardiac responses.
4) LINKER-AL2: Linvoseltamab in relapsed AL amyloidosis. (Wechalekar, Lee, 7502)
BCMA bispecifics are like magic in this population.
In 20 pts:
✅ No DLTs or ICANS
✅ CRS/IRR were Grade 1–2, mostly during step-up dosing
✅ heme OR: 100% with 80 mg; 92% with 240 mg
✅ Median time to hemeCR ~3 weeks
Small cohort + short follow-up, but the signal is notable: rapid plasma cell clone suppression in a disease where fast iFLC normalization matters.
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Updates from the anselamimab presentation:
This was a pre-specified subgroup analysis.
These curves for the kappa LC subgroup are impressive, and track with symptomatic improvements.
Perhaps there is a real signal here.
The paper is out now: ascopubs.org/doi/10.1200/JC…
This was a pre-specified subgroup analysis.
These curves for the kappa LC subgroup are impressive, and track with symptomatic improvements.
Perhaps there is a real signal here.
The paper is out now: ascopubs.org/doi/10.1200/JC…
5) Anselamimab in κ light-chain amyloidosis.
Remember: Anselamimab is a monoclonal antibody designed to remove amyloid fibrils.
The phase 3 study was negative (no difference in mortality in stage 3a/3b amyloid).
But a post-hoc analysis shows anselamimab-treated patients with κ iFLC had a 62% reduction in mortality and a 71% reduction in risk for cardiovascular hospitalization.
My take: An interesting signal, but far from definitive. These 'amyloid eaters' have disappointed us so far, but the story is not over!
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We now have release of SUCCESSOR-2 data!
Mezi + weekly Kd vs twice weekly Kd
- 85% anti cd38 refractory
- mPFS 18 vs 8 months (control arm did the same as MajesTEC-9)
My take: 18 months is nothing to scoff at, and compares favorably with KPd data. It still leaves something to be er options in the same lines BUT one more time for those in the rafters - we can stop using Kd and VPd as comparator arms now?
Mezi + weekly Kd vs twice weekly Kd
- 85% anti cd38 refractory
- mPFS 18 vs 8 months (control arm did the same as MajesTEC-9)
My take: 18 months is nothing to scoff at, and compares favorably with KPd data. It still leaves something to be er options in the same lines BUT one more time for those in the rafters - we can stop using Kd and VPd as comparator arms now?
3) SUCCESSOR-2. Mezi-Kd vs. Kd. It's a late breaker so stay tuned for the data.
This will be an important study as it will serve as the FIRST randomized study of carfilzomib with an IMiD/CELMoD.
This could help to establish an effective regimen for anti-CD38 refractory patients that isn't T-cell redirecting.
Elements to pay attention to:
- % anti-CD38 exposed/refractory?
- PFS / OS
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Working on this study was truly a labor of love!
Durca-cel is a BCMA-directed CAR T that was manufactured exceedingly quickly, and this phase I study came at a time when we had very limited slot availability for commercial CAR T. While the PFS was ‘only’ 12 months, we were able to get patients with very challenging disease to CAR T. I think this truly changed the trajectory of their entire disease course. IEC-HS was more common with this product, and we learned a great deal about optimal management of this entity.
Shoutout to @adamssperling who put so much effort into this study and to Novartis for their collegiality and support.
science.org/doi/10.1126/sc…
Durca-cel is a BCMA-directed CAR T that was manufactured exceedingly quickly, and this phase I study came at a time when we had very limited slot availability for commercial CAR T. While the PFS was ‘only’ 12 months, we were able to get patients with very challenging disease to CAR T. I think this truly changed the trajectory of their entire disease course. IEC-HS was more common with this product, and we learned a great deal about optimal management of this entity.
Shoutout to @adamssperling who put so much effort into this study and to Novartis for their collegiality and support.
science.org/doi/10.1126/sc…
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Ben Derman retweeted
🧬 Is CAR-T moving beyond relapsed myeloma and into high-risk smoldering disease?
In Part 2 of the Miami Myeloma Cross-Country series, Dr. Dickran Kazandjian (@dikokaz) leads a discussion with Drs. Ola Landgren (@DrOlaLandgren), Kenneth Shain, and Benjamin Derman (@bdermanmd) on AR-T in high-risk smoldering myeloma.
The panel explores the promise—and challenges—of earlier intervention, including MRD negativity, neurologic toxicity concerns, and whether aggressive treatment can truly alter disease course.
🎥 Watch on Vumedi: tinyurl.com/yn3sau64
🔗 Visit the Miami Myeloma Cross-Country Vumedi Channel to keep up with hot topics in Myeloma: tinyurl.com/yc2bxf3u
Featuring experts from @SylvesterCancer / @UMiamiHealth, @MoffittNews, and @UCCancerCenter / @UChicagoMed
With thanks to organizations advancing myeloma research and care, including @theMMRF, @IMFmyeloma, @HealthTree, @ASH_hematology, @AmericanCancer, @Myeloma_Society and @ConquerCancerFd
#MMSM #CAR_T
In Part 2 of the Miami Myeloma Cross-Country series, Dr. Dickran Kazandjian (@dikokaz) leads a discussion with Drs. Ola Landgren (@DrOlaLandgren), Kenneth Shain, and Benjamin Derman (@bdermanmd) on AR-T in high-risk smoldering myeloma.
The panel explores the promise—and challenges—of earlier intervention, including MRD negativity, neurologic toxicity concerns, and whether aggressive treatment can truly alter disease course.
🎥 Watch on Vumedi: tinyurl.com/yn3sau64
🔗 Visit the Miami Myeloma Cross-Country Vumedi Channel to keep up with hot topics in Myeloma: tinyurl.com/yc2bxf3u
Featuring experts from @SylvesterCancer / @UMiamiHealth, @MoffittNews, and @UCCancerCenter / @UChicagoMed
With thanks to organizations advancing myeloma research and care, including @theMMRF, @IMFmyeloma, @HealthTree, @ASH_hematology, @AmericanCancer, @Myeloma_Society and @ConquerCancerFd
#MMSM #CAR_T
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