Thank you to our sponsors!
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Virtual ASCO 2021 Total ASCO abstracts for 2021 = 4,782 Myeloma Abstracts = 282 Oral = 26 Poster Discussion = 32 Poster Session = 106 Publication Only = 118 3
Abstracts Overview 1. Immune Therapies • CAR-T • Bispecifics 2. Frontline Therapy • Triplets • Quadruplets 4
Abstracts Overview 3. Monitoring • Mass spectrometry • Imaging 4. Relapsed therapies • Ninlaro®(ixazomib) • Xpovio®(selinexor) 5
Immune Therapies
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Abstract #8005: CARTITUDE-1
https://www.myeloma.org/videos/ciltacabtagene-autoleucel-bcma-directed-cart-therapy-relapsed-refractory-multiple-myeloma-cartitude1
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CARTITUDE-1 Update • • • • •
Median follow-up – 18 months Overall response rate = 98% (!) sCR = 80% Response duration = 66% at 18 months Some newer concerns about delayed toxicities and how to mitigate. 8
Idecabtagene vicleucel (ide-cel, bb2121) •
Idecabtagene vicleucel (ide-cel, bb2121), a BCMA-directed CAR T cell therapy, inrelapsed and refractory multiple myeloma: Updated KarMMa results
•
https://www.myeloma.org/videos/idecabtagene-vicleucel-ide-cel-bb2121-bcma-directed-car-t-cell-therapyrelapsed-refractory
•
Characteristics of neurotoxicity associated with idecabtagene vicleucel (ide-cel, bb2121)in patients with relapsed and refractory multiple myeloma (RRMM) in the pivotal phase II myeloma KarMMa study
•
https://www.myeloma.org/videos/characteristics-neurotoxicity-associated-idecabtagene-vicleucel-patientsrelapsed-refractory
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Idecabtagene Vicleucel (Ide-cel, bb2121), a BCMA-Directed CAR T Cell Therapy, in Patients With Relapsed andRefractory Multiple Myeloma: Updated KarMMa Results
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https://www.myeloma.org/videos/idecabtagene-vicleucel-relapsed-refractory-myeloma-patients-karmma
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KarMMa-4: Idecabtagene vicleucel (ide-cel, bb2121), a BCMA-directed CAR T-celltherapy in high-risk newly diagnosed multiple myeloma
•
https://www.myeloma.org/videos/karmma-4-idecabtagene-vicleucel-bcma-directed-car-t-cell-therapy-high-risknewly-diagnosed
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Abstract #8007 - teclistamab
https://www.myeloma.org/videos/updated-phase-1-teclistamab-trial-results-relasped-refractory-multiple-myeloma
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Teclistamab Update • 40 patients • Response rate = 65% • Of responders: • VGPR = 58% • CR/ sCR = 30% • Toxicities acceptable/ manageable for this bispecific 11
Abstract #8006: elranatamab
https://www.myeloma.org/videos/efficacy-safety-elranatamab-bcma-cd3-bispecific-antibody-patients-relapsed-or-refractory
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What’s next for CAR T? • Rollout of approved products • Earlier use
• Next generation CARs 13
Where will bi-specifics fit in? • Ongoing IV/ SC • Course of therapy – 6 months?
• Toxicity concerns persist? 14
Audience Q&A Type and submit your questions here. Click the Q&A icon circled below if you have minimized the “Ask Question” window.
Triplets and Quadruplets
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EHA Late Breaking Abstract
https://www.myeloma.org/videos/overall-survival-results-daratumumab-lenalidomide-dexamethasone-transplant-ineligible-MAIA
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Progression Free Survival (PFS) data 60-month PFS rate
% surviving without progression
100 80 52.5%
60
D-Rd: median, NR 28.7%
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Rd: median, 34.4 months 20
HR, 0.53; 95% CI, 0.43-0.66; P <0.0001
0 0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 Months No. at risk Rd 369 333 307 280 255 237 220 205 196 179 172 155 146 133 123 113 105 94 63 36 12 4 D-Rd 368 347 335 320 309 300 290 276 266 256 246 237 232 222 210 199 195 170 123 87 51 17
2 5
0 0
• D-Rd continued to demonstrate a significant PFS benefit, with median PFS not reached with D-Rd • These data provide a new PFS benchmark in patients with NDMM who are transplant ineligible
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Overall Survival (OS) data 60-month OS rate 100
% surviving
80
66.3% D-Rd: median, NR
53.1%
60
Rd: median, NR 40 20
HR, 0.68; 95% CI, 0.53-0.86; P = 0.0013
0 0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 72 Months No. at risk Rd 369 351 343 336 324 317 308 300 294 281 270 258 251 241 232 223 213 183 134 85 42 14 5 D-Rd 368 350 346 344 338 334 328 316 305 302 297 286 280 273 266 255 249 228 170 118 63 22 6
1 1
0 0
D-Rd demonstrated a significant benefit in OS, with a 32% reduction in the risk of death, in patients with NDMM who are transplant ineligible 19
Abstract #8004: CASSIOPEIA Part II
https://www.myeloma.org/videos/daratumumab-maintenance-or-observation-after-treatment-vtd-asct-patients-cassiopeia
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CASSIOPEIA Update Key Point • Dara maintenance – no added benefit with Dara VTd induction/ consolidation
• Does this change thinking about Dara maintenance? 21
Audience Q&A Type and submit your questions here. Click the Q&A icon circled below if you have minimized the “Ask Question” window.
Monitoring
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Abstract #8009: STAMINA Trial
MASS-FIX versus standard methods to predict for PFS and OS among multiple myeloma patients participating on the STAMINA trial. https://meetinglibrary.asco.org/record/196625/abstract
Angela Dispenzieri Mayo Clinic Rochester, MN, USA
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MASS-FIX Testing in STAMINA Trial • MASS-FIX excellent independent predictor of PFS and OS • Compared with MRD Testing with NGF * Promising use of simple blood testing 25
Abstract #8010: GEM (Spanish) Trial
Analysis of minimal residual disease in bone marrow by NGF and in peripheral blood by mass spectrometry in newly diagnosed multiple myeloma patients enrolled in the GEM2012MENOS65 clinical trial.
Noemi Puig University of Salamanca Salamanca, Spain
https://meetinglibrary.asco.org/record/195522/abstract
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Mass spectrometry in GEM (Spanish) Trial • Mass Spec and MRD by NGF found to be complementary in assessing outcomes • Patterns of NGF +/- and Mass Spec +/being further studied 27
Abstract #8012
https://www.myeloma.org/videos/prospective-comparison-whole-body-mri-fdg-pet-ct-detection-multiple-myeloma-correlation
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Key questions about imaging • Is WBLDCT (Whole Body Low Dose CT) the standard? • What about PET/CT versus MRI?
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Audience Q&A Type and submit your questions here. Click the Q&A icon circled below if you have minimized the “Ask Question” window.
Relapsed Therapies
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Ninlaro®(ixazomib)
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Abstract EP963
https://www.myeloma.org/videos/final-analysis-phase-3-tourmaline-mm1-study-investigating-ixazomib-lenalidomide
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Abstract S184
https://www.myeloma.org/videos/mrd-evaluation-during-ixazomib-maintenance-newly-diagnosed-myeloma-tourmaline
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Significant PFS benefit with ixazomib vs placebo in patients converting from MRD+ to MRD– status 1.0
Censored
MRD+ to MRD–
n
Events
24month PFS, %
Median PFS, months
Ixazomib
42
2
97.5
NE
Placebo
18
5
80.1
NE
Ixazomib, MRD+ to MRD–
Probability of PFS
0.8
0.6
HR 0.139, 95% CI 0.026–0.733, p=0.007
Placebo, MRD+ to MRD–
0.4
• There was no significant difference in PFS between ixazomib and placebo among patients with sustained MRD– status
0.2
0.0 0 3 Number of patients at risk Ixazomib, MRD– to MRD– Ixazomib, MRD+ to MRD– Placebo, MRD– to MRD– Placebo, MRD+ to MRD–
6
9
12
15
18 21 24 27 30 Months since randomization
33
36
39
42
45
48
75
72
71
71
69
65
63
57
52
38
28
22
16
3
1
0
0
42
41
41
41
41
40
38
34
32
28
20
11
6
3
2
0
0
43
43
43
42
41
41
38
35
35
24
17
15
5
2
0
0
0
18
16
16
16
16
15
13
13
11
9
6
4
2
0
0
0
0
Xpovio®(selinexor)
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Abstract #8018: STOMP Trial
Oral selinexor, pomalidomide, and dexamethasone (XPd) at recommended phase 2 dose in relapsed refractory multiple myeloma (MM). https://meetinglibrary.asco.org/record/195449/abstract
Darrell White, MD Dalhousie University Halifax, NS, Canada
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Abstract #8038: Selinexor + Kd
https://www.myeloma.org/videos/once-weekly-selinexor-carfilzomib-dexamethasone-xkd-heavily-pretreated-multiple-myeloma
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Abstract #8024: Selinexor + Vd
https://www.myeloma.org/videos/effects-refractory-status-to-revlimid-to-either-XVd-or-Vd-myeloma-treatment-boston-trial
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Abstract #8019: BOSTON Study
Survival among older patients with previously treated multiple myeloma treated with selinexor, bortezomib, and dexamethasone (XVd) in the BOSTON study. https://meetinglibrary.asco.org/record/195458/abstract
Prof. Thierry Facon, MD Université of Lille, CHU Lille, Service des Maladies du Sang, Lille, France
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Selinexor in Elderly: Update • Patients over age 65 years • Excellent results with selinexor + Vd (BOSTON regimen) re: efficacy/ toxicity • Both PFS and OS improved 41
Abstract #8027
Effects of weekly selinexor, bortezomib, dexamethasone (XVd) versus standard twice weekly bortezomib and dexamethasone (Vd) on RASmutated previously treated multiple myeloma (MM). https://meetinglibrary.asco.org/record/195493/abstract
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Audience Q&A Type and submit your questions here. Click the Q&A icon circled below if you have minimized the “Ask Question” window.
Key questions from IMWG Summit • Several items already discussed • Additional points: • Diagnosis/ treatment for HR/ ultra HR SMM (2/20/20 system) • Immune therapy registry and virtual biobank 44
Key questions from IMWG Summit • Additional points: • Role of new MoAbs and new agents (ex. CelMods) • COVID-19 vaccination
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Additional IMF Resources Acronyms & Abbreviations: https://imf-d8-prod.s3.us-west-1.wasabisys.com/2021-03/acronymand-abbrev-3-2021.pdf
Myeloma Terms & Definitions: https://issuu.com/international-myeloma-foundation/docs/myelomaterms-definitions
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Webinar Replay and Slides
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Thank you to our sponsors!
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