Nice #MMsm work by UCSF Helen Diller Family Comprehensive Cancer Ctr team including Tom Martin Nina Shah Sandy Wong:

Previous work has shown apheresis T-cell composition predicts outcomes, but post-CAR-T expansion matters too!

More exhausted CD4+ cells (real ones, not Tregs) means less durable response.

I celebrate having good options for my pts.

Until better CAR-T's are available widely/in earlier lines, easier access to ide-cel can be a good thing

BUT I do not view the approval of ide-cel as a game-changer or transformative, simply because this PFS curve speaks for itself.

The hallmarks of cancer framework provide an exceptional synthesis of carcinogenesis, but does not address complexities of cancer as a systemic disease, including tumor initiation & promotion, tumor micro- & immune macro-environments, aging, metabolism & obesity, cancer cachexia,…

Longitudinal plasma proteomics in CAR T–cell therapy patients implicates neutrophils and NETosis in the genesis of CRS
ow.ly/H9CS50R2uoW #researchletter #clinicaltrialsandobservations #immunobiologyandimmunotherapy

Classic figure for myeloma

My current approach to first relapse of myeloma.

(Obviously, lots of nuance is lost in this slide, and this may change with availability of newer therapies for early relapse)

#mmsm

1/ So excited to see this out!
nature.com/articles/s4140…

In myeloma, trials continue to use 2x weekly bortezomib because of a belief that standard of care (SOC) is only based on older trials.

In reality, the SOC is how typical physicians would approach #MMsm care - so we asked!

Excited to be a part of this one-day (May 17) conference focused on patient-centered integrative medicine advances in exercise, nutrition, acupuncture, massage, meditation, yoga, & music therapy in cancer!
Registration/details:
bit.ly/IntegrativeOnc…
#MSKIntegrativeOncCME

Now in JCO Oncology Practice: Excellent but sobering #MMsm work by Fiala ravi vij et al about financial toxicity in myeloma.

Longitudinal COST scores & interviews showed worsened FinTox in 1/3 of pts. In interviews, interplay between TimeTox & FinTox for some 👇

ascopubs.org/doi/10.1200/OP…

Antibody–drug conjugates come of age in oncology | Nature Reviews Drug Discovery nature.com/articles/s4157…

It's still going to be complicated to go through consent. #mmsm

We are getting a window into second cancers from CARTITUDE-4 as well from FDA documents. Interestingly, there are 5 (2.7%) heme malignancies in CAR T group but none in the SoC though follow-up is limited.

Breaking: ODAC votes 11-0 to recommend approval of ciltacel in patients with relapsed/refractory multiple myeloma in earlier stages.

I’m glad. Right call. But we need to be careful. Read on.

cancernetwork.com/view/odac-cast…

Excellent 🧵 on what this vote means and some important factors to assess and be aware of!

#oncopharm

Ben Derman This and no OS benefit after 1 line make me hesitant offering right away. Since i still give rev maintenance for most patients i may try dara combo next still as opposed to jumping to CART right away. After dara refractoriness i think the risk/benefit becomes pretty clear

FDA does another deep dive into causes of early death with cilta-cel.
They note that 'the increased risk of death on the cilta-cel arm appears to persist until at least 5 months and possibly up to 11 months.'

Below was provided by J&J.
The FDA documents use a shorter cutoff but they do look different, especially for patients with 1 prior line of therapy. FDA also notes some concerns in how the forest plot was generated.

The present and future of bispecific antibodies for cancer therapy | Nature Reviews Drug Discovery nature.com/articles/s4157…

Incredibly gratifying The Leukemia & Lymphoma Society event for our Hispanic community 🫶🏻

Happy to share the stage with Dr Paul Rubinstein to discuss Hispanic representation in clinical trials.

1135 AML cases reclassified according to the 2 recently published guidelines for AML diagnosis & classification: WHO-HAEM5 & ICC.

Both new criteria significantly reduce the # of AML cases defined by differentiation, but displayed discrepancies in 16%.

onlinelibrary.wiley.com/doi/epdf/10.10…