Vincent Rajkumar

Just out ASH abstracts online: I will present overall survival results of AQUILA trial in high risk smoldering myeloma at #ASH26 Overall survival was significantly improved with Dara; significant 48% reduction in risk of death (HR 0.52; 95% CI, 0.32–0.87; P=0.0108). The 7-year

AQUILA results have already changed practice widely all over the world establishing daratumumab for 3 years as early intervention option for high risk smoldering myeloma. Approved for this indication in the US, UK, Europe, and Japan. https://t.co/lfVlCWRyLg

4. Daratumumab is effective in high risk smoldering multiple myeloma. (AQUILA). @NEJM 2024 Randomized trial that showed early intervention works. International effort that to the first approved therapy for high risk smoldering myeloma. Changed paradigm. 10 years from trial concept to publication. But over 20 years from the time of my first trial in SMM. It takes time and there are no shortcuts. This type of trial requires a track record in the field on the particular topic. Leading many natural history studies, phase IIs and a phase III in SMM before helped. Patience and time. It also needs a conviction in the hypothesis: in this case that early intervention works.

For relapsed myeloma not refractory to dara (including dara exposed but not refractory), Teclistamab plus Dara or ciltacel remain first choice. Based on Majestec-3 trial. Tec and Tec Dara and Ciltacel are all contingent on access, and whether the treatment can be administered

Just out in @NEJM Majestec-3 trial. Tec-Dara in relapsed myeloma. #ASH25 @End_myeloma @mvmateos Link: https://t.co/DnTeuBMsLU More in thread https://t.co/GrYwRuLUIL

The major change was all due to the unprecedented results of Majestec-3 trial #ASH25 I cannot emphasize enough that to do Tec-Dara safely you absolutely need good preventive measures: close monitoring, routine monthly IVIG, and other infection prevention measures as in the https://t.co/GMgLMUhZK2

Just out: Majestic Majestec-9 results. #ASCO26 @NEJM Single agent teclistamab beats standard triplet in relapsed myeloma. https://t.co/2TeFjBuZSv @DrOlaLandgren @thanosdimop https://t.co/YzL3USaptY

Most important #ASCO26 myeloma abstract. Practice changing. Majestec-9 trial. PFS significantly better with Teclistmaab vs PVd/Kd (HR, 0.29; 95% CI, 0.23–0.38; P<0.0001); 18-mo PFS rate: 69.8% vs 26.9%. OS significantly better with Tec vs PVd/Kd (HR, 0.60; 95% CI, 0.43–0.83;

PERSEUS is the gold standard benchmark outcome for Newly Diagnosed Myeloma 6 year overall survival: 86% 6 year PFS 81% with quad induction and Dara-Len maintenance. As we test bispecifics, ADCs, CARTs etc, any new approach should be better. A new therapy CANNOT have even 5% https://t.co/Z29oBm0ylR

Just out: presented at #EHA26 and published @NEJM Randomized trial of 2 talquetamab combinations vs DPd in relapsed myeloma. The Monumental-3 trial. Both Talq-Dara-Pom and Talq-Dara beat DPd in PFS and OS. Choice of a Talq combination vs Tec or Tec-Dara in relapsed myeloma https://t.co/mgSlY8T8cu

Just out: Effective treatment of extra medullary relapsed myeloma with teclistamab plus talquetamab (Tec-Tal). RedirecTT-1 @NEJM #ASH25 @myelomaMD @szusmani @mvmateos 80% response rate. 60% PFS at 12 months. Link in thread https://t.co/Iiox448sO4

Impressive results with cilta-cel CAR-T cell therapy in CARTITUDE 4 trial compared to standard triplets in relapsed myeloma. #ASH25 @End_myeloma We as a myeloma community are now gonna have provide guidelines on Tec-Dara and cilta-cel in early relapse, especially 1st relapse. https://t.co/mWwlW7KWFL

#4 In vivo CAR-T for myeloma: inMMyCAR phase 1 study of KLN-1010. Simon Harrison, Joy Ho et al. Off the shelf CART— made possible by selective transduction of T cells in vivo with lentiviral vector. Only 3 patients in abstract but chosen as LBA for its novelty. #ASH25 Link: