Thread by @bdermanmd

So many excellent #ASH22 abstracts to choose from. Sharing my thoughts on 11 important works, with more to come as we get closer to the meeting! In order of abstract number (not merit)...let's go! #mmsm

158: Elrantamab in R/R MM to be presented by @NoopurRajeMD.
☀️27% Black or asian enrollment
☀️ 24% with prior BCMA-dir therapy
👉ORR 64% (38% CR+)
🚨7/13 (54%) ORR w/prior BCMA-dir therapy. This is the important take home!
⏳Duration of response 17 months
ash.confex.com/ash/2022/webpr…

160: MajesTEC-2: Teclistamab/Len/Dara (Searle).
n=32; f/u 6 months. Median 2 prior lines. 31% anti-CD38 exposed.
⚠️Infections 75% (respiratory). CRS 81% (gr 1-2)
🚨 ORR 100% (VGPR 12/13).
So important to establish whether bispecifics can play nice with other myeloma therapies.

248 (Lowther): BCMA expression is preserved after relapse with Belantamab mafodotin. Important for understanding how to potentially sequence drugs if belamaf makes it back onto the market. Could belamaf be used in earlier lines without affecting efficacy of CAR T/bispecifics?

364 (@SusanBal9): BMS-986393 (CC-95266), a(nother) GPRC5D directed CAR T-cell therapy.
🚨ORR 86%
⚠️CRS 65%
👍Less skin/nail toxicity than with talquetamab (18% skin, 12% nail, 12% dysgeusia)
This along with recently reported GPRC5D-dir. CAR T show this strategy is here to stay!

366 (Du): BCMA/CD19 CAR T (GC012F) for FIRST LINE therapy in high-risk #mmsm.
n=13, f/u 5.3 months.
⚠️Mostly VRd or PAD (!) induction
👍100% ORR; deepening of responses with CAR T.
👍CRS in only 23%.
Need to see duration of response; important step in moving CAR T to front-line

567 (Trudel): Pretreatment with tocilizumab prior to Cevostamab in RRMM.
I love this study and so very practical.
🔑CRS w/out toci: 91% (mostly grade 1-2)
🔑CRS w/ toci: 36%.
Can we do this with anakinra too? (YES per lymphoma abstracts!) #mmsm
doi.org/10.1182/blood-…

865 (Notarfranchi, @BrunoPaiva_UNAV ): 'Bloodflow' for #mmMRD testing in #mmsm.
👉50 mL blood (!) = ~2x10^8 cells to achieve 10^-7 sens. Run NGF.
🔑MRD(-) = better prognosis
🔑79% agreement in blood/marrow. Most disagreement were BM(+)/PB(-)
Lot of blood but easier than biopsy?

970 (Claveau): Persistence/Reappearance of M-protein by mass spectrometry is prognostic.
Mass spec is the alternative (or complement?) to NGF or NGS in the blood for #mmMRD evaluation. And it's really good at picking out persistent or resurgent disease!

4860 (Pearson): A clinical decision support tool for an electronic medical record improved rates of correctly ordering light chains when evaluating for monoclonal gammopathies. So simple, and so helpful! We should all be doing this! #ASH22 #mmsm ash.confex.com/ash/2022/webpr…

361 (@szusmani) and 3354 (Van De Donk): Ide-cel & cilta-cel in MM with early relapse after initial therapy.
👉Ide-cel: ORR 84%, 46% CR+, mPFS 11.4 months, DOR 16 months. Not much diff from pivotal trial!
👉Cilta-cel: ORR 100%, 90% CR+ (image), 90% 1-yr PFS. Need longer f/u.

570 (Pawlyn): for how long should patients be on maintenance? Is there a time after which there are diminishing returns? Myeloma XI analysis suggests that yes, there is around 4-5 years. I’ll later highlight the work we & others are doing re stopping to doi.org/10.1182/blood-…