Post

More from @Abdallah81MD

Al-Ola A Abdallah MD (USMIRC)

@Abdallah81MD

Oct 15

An Interesting Paper ⬇️⬇️⬇️
🧵 Prognostic Value of Splenomegaly in BCMA CAR-T Therapy for Myeloma

📍Study from Univ. Hospital Leipzig explores whether spleen size can predict outcomes in RRMM patients receiving BCMA-CAR-T (ide-cel or cilta-cel).
#Myeloma #CARTcell #HemOnc #Immunotherapy

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

1️⃣ Why spleen size?
🩸 CAR-T success varies widely. Existing scores (EASIX, CAR-HEMATOTOX, sBCMA) predict toxicity & survival—but none account for immune sequestration or EMH.
👉 Hypothesis: an enlarged spleen = immune “sink” that impairs CAR-T expansion.

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

2️⃣ Study design
📊 N=73 RRMM pts (ide-cel 35, cilta-cel 38)
Median age 64; 74% triple-class refractory.
Splenomegaly > 340 cm³ by CT.
Endpoints: PFS, OS, thrombocytopenia, CAR-T expansion.

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

Read 11 tweets

Al-Ola A Abdallah MD (USMIRC)

@Abdallah81MD

Oct 4

🧵 Real-World Efficacy & Safety of Ciltacabtagene Autoleucel (Cilta-cel) in Multiple Myeloma

1️⃣ Study Snapshot
Real-world (RW) data compared cilta-cel outcomes in relapsed/refractory MM vs the pivotal CARTITUDE-1 trial 💥
Despite higher-risk features, survival outcomes were strikingly similar! ⚖️

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

2️⃣ Baseline Differences
RW pts had:
🧬 More extramedullary disease (29% vs 13%)
⚡ Worse performance status (ECOG 0: 16% vs 40%)
🧠 45% would’ve been ineligible for CARTITUDE-1 — yet still benefitted!

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

3️⃣ Response Rates
🧫 ORR: 88% RW vs 97% C-1
🎯 ≥VGPR: 74% RW vs 93% C-1
🔬 sCR: 30% RW vs 67% C-1
Differences likely reflect real-world assessment variability—not biology.

#ICE_T #mmsm #MedEd #myeloma #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

Read 7 tweets

Al-Ola A Abdallah MD (USMIRC)

@Abdallah81MD

May 27

🧵The Impact of Sponsors on Development of Clinical Research in Multiple Myeloma and AL Amyloidosis

1/Importance of Sponsoring Sources: Academic (AS), industrial (IS), & government sectors play crucial roles in funding and advancing medical research

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @OncoAlert @USMIRCNEWS #سرطان_الدم #المايلوما

2/Multiple Myeloma trials: Industrial trials constitute the largest proportion of MM trials (40%), followed closely by AS trials (37%).
Phase 2 trials are also the most common (61%), with AS leading in this phase (44%). However, industry significantly dominates both Phase 1 (54%) and Phase 3 (62%) MM trials. This suggests a greater industry focus on early-stage exploration and late-stage validation.

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @OncoAlert @USMIRCNEWS #سرطان_الدم #المايلوما

3/A much larger number of patients (112,419) enrolled in MM trials. IS trials accounted for the overwhelming majority of patient enrollment (65%), demonstrating a substantial dominance in this area. AS, NIHS, NS, and MS trials enrolled significantly fewer patients. Enrollment in IS trials has consistently led since 2001.

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @OncoAlert @USMIRCNEWS #سرطان_الدم #المايلوما

Read 8 tweets

Al-Ola A Abdallah MD (USMIRC)

@Abdallah81MD

May 10

🧵Intrathecal chemotherapy for ciltacabtagene autoleucel-associated movement and
neurocognitive toxicity

1/ Cilta-cel-associated parkinsonism is a rare but serious delayed toxicity

*🚨Incidence reported in this study was 8% (5 cases out of the first 60 consecutive patients).
♾️ Previous studies cited show varying incidence rates: 6% in CARTITUDE-1, 1% in CARTITUDE-4, and 2% in commercial cilta-cel treatment.
#mmsm #myeloma #MedEd #medtwitter #USMIRC @USMIRCNEWS @OncoAlert #المايلوما #سرطان_الدم

2/🌡️ Characteristics of Cilta-cel-associated Parkinsonism: The onset is typically subacute, emerging approximately 1-2 months after CAR T-cell infusion.

**The median time to onset in this study was 26 days (range 9-36).
⚛️ Common symptoms observed in all 5 pts included personality changes (flat affect, anhedonia, avolition), difficulty with word finding, masked facies, anosmia, resting tremor, rigidity, impaired swallowing, micrographia, bradykinesia, & shuffling gait.

#mmsm #myeloma #MedEd #medtwitter #USMIRC @USMIRCNEWS @OncoAlert #المايلوما #سرطان_الدم

3/🧪 The study highlights the presence of CSF lymphocytosis, primarily comprised of T-cells, in patients experiencing MNTs.
- The median CSF WBC count was 42/μL (range 2-140), with 80% of patients showing CSF pleocytosis (>5 WBC/μL).
- The median CSF lymphocyte percentage was 90% (range 89-95%), with FC confirming these were almost exclusively T-cells.
- 🚦 This finding is significant as it suggests CAR T-cells are trafficking into the CSF.

#mmsm #myeloma #MedEd #medtwitter #USMIRC @USMIRCNEWS @OncoAlert #المايلوما #سرطان_الدم

Read 8 tweets

Al-Ola A Abdallah MD (USMIRC)

@Abdallah81MD

May 4

🚨🚨Very important Concept: ISB 2001, a novel BCMAxCD38xCD3 trispecific antibody from the first-in-human phase 1 study in RRMM:

1/ ISB 2001 is a novel trispecific TCE Ab designed to target three key antigens: BCMA & CD38 (on myeloma cells), & CD3 ( T-cell receptor complex)
#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

2/ ⚜️Study Design: ISB 2001 is administered weekly SC with a step-up dosing strategy (D1 & D4) followed by the full target dose (D8 onwards).
- Patient Population and Doses: 21 pts have been treated across 7 dose levels (5-1200 µg/kg).
- Across the effective dose levels (50-1200 µg/kg), the ORR was remarkably high at 89.5% (n=19).
ORR in patients previously treated w T-cell-directed therapy was 78% (n=9), suggesting efficacy even in this difficult-to-treat subgroup

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

3/⚛️ PK data up to 1200 µg/kg showed a dose proportional increase in serum exposures. A tentative half-life of > 10 days was observed, which "supporting the potential for less-frequent dosing
- Pharmacodynamics & Biomarkers:Rapid Reduction in Serum sBCMA levels & circulating B-cell counts were reduced rapidly within the first 2 treatment cycles

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

Read 6 tweets

Al-Ola A Abdallah MD (USMIRC)

@Abdallah81MD

Apr 23

🧵Anti-GPRC5D CAR T-cell therapy as a salvage treatment in patients with progressive multiple myeloma after
anti-BCMA CAR T-cell therapy: a single-centre, single-arm, phase 2 trial

1/🚨Study Design: Single-centre, single-arm, phase 2 trial
• 37 patients with RRMM who had progressed after previous anti-BCMA CAR T-cell therapy, aged 18–70 years, with a Karnofsky Performance score ≥ 50.
*Patients were heavily pre-treated, with a median of 6 previous LOT. 59% had triple-class refractory disease!! (Not totally heavily treated IMO) ⚛️

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

2/Treatment: Single IV dose of anti-GPRC5D CAR T cells at 2 × 10⁶ cells per kg.
•Primary Endpoint: ORR based on IMWG.
•♦️Key Efficacy Finding: ORR was 84% (95% CI 68–94, 31 of 37 patients).
13 (35%) CR (8 sCR, 5 CR).

^^Response in Biochemical Progression: Responses were observed in 91% (10 of 11) of pts with only biochemical progression after anti-BCMA CAR T-cell therapy, including 64% (7 of 11) w CR

#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

3/🧭 Comparison to Previous Salvage Therapies: In a post-hoc analysis of 14 patients who received subsequent antimyeloma therapies (CD38 antibody-based, carfilzomib-based, or selinexor-based) after anti-BCMA CAR T-cell progression, the ORR was 21% (3 of 14) 👎. The ORR of anti-GPRC5D CAR T-cell therapy in these same 14 pts was 71% (10 of 14), which was significantly higher (p=0·039). 👍🏻
- 20 (54%) of 37 patients achieved MRD-negativity.
- 🍋 mPFS in the entire cohort was 4·5 months (95% CI 2·9–6·2). PFS was not reached in pts with CR
#mmsm #myeloma #MedEd #MedTwitter #USMIRC @USMIRCNEWS @OncoAlert #سرطان_الدم #المايلوما

Read 8 tweets

Share this page!

Enter URL or ID to Unroll

Al-Ola A Abdallah MD (USMIRC)

Try unrolling a thread yourself!

More from @Abdallah81MD

Al-Ola A Abdallah MD (USMIRC)

Al-Ola A Abdallah MD (USMIRC)

Al-Ola A Abdallah MD (USMIRC)

Al-Ola A Abdallah MD (USMIRC)

Al-Ola A Abdallah MD (USMIRC)

Al-Ola A Abdallah MD (USMIRC)

Did Thread Reader help you today?

Don't want to be a Premium member but still want to support us?

Send Email!