IMS 2025 | The use of CELMoDs to improve outcomes with T-cell redirection therapies in RRMM

So one of the things that we’ve really focused on in the world of relapsed and refractory myeloma is the use of T-cell redirection therapy. Therapies like bispecific antibodies and CAR T-cell therapy. Now although these have provided some of the most amazing responses to date, so far it’s still not a cure for everyone all the time. So we’re looking for ways to improve these outcomes. And one of the ways that we’re seeing this is by including the use of CELMoDs. So, I think everyone’s become very familiar with drugs like lenalidomide and pomalidomide, the immunomodulatory agents. But the next generation’s CELMoDs, iberdomide and mezigdomide, we think about more than just their direct attack on plasma cells. They still have this core of immune-boosting activity where they ramp up T-cell activity. So we can actually get away with actually not only giving these drugs either in combination or after T-cell redirection, but we can use lower doses with lower toxicity because we don’t need those higher doses to directly kill the plasma cells. We just need the immune-altering effect. So the two ways that we’re really seeing this come out mostly is in combination with bispecific antibodies. So combinations of the bispecifics with iberdomide or mezigdomide, and then post-CAR-T maintenance therapy with drugs like iberdomide. And we know that iberdomide has relatively low hematologic toxicity, which makes it an ideal partner drug to give in these settings. And we’re seeing increased rates of MRD conversion when we use iberdomide in a maintenance setting. So really exciting to use these drugs as they were intended to push the immune system forward to attack the myeloma.

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