ASH 2025 | Motixafortide + G-CSF HSC mobilization in pts with myeloma following quadruplet induction therapy

The premise behind this study was that at Washington University, we led the pivotal trial, the GENESIS trial, that led to the FDA approval of motixafortide plus G-CSF to mobilize hematopoietic stem cells for patients with multiple myeloma going on to transplant. And so one of the things about that trial was that patients didn’t receive quadruplet induction therapy on that trial because of the timing of when it was conducted, but during that time, quadruplet induction therapy became the standard of care. And so what we wanted to do is perform a prospective trial where patients were receiving quadruplet four drug induction for myeloma, including a CD38 monoclonal antibody, which we know impairs stem cell mobilization, and then prospectively assess whether or not motixafortide plus G-CSF has the same sort of mobilization efficacy that we observed in the pivotal GENESIS trial. And so what we were able to see with this study was that the addition of a CD38 monoclonal antibody or four-drug induction does reduce stem cell mobilization, even with motixafortide plus G-CSF mobilization, but that in general, the motixafortide plus G-CSF mobilization still led to a relatively high rate of mobilization success within the first mobilization cycle and even on the first day. So it seems that motixafortide plus G-CSF is able to overcome some, but not all, of the deleterious effect of quadruplet induction on stem cell mobilization efficiency and effectiveness.

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