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ASH 2025 | Transplant versus T-cell redirecting therapies in the upfront setting for multiple myeloma
Amrita Krishnan, MD, City of Hope, Duarte, CA, discusses the evolving role of stem cell transplantation for multiple myeloma in the upfront setting, given the effectiveness of T-cell redirecting therapies. Dr Krishnan notes that there is a lack of direct comparisons, but data from trials using bispecific antibodies plus daratumumab and lenalidomide are promising. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
As of right now, we don’t have any trials comparing transplant to T-cell redirecting therapies in the upfront setting. So what we’re forced to do is just extrapolate data, and certainly data from trials using bispecific antibodies plus daratumumab and lenalidomide in newly diagnosed patients are very exciting in terms of extremely high MRD-negative rates. We need to see longer follow-up with those trials...
As of right now, we don’t have any trials comparing transplant to T-cell redirecting therapies in the upfront setting. So what we’re forced to do is just extrapolate data, and certainly data from trials using bispecific antibodies plus daratumumab and lenalidomide in newly diagnosed patients are very exciting in terms of extremely high MRD-negative rates. We need to see longer follow-up with those trials. And again, if we see durability of that, it certainly does beg the question of the role of transplant. But having said that, you know, currently still with the bispecifics, many of them are being dosed till progression. So the other question becomes with fixed duration of therapy and durability of response as well. So, you know, the field continues to evolve, but certainly T-cell redirection, not just in the advanced relapse setting, but now certainly in the early setting. And MajesTEC-3, of course, shows us that in the one to three prior lines of therapy, the promise of T-cell redirection earlier in myeloma.
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