iwHRMM 2025 | Promising approaches being explored in high-risk myeloma & trials to look out for

I think it’s very difficult to pick one. They’re all quite promising in different ways. I think the things that I’m most intrigued about and I’m looking forward to seeing some data in the next two, three years is the larger data sets incorporating bispecific antibodies into frontline therapies. So there are now some early data sets that have looked at incorporating teclistamab, elranatamab, other bispecific antibodies into patients with newly diagnosed myeloma, including high-risk newly diagnosed myeloma in the context of other standard of care treatments. And the early results look very promising in terms of almost 100% of patients responding and having very deep MRD-negative responses at short intervals. So does this hold with larger groups of patients and with longer follow-up? I think it would be particularly interesting if it does. It would probably represent a huge paradigm change in the next paradigm change, I should say, in the treatment of newly diagnosed myeloma. We already have data; patients are completely enrolled on the two CAR T-cell trials. These are trials looking at incorporating CAR T-cells into frontline newly diagnosed myeloma patients. We’re waiting for the data collection to be complete and some of the primary results to come out in the next few years. So that’s another important observational trial we’re looking for. And then finally, I think the multi-antigen targeting. So there’s been some talk at this meeting about why limit to targeting only BCMA or GPRC5D. Could we incorporate many or all of these treatments, particularly for high-risk patients? So the team from Emory presented their trial concept for total immunotherapy, where they’re incorporating the standard treatments plus a BCMA antibody plus a GPRC5D-targeting drug or treatment and an FcRH5-targeting treatment. So truly a total immunotherapy combination with the idea that with time-bound treatments with all of these, perhaps we can potentially cure patients with multiple myeloma. I think it’s a very bold approach and one that the field will look at very carefully and closely in the years to come as this study will launch and patients will be enrolled. So lots of exciting things to look forward to in the next three to five years.

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