How Iberdomide and CELMoDs Are Transforming Relapsed Myeloma Care

For years, first-relapse myeloma regimens have delivered just 1 to 2 years of progression-free survival, and immunomodulatory drugs, or IMiDs, were dosed to the maximum tolerated dose. Iberdomide, the first CELMoD approved by the FDA and the first myeloma approval based on minimal residual disease (MRD) negative status, changes the narrative.

In this special Director’s Cut episode of Managed Care Cast, we are speaking with Sagar Lonial, MD, FACP, FASCO, professor and chair of the Department of Hematology and Medical Oncology at Emory University School of Medicine, chief medical officer at Winship Cancer Institute, and lead investigator of the phase 3 EXCALIBER trial (NCT04975997), new findings from which he presented at the recent International Myeloma Society 2026 annual meeting.

Lonial breaks down these data: how the study arm of iberdomide-daratumumab-dexamethasone demonstrated an MRD negativity rate of 41% compared with 20% seen for the comparator arm of daratumumab-bortezomib-dexamethasone; how dosing was chosen for fit rather than force by testing iberdomide doses of 1.0, 1.3, and 1.6 mg; and why MRD as an end point has potential to get new therapeutics to patients faster. He also explains how he managed neutropenia with dose holds and granulocyte colony-stimulating factor vs early dose reductions and where mezigdomide fits in.

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