ICYMI: Highlights From IMS 2024

The 21st annual meeting of the International Myeloma Society (IMS) took place in Rio de Janeiro, Brazil, September 25-28, where the top topics of discussion encompassed minimal residual disease (MRD) testing and status, defining and treating high-risk disease, the CEPHEUS trial (NCT03652064) of daratumumab (Darzalex Faspro; Johnson & Johnson), and an off-the-shelf chimeric antigen receptor (CAR) T-cell therapy made from healthy donor T cells. This is our top IMS coverage of 2024.

You can also catch up on all of our conference coverage on our dedicated IMS page.

5. How Do Community Oncologists View the Use of MRD Testing?

IMS 2024 kicked off a brief 5 months after the FDA’s Oncology Drugs Advisory Committee (ODAC) unanimously voted on the use of MRD negativity as a surrogate end point for accelerated approvals in the US. In this interview, Lucio N. Gordan, MD, Florida Cancer Specialists & Research Institute, lead author of the abstract and poster, “Perspectives of Single-Center Community Hematologists/Oncologists on Minimal Residual Disease Testing Among Patients With Multiple Myeloma,” addressed his team’s findings. He explored topics that included the influence of insurance status of MRD testing, the utility of MRD-negative status, and the potential payer impact.

Read this interview.

4. After ODAC, What’s Next for MRD Testing in Multiple Myeloma?

Panelists for the discussion, “MRD Is an End Point: Our Success Story,” hit on several topics vital to moving the field of MRD testing forward. They addressed that even with its vote on MRD negativity as a surrogate end point, the FDA will continue to monitor the field; that with improved treatments and the gains they help secure in progression-free survival, patient recruitment has become more challenging for clinical trials; and the potential for European regulators to echo the FDA’s decision. Joining session cochairs Brian G. M. Durie, MD, of Cedars-Sinai, Los Angeles, and the International Myeloma Foundation, and Jean-Luc Harousseau, MD, Institut de Cancerologie de L’ouest France, were Shaji Kumar, MD, Mayo Clinic; Carl Ola Landgren, MD, PhD, Sylvester Comprehensive Cancer Center; Nikhil Munshi, MD, Dana-Farber Cancer Institute; and Jesus San Miguel, MD, PhD, Clinica Universidad de Navarra.

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Image Credit: © International Myeloma Society

3. Reaching Consensus on Defining, Treating High-Risk Myeloma

Twenty percent of patients diagnosed with multiple myeloma will not live beyond 3 years—these are the patients with high-risk disease. The focus of this session was the new consensus definition on what constitutes high risk using patients’ genomic features, and it was based on the Second Revision of the International Staging System. For patients with multiple myeloma to be classified as high risk, they need to have 1 of 4 genetic alterations, explained Jill Corre, PharmD, PhD, the University Toulouse Hospital, and session cochair Faith Davies, MD, director of the Center for Blood Cancers, NYU Langone. However, countered Wee Joo Chng, PhD, National University of Singapore, there are factors beyond the genetic that help predict poor patient outcomes, and these include patient age, frailty status, medullary disease, and Immunoglobulin D levels.

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2. Coming Soon: An Off-the-Shelf CAR T Therapy for Myeloma

In this interview with Bhagirathbhai R. Dholaria, MBBS, Malignant Hematology & Stem Cell Transplantation at Vanderbilt University Medical Center in Nashville, Tennessee, he discusses phase 1 findings of the investigational allogeneic product, P-BCMA-ALLO1, which aims to prevent graft-vs-host disease using a mix of a stem-cell rich CAR and endogenous T-cell receptor gene editing. The CAR T-cell therapy also hopes to overcome many of the challenges that patients with myeloma face, chief among them being a lengthy manufacturing process and exorbitant treatment costs. Among the findings on 34 patients, who had a median age of 66 years and had received 5 prior lines of therapy, were results showing no dose-limiting toxicity and potential for a 1-day window between decision and time to treatment initiation.

Read this interview.

1. CEPHEUS: Sub-Q Daratumumab With VRd Improves MRD Negativity, PFS in Myeloma if Transplant Deferred

The CEPHEUS trial remains ongoing, with an estimated completion date of January 9, 2026. In this presentation of data on the anti-CD38 antibody daratumumab administered with the standard backbone combination of bortezomib (Velcade; Takeda), lenalidomide (Revlimid; Bristol Myers Squibb), and dexamethasone (D-VRd) vs VRd alone, the results demonstrate sustained MRD negativity at a sensitivity threshold of 10^–5 for those in the treatment group. The overall MRD negativity rate was 60% for those who received D-VRd vs 39.4% from VRd, after a median 58.7 months of follow-up. As these results were not broken down by race, that data analysis will be performed and reported on at some point in the future.

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