VIDEO: Highlights in multiple myeloma from ASCO 2021

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So it's hard for me to identify the most exciting thing from ASCO, just because I think there are very exciting things in different senses. There is things that are exciting in terms of being immediately clinically impactful, and then there are other things. There are even pre-clinical things that the nerd in me gets especially excited about in terms of new frontiers of therapy that aren't proven, but maybe very promising. I think the elephant in the room in a good way, maybe that's the wrong figure of speech for this, would be the CARTITUDE data, specifically the CARTITUDE-1 data that were presented by Saad Usmani, just with the exceedingly high response rate, the very high rate of deep responses. So far, the duration of responses that it looks like we're seeing with cell to cell in a largely triple class refractory, highly refractory patient population. So I think that's the one abstract that probably blew my hair back, so to speak the most, in terms of hopefully being immediately clinically applicable. But again, I know I've been talking about CAR T-cell therapy a lot and that's by no means the only promising form of therapy on the horizon, definitely don't want to go without mentioning the bispecific antibodies, which again, utilizes a very similar mechanism of action to the CAR T-cell therapies, but have the definite advantage of being quote, unquote off the shelf, not having to have all the stars align or all the pieces fall into place in terms of aphorysis, effective bridging, while waiting for manufacturing and for the cells to come back and crossing the fingers in hoping that there's no issues with manufacturing. Again, CAR T-cell therapy is an amazing therapy, like I just said, but there are things that have to fall into place to ensure a successful therapy that don't always happen. And I suspect possibly the risk of those things not happening could be greater in the real world as opposed to in the clinical trial setting up to this point, whereas the biospecifics are off the shelf. Essentially, they're a drug like we're used to that would be in the pharmacy that we could more or less start our patients in need on at a moment's notice, and I think there's a huge advantage to that. And also with what we're seeing from the decleaster mAb and the El Renada mAb abstracts that were presented at ASCO, I think we're seeing a pretty impressive response rate. Again, it's tough to compare across trials, perhaps not quite the eye-popping response rate that we see with cell to cell, but by no means a low response rate in excess of 50%, significant excess. So I think that's very encouraging. Perhaps equally or maybe even more encouraging, I think is the toxicity profile we're seeing from these biospecifics with the cytokine release syndrome definitely occurring, but being essentially exclusively low grade as opposed to the CAR T-cells, which are predominantly low grade, but I think we're seeing a signal for a minority of cases. Some more problematic or more scary, if you will, types of CRS that I don't think we're really seeing the same thing with the biospecifics, and then the neurotoxicity as well, at least to me it looks like it's probably less of a concern with the biospecifics than with cell to cell or ide-cell for that matter. So I think the biospecifics are hopefully on their way. I think they will definitely, in my mind, they will definitely have a place in a similar triple class refractory population in the immediate setting, perhaps for patients who aren't the most robust non-frail patients in the world, and perhaps for those who just don't have the time to wait for all the pieces to fall in place for a successful CAR T-cell therapy. So many more exciting abstracts, but I think those were probably the big things that I took away from ASCO. And then in terms of ASH, who knows? That's why it's always such an exciting kind of a surprise when all the abstracts are released. Again, there are ongoing studies to try to help us answer some of the questions that we've been trying to answer for at least the past decade, specifically the question about the role of autologous stem cell transplant. And, we've been getting a lot of data over recent years from the FORTE study from Italy led by Francesca Gay. And I don't believe we're going to see results from the ongoing determination study, which again was the North American counterpart to the IFM 2009 study that was identical in design except for the use of long-term Revlamid maintenance. So I think we're still gonna have to hold our breath a little bit longer than December of this year for the determination results, but once they come out, I think they will hopefully further help to kind of inform our treatment decisions regarding first-line therapy and transplant. Probably another half hour of things that I could talk about that I'm eager to see in terms of data that we're waiting for. I would say in terms of COVID-19, which obviously is the enormous elephant in the room, we'll hopefully have some data to present soon in terms of our vaccine responsiveness study in patients with myeloma and Waldenstrom's that's currently being led here in Boston by our partner at MGH, Andy Brannigan. So, that's something that I think every single patient and every single oncologist is waiting for, some more clarity in terms of what's going on with that. So that's one specific thing, maybe not directly related to myeloma therapy that hopefully will come out in ASH, but we'll see.