Blood Cancer Talks

Episode summary
In this episode, we bring Dr. Manni Mohyuddin from Huntsman Cancer Center [Utah] to go through the biggest myeloma data from the 2026 International Myeloma Society (IMS) Annual Meeting at Glasgow. 
In this episode
1. CERVINO (Phase 3): Etentamig vs. standard therapy in triple-class-exposed RRMM
  • Patients had at least 2 prior lines, were triple-class exposed and had no prior BCMA therapy. They were randomized to etentamig or the investigator’s choice of Kd, EPd or SVd. The co-primary endpoints were ORR and PFS.
  • Etentamig is dosed every 4 weeks from the start, and patients in CR could stop after 2 years.
  • The population was more heavily pretreated than MajesTEC-9: 51% were triple-class refractory (vs. about 30%), with a median of 3 prior lines.
  • Discussion: 
    • Where CERVINO fits with MajesTEC-3 and MajesTEC-9
    • Efficacy compared with teclistamab, elranatamab and linvoseltamab
    • Whether low-affinity CD3 binding really means less CRS
    • Infection risk
2. EXCALIBUR-RRMM (Phase 3): Iberdomide-Dara-Dex vs. DVd
  • The trial enrolled patients with relapsed myeloma that was not refractory to anti-CD38 therapy. About 70% had 1 prior line, about 90% had prior IMiD exposure and about 40% were IMiD-refractory. Iberdomide was given at 1 mg, the dose chosen in stage 1.
  • The dual primary endpoints both favored the iberdomide arm: 
    • MRD-negative CR: 41% vs. 21%
    • Median PFS: 42 vs. 20 months
  • Discussion: 
    • How this compares with MajesTEC-3 and DREAMM-7 in a similar population
    • Where IberDd may fit in practice: as a bridge before CAR-T, or for indolent or biochemical relapse in patients whose disease isn’t dara-refractory
    • Whether the more selective CELMoD design means fewer non-hematologic side effects than lenalidomide-based triplets
3. GEM-TECTAL (Spanish Myeloma Group): MRD-guided Tec-Dara and Tal-Dara in high-risk NDMM
  • The schema: 
    1. 4 cycles of Dara-VRd
    2. Stem cell collection and MRD assessment
    3. 6 cycles of Tec-Dara consolidation
    4. Next step by MRD status: patients who are MRD-negative get 2 years of Tec-Dara maintenance, and patients who are MRD-positive get early rescue with 6 cycles of Tal-Dara.
  • 63% of patients were high-risk by the IMS-IMWG definition.
  • MRD negativity at 10⁻⁶ by NGF was 40% after Dara-VRd and 86% after Tec-Dara consolidation. Only 1 patient was still MRD-positive.
  • Discussion: the safety of Tec-Dara consolidation, and whether this will be the next frontier for high-risk disease
4. TRILOGY-1: Updated Phase 1 data for ramantamig (BCMA×GPRC5D trispecific)
  • The patients were heavily pretreated: 
    • Median of 3 prior lines
    • 100% triple-class exposed and 50% triple-class refractory
    • 96% CD38-refractory
    • 14% with prior BCMA therapy
  • Dosing is every 4 weeks from the start, moving to every 8 weeks after 6 months.
  • In BCMA/GPRC5D-naïve patients, the CR rate was about 80%, and 90% of those CRs were MRD-negative at 10⁻⁶. 2-year PFS was 81%, and about 85% in the original cohort with 26 months of follow-up.
  • Grade ≥3 infections occurred in 25% of patients, which is lower than in MajesTEC-9 at similar follow-up and may reflect more routine primary IVIG prophylaxis.
  • Skin, nail and oral side effects were milder than with talquetamab, and mean weight loss was under 5%.

What is Blood Cancer Talks?

This is a podcast on latest advances in the understanding and management of blood cancers. Here, we will bring a wide range of experts within hematologic malignancies to discuss various topics in depth.
Host: Raj Chakraborty, MD from Columbia University, New York, Ashwin Kishtagari, MD, from Vanderbilt University, Nashville, and Edward Cliff, MD, from Harvard University, Boston
Tweet your suggestions and feedback to @rajshekharucms @AshKishtagari @Eddie_Cliff @BloodCancerTalk