This episode provides comprehensive coverage of key clinical trial updates from the 2025 International Myeloma Society (IMS) Annual Meeting in Toronto, with special focus on bispecific antibodies and novel immunotherapies across the multiple myeloma disease continuum—from smoldering disease through relapsed/refractory settings. Dr. Alfred Garfall provides expert commentary on study design, efficacy, safety considerations, and clinical implications.
Topics Covered
1. SMOLDERING MULTIPLE MYELOMA
LINKER-SMM1
Phase 2, open-label study of linvoseltamab monotherapy (200 mg) in patients with high-risk smoldering multiple myeloma by 20/2/20 or PETHEMA criteria, with 2-year treatment duration.
Discussion Points:
2. NEWLY DIAGNOSED MULTIPLE MYELOMA
MajesTEC-5
Phase 2 trial evaluating three teclistamab-daratumumab-based induction regimens in 49 transplant-eligible NDMM patients, followed by auto-transplant and fixed-duration Tec-Dara maintenance.
Discussion Points:
MagnetisMM-6
Phase 1/2 dose-finding study of fixed-dose elranatamab 76 mg Q4W with Dara-Len in 37 transplant-ineligible NDMM patients (median age 75 years).
Discussion Points:
LINKER-MM4
Phase 1/2 study of linvoseltamab monotherapy in NDMM with both transplant-eligible and transplant-ineligible pathways, exploring three dose levels (50, 100, 200 mg).
Discussion Points:
3. RELAPSED/REFRACTORY MULTIPLE MYELOMA
CAMMA-1
Phase 1b randomized dose-expansion study of cevostamab (FcRH5×CD3 bispecific) combined with pomalidomide-dexamethasone in BCMA-naïve patients with median 2 prior lines of therapy.
Discussion Points:
Sonrotoclax + Dexamethasone in t(11;14) R/R MM
Phase 1/2 study of sonrotoclax (next-generation BCL2 inhibitor) plus dexamethasone as an all-oral regimen in patients with t(11;14) R/R MM (median 3 prior lines, ~75% triple-exposed).
Discussion Points:
RedirecTT-1
Phase 2 trial combining teclistamab + talquetamab in 90 heavily pretreated patients with R/R extraosseous extramedullary disease (84% triple-class refractory, 36% penta-refractory, 20% prior BCMA CAR T).
Discussion Points:
4. CAR T-CELL THERAPY TOXICITIES
CAR T Immune-Related Adverse Events (UPenn Study - Ho et al)
Large cohort study of 198 patients (125 cilta-cel, 73 ide-cel) examining all adverse events other than CRS, ICANS, IEC-HS, and IECAHT.
Discussion Points:
In this episode of Blood Cancer Talks, hosts Eddie, Ashwin, and Raj welcome two distinguished experts to explore the cutting-edge field of circulating tumor DNA (ctDNA) in B-cell lymphomas. Dr. David Russler-Germain, a lymphoma clinician from Siteman Cancer Centre at Washington University in St. Louis, returns as a familiar voice to the podcast audience. Joining him is Dr. Ash Alizadeh, the Moghadam Family Professor of Medicine, Oncology, and Hematology at Stanford University and leader of the Cancer Genomics Program at Stanford Cancer Institute. Dr. Alizadeh has been instrumental in advancing our understanding of lymphomagenesis and lymphoma genetics over the past two decades, pioneering multiple ctDNA techniques that are revolutionizing cancer care. Together, they discuss the transformative potential of ctDNA technology in B-cell lymphomas, particularly DLBCL, covering everything from the technical evolution of biomarker detection to groundbreaking clinical data that may reshape how we monitor and treat these aggressive cancers.
Key Discussion Topics
1. Genetic Heterogeneity in B-Cell Lymphomas
Complex genetic landscape of DLBCL
Implications for treatment strategies
Need for personalized approaches
2. Clinical Need for ctDNA in Lymphoma
Why ctDNA is needed in aggressive lymphomas:
Curative vs. non-curative treatment settings
Limitations of current PET imaging
Additional prognostic information beyond imaging
Risk stratification capabilities
Potential to avoid overtreatment
Therapy adaptation opportunities
3. Challenges in Lymphoma MRD Assessment
Why lymphoma MRD is more complex than other hematologic malignancies:
Differences from acute leukemias, CLL, and myeloma
Technical challenges specific to lymphoid tumors
Lower circulating tumor burden compared to liquid tumors
4. ClonoSEQ Technology
Mechanism: Immunoglobulin sequencing approach
Advantages: Established platform with regulatory approval
Disadvantages: Limited sensitivity in peripheral blood, requires adequate tumor sample
5. CAPP-Seq Technology
Full Name: Cancer Personalized Profiling by Deep Sequencing
Innovation: Developed ~10 years ago by Dr. Alizadeh's group
Mechanism: Targeted sequencing of cancer-specific mutations
Advantages: High sensitivity, personalized approach
6. PhasED-Seq Technology
Evolution: Next-generation advancement of CAPP-Seq
Key Improvements: Enhanced sensitivity and specificity
Technical Advances: Phased variant detection
Clinical Data Highlights
1. Remission Assessment by ctDNA in LBCL on 5 prospective studies of frontline anthracycline-based chemo-immunotherapy: https://pubmed.ncbi.nlm.nih.gov/40802906/
2. Prospective validation of end of treatment ctDNA-MRD by PhasED-Seq in DLBCL patients from HOVON-902 clinical trial: https://ascopubs.org/doi/10.1200/JCO.2025.43.16_suppl.7000
3. Korean data on prognostic utility of ctDNA: https://ashpublications.org/blood/article/142/Supplement%201/69/501573
In this episode of Blood Cancer Talks, we have Dr. Adrian Minson from the Peter MacCallum Cancer Centre to discuss the latest developments in lymphoma presented at the recent EHA and ICML meetings in June 2025. The episode focuses primarily on the emerging role of bispecific antibodies in various combinations and treatment settings for diffuse large B-cell lymphoma (DLBCL).
Key Clinical Trials Discussed
1. POLARGO Trial - Polatuzumab + R-GemOx vs R-GemOx in R/R DLBCL
2. SUNMO Trial - Mosunetuzumab + Polatuzumab vs R-GemOx in R/R DLBCL
3. STARGLO Trial - Glofitamab + GemOx vs R-GemOx in R/R DLBCL (2-Year Update)
4. EPCORE NHL-5 & NHL-7 - Epcoritamab Combinations in Frontline DLBCL
5. EPCOR-RICE - Epcoritamab + R-ICE in Transplant-Eligible R/R DLBCL
6. LOTIS-7 Trial - Loncastuximab + Glofitamab in R/R DLBCL
7. Additional Studies Mentioned:
R-Pola-Glo Frail Study
DLBCL Classification
In this episode, we discuss the management of follicular lymphoma with Dr. Gilles Salles from Memorial Sloan Kettering Cancer Center. Here are the articles we discussed:
1. Relevance of Bone Marrow Biopsy in Follicular Lymphoma: https://pubmed.ncbi.nlm.nih.gov/35787017/
2. TROG 99.03 (RCT of Systemic Therapy after Involved-Field Radiotherapy in Patients with Early-Stage Follicular Lymphoma): https://pubmed.ncbi.nlm.nih.gov/29975623/
3. Long-term follow-up results of RCT comparing early rituximab monotherapy versus watchful waiting for advanced stage, asymptomatic, low tumor burden follicular lymphoma: https://pubmed.ncbi.nlm.nih.gov/40306831/
4. RELEVANCE RCT: Lenalidomide plus Rituximab (R2) Versus Rituximab-Chemotherapy Followed by Rituximab Maintenance in Untreated Advanced Follicular Lymphoma: https://ascopubs.org/doi/10.1200/JCO.22.00843
5. GALLIUM RCT: Obinutuzumab Versus Rituximab Immunochemotherapy in Previously Untreated iNHL. https://pubmed.ncbi.nlm.nih.gov/37404773/
https://pubmed.ncbi.nlm.nih.gov/28976863/
6. Long-term follow-up of mosunetuzumab in relapsed/refractory FL:
https://pubmed.ncbi.nlm.nih.gov/39447094/
7. Epcoritamab in relapsed/refractory FL: https://pubmed.ncbi.nlm.nih.gov/38889737/
8. Phase 3 inMIND RCT: Tafasitamab plus Lenalidomide and Rituximab for Relapsed or Refractory Follicular Lymphoma: https://ashpublications.org/blood/article/144/Supplement%202/LBA-1/534319
9. Long term follow-up results from the Phase 3 PRIMA trial of rituximab maintenance in Follicular Lymphoma: https://ascopubs.org/doi/10.1200/JCO.19.01073
In this episode, we dissect the phase 3 MIDAS trial in newly diagnosed transplant-eligible multiple myeloma with Dr. Meera Mohan.
https://pubmed.ncbi.nlm.nih.gov/39841461/
https://pubmed.ncbi.nlm.nih.gov/40459097/
In this episode, we took a deep dive intro the landscape of menin inhibitors in AML with Dr. Eytan Stein from MSKCC. Here are the key trials and studies we discussed:
In this episode, we discuss the recent proceedings at the FDA ODAC meeting on AQUILA trial in smoldering myeloma and STRAGLO in R/R DLBCL, and provide an update to our audience on some of the clinically relevant data presented from those trials, along with insights from the panelists. Here is the link to the webpage with FDA briefing documents and slides:
https://www.fda.gov/advisory-committees/advisory-committee-calendar/may-20-21-2025-meeting-oncologic-drugs-advisory-committee-05202025#event-materials
Here is the youtube link for FDA proceedings:
https://www.youtube.com/watch?v=5ecyDbK9ezc
In this episode, we discussed the management of systemic mastocytosis with Dr. Daniel DeAngelo from the Dana Farber Cancer Institute. Here are the key studies we discussed:
In this episode, we explore the emerging entity of CAR Transgenic T-cell Lymphoproliferative Neoplasms (CTTLN), a rare but important complication of CAR T-cell therapy. Dr. Piers Blombery from Peter MacCallum Cancer Center joins us to dissect two cases from the CARTITUDE-4 trial where patients developed T-cell lymphomas expressing the chimeric antigen receptor following cilta-cel treatment for multiple myeloma. As a bonus, we also briefly discussed Dr. Blombery’s paper on menin inhibitors in UBTF tandem duplicated AML. Here are the papers we discussed:
1. CTTLN cases from CARTITUDE-4: https://pubmed.ncbi.nlm.nih.gov/39938094/
2. CTTLN case from MSKCC with insertional mutagenesis: https://pubmed.ncbi.nlm.nih.gov/39908432/
3. Other CTTLN cases in myeloma:
https://pubmed.ncbi.nlm.nih.gov/38865661/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8417502/
4. Response and resistance to menin inhibitors in UBTF tandem duplication AML: https://pubmed.ncbi.nlm.nih.gov/38924737/
In this episode, we delve into the key clinically relevant abstracts in leukemia and myeloid neoplasms with Dr. Jayastu Senapati from the MD Anderson Cancer Center. Here are the links to the abstracts we discussed:
Older AML: Ven+HMA vs 7+3
Abstract 450: https://ash.confex.com/ash/2024/webprogram/Paper210320.html
Abstract 971: https://ash.confex.com/ash/2024/webprogram/Paper202801.html
Abstract 969: https://ash.confex.com/ash/2024/webprogram/Paper199267.html
Venetoclax resistance mechanisms
https://pubmed.ncbi.nlm.nih.gov/39478230/
FLAG-GO vs FLAG-IDA
CPX-351:
Abstract 55: https://ash.confex.com/ash/2024/webprogram/Paper207094.html
Abstract 60: https://ash.confex.com/ash/2024/webprogram/Paper200413.html
Menin Inhibitors
Abstract 211 https://ash.confex.com/ash/2024/webprogram/Paper194384.html
Abstract 212 https://ash.confex.com/ash/2024/webprogram/Paper207106.html
Abstract 213 https://ash.confex.com/ash/2024/webprogram/Paper194827.html
Abstracts 214 https://ash.confex.com/ash/2024/webprogram/Paper198218.html
Abstract 215 https://ash.confex.com/ash/2024/webprogram/Paper198218.html
Abstract 216 https://ash.confex.com/ash/2024/webprogram/Paper204375.html
FLT3 inhibitors
Abstract 221: https://ash.confex.com/ash/2024/webprogram/Paper201595.html
MDS
Abstract 349: https://ash.confex.com/ash/2024/webprogram/Paper194510.html
ATRA in MDS:
https://ash.confex.com/ash/2024/webprogram/Paper200433.html
In this episode, we discuss the management of CML with Dr. Hagop Kantarjian from MD Anderson Cancer Center. Here are the key articles we discussed:
1. ASC4FIRST RCT: Asciminib in newly diagnosed CML.
https://pubmed.ncbi.nlm.nih.gov/38820078/
2. 5-year follow-up of ENESTnd RCT (nilotinib):
https://pubmed.ncbi.nlm.nih.gov/26837842/
3. 10-year follow-up of ENESTnd RCT (nilotinib):
https://pubmed.ncbi.nlm.nih.gov/33414482/
4. 10-year follow-up of CML-IV RCT (imatinib):
https://pubmed.ncbi.nlm.nih.gov/25676422/
5. MD Anderson data on low-dose dasatinib (50 mg):
https://pubmed.ncbi.nlm.nih.gov/36054032/
https://pubmed.ncbi.nlm.nih.gov/31553487/
6. CML: 2025 update on diagnosis, therapy, and monitoring:
https://pubmed.ncbi.nlm.nih.gov/39093014/
In this episode, we dive into the hottest updates in myeloma and amyloidosis at ASH 2024 annual meeting with Dr. Rakesh Popat. Here are the abstracts we discussed:
1. AQUILA Trial in High-Risk SMM
2. Anito-Cel: New BCMA CAR T Therapy
3. CARTITUDE-4 Update
4. ANDROMEDA OS Data in AL Amyloidosis
5. OPTIMUM Trial in Ultra-High-Risk NDMM
6. GMMG-HD7 Trial PFS Update
7. Exciting New Drugs
In this episode, we discussed the top abstracts in lymphoma and CLL presented at the ASH 2024 annual meeting in San Diego with Dr. David A Russler-Germain from Washington University. Here are the key abstracts we discussed:
1. 3 RCTs in Mantle Cell Lymphoma:
a) Update on TRIANGLE: https://ash.confex.com/ash/2024/webprogram/Paper200735.html
b) ENRICH Trial (Continuous Ibrutinib-Rituximab vs CIT [R-CHOP or BR]): https://ash.confex.com/ash/2024/webprogram/Paper199710.html
c) ECOG-ACRIN EA4151 Trial (Auto-HCT vs Rituximab maintenance alone in patients with undetectable MRD after induction): https://ash.confex.com/ash/2024/webprogram/Paper212973.html
2. DLBCL:
a) Update on POLARIX Trial: https://ash.confex.com/ash/2024/webprogram/Paper197938.html
b) Predictive Value of Cell-of-Origin Subtype By Hans Algorithm in DLBCL Patients Receiving Polatuzumab Vedotin: https://ash.confex.com/ash/2024/webprogram/Paper202153.html
c) COALITION trial: https://ash.confex.com/ash/2024/webprogram/Paper204930.html
3. Follicular Lymphoma:
a) Phase 3 inMIND trial (Tafasitamab + R2 vs Placebo + R2): https://ash.confex.com/ash/2024/webprogram/Paper212970.html
b) Loncastuximab tesirine with rituximab in patients with R/R FL: https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00345-4/abstract
4. CLL:
a) AMPLIFY Trial (Fixed-Duration Acalabrutinib Plus Venetoclax with or without Obinutuzumab Versus Chemoimmunotherapy in 1st line CLL): https://ash.confex.com/ash/2024/webprogram/Paper200701.html
5. Hodgkin Lymphoma:
a) Pembrolizumab Maintenance Instead of Auto-HCT for R/R HL: https://ash.confex.com/ash/2024/webprogram/Paper202537.html
In this episode, we discuss the comeback of belantamab mafadotin in multiple myeloma with Dr. Hang Quach, along with some other important abstracts presented at EHA/ASCO 2024. Here are the studies we discussed:
1. DREAMM-7 RCT: Belantamab-Vd vs Daratumumab-Vd in relapsed MM. https://pubmed.ncbi.nlm.nih.gov/38828933/
2. DREAMM-8 RCT: Belantamab-Pd vs PVd in relapsed MM. https://pubmed.ncbi.nlm.nih.gov/38828951/
3. Long-term follow-up of CASSIOPEIA Trial: https://pubmed.ncbi.nlm.nih.gov/38889735/
4. Update on MRD data from PERSEUS Trial: https://ascopubs.org/doi/10.1200/JCO.2024.42.16_suppl.7502
In this episode, we dive into the management of older adults with Hodgkin Lymphoma with Dr. Andrew Evens.
Here are the key articles we discussed:
1. Comparison of ABVD versus Stanford V in older Hodgkin Lymphoma patients: https://pmc.ncbi.nlm.nih.gov/articles/PMC3906856/
2. Outcome of older adults ECHELON-1: https://pubmed.ncbi.nlm.nih.gov/34162178/
3. Sequential BV-AVD in older adults with Hodgkin Lymphoma: https://pubmed.ncbi.nlm.nih.gov/30179569/
4. SWOG S1826 trial (Nivo-AVD vs AAVD in advanced stage classical HL): https://pubmed.ncbi.nlm.nih.gov/39413375/
5. S1826 outcomes in older adults: https://ash.confex.com/ash/2023/webprogram/Paper180114.html
6. Single-agent BV for older adults with Hodgkin: https://ashpublications.org/blood/article/142/Supplement%201/4435/503453
In this episode, we discuss the history of venetoclax in AML, along with key clinical trials that have shaped its current use in AML. Here are the trials discussed in this episode:
1. VIALE-A study: https://www.nejm.org/doi/full/10.1056/NEJMoa2012971
2. 10 day Decitabine plus venetoclax for ND AML https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(20)30210-6/abstract
3. Genetic Risk Stratification and Outcomes with AML treated with venetoclax and azacitidine https://ashpublications-org.proxy.library.vanderbilt.edu/blood/article/doi/10.1182/blood.2024024944/517355/Genetic-Risk-Stratification-and-Outcomes-Among
4. Genetic risk classification for adults with AML receiving less-intensive therapies: the 2024 ELN recommendations https://ashpublications-org.proxy.library.vanderbilt.edu/blood/article/doi/10.1182/blood.2024025409/517356/Genetic-risk-classification-for-adults-with-AML
5. AGILE study: Ivosidenib and azacitidine in IDH1-mutated AML https://www.nejm.org/doi/full/10.1056/NEJMoa2117344
6. MRD response and prognosis in treatment naïve AML with AZA/VEN https://ascopubs.org/doi/10.1200/JCO.21.01546?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
7. Monocytic subclone confer resistance to venetoclax-based therapy in patients with AML https://aacrjournals.org/cancerdiscovery/article/10/4/536/2403/Monocytic-Subclones-Confer-Resistance-to
8. VEN/DEC vs 7+3 https://ashpublications.org/blood/article/142/Supplement%201/970/503790/Comparing-the-Efficacy-and-Safety-of-Venetoclax
9. FILO study: Outcomes of AML https://onlinelibrary.wiley.com/doi/10.1002/ajh.27417
10. Treatment-free remission after ceasing venetoclax-based therapy in patients with AML https://ashpublications-org.proxy.library.vanderbilt.edu/bloodadvances/article/6/13/3879/485175/Treatment-free-remission-after-ceasing-venetoclax
11. Targeting molecular MRD and low-blast relapse in AML with Venetoclax and LDAC (VALDAC) https://ascopubs-org.proxy.library.vanderbilt.edu/doi/10.1200/JCO.23.01599?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
12. INTERCEPT trial: https://ashpublications.org/blood/article/140/Supplement%201/3341/492722/ALLG-AMLM26-Phase-1B-2-Study-Investigating-Novel
In this episode, we discuss the management of newly diagnosed transplant in-eligible multiple myeloma with Dr. Timothy Schmidt, with a special focus on IMROZ and BENEFIT RCTs testing quadruplets in this space.
Here are the key papers we discussed:
1. MAIA trial (Daratumumab-Lenalidomide-Dexamethasone [DRd] vs Rd in newly diagnosed transplant ineligible myeloma): https://pubmed.ncbi.nlm.nih.gov/34655533/
2. S0777 trial (VRd vs Rd in newly diagnosed myeloma [transplant-ineligible or transplant-deferred]): https://pubmed.ncbi.nlm.nih.gov/32393732/
3. IMROZ trial (Isatuximab-VRd vs VRd in newly diagnosed transplant-ineligible myeloma): https://pubmed.ncbi.nlm.nih.gov/38832972/
4. IFM-2020/BENEFIT trial (Isatuximab-VRd vs Isatuximab-Rd in newly diagnosed transplant-ineligible myeloma): https://pubmed.ncbi.nlm.nih.gov/38830994/
5. GEM2017FIT trial (VMP-Rd vs KRd vs Dara-KRd in newly diagnosed transplant-ineligible myeloma): https://ashpublications.org/blood/article/142/Supplement%201/209/500199
In this episode, we discuss updates on low-risk MDS with Dr. Maximilian Stahl with a focus on imetelstat and luspatercept.
Here are the trials we discussed:
1. IWG 2019 response criteria
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042664/
2. MEDALIST trial: Luspatercept
3. COMMANDS trial : Luspatercept
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00874-7/abstract
https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00203-5/abstract
4. IMerge trial: Imetelstat
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01724-5/abstract
In this episode, we discussed the diagnosis and management of polycythemia vera with Dr. Aaron T. Gerds. Here are the shownotes with the key studies discussed:
1. MIPS PV scoring system
https://pubmed.ncbi.nlm.nih.gov/31945802/
2. REVEAL study
3. MAJIC PV study
4. Cyto-PV Study
https://www.nejm.org/doi/full/10.1056/NEJMoa1208500
5. PROUD-PV and CONTINUATION-PV trials
https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(19)30236-4/abstract
6. RESPONSE clinical trial
https://www.nejm.org/doi/full/10.1056/NEJMoa1409002
7. Rusferitide in PV
In this episode, we reviewed the hottest updates in lymphoma from ASCO and EHA 2024, held in Chicago and Madrid respectively, with Dr. Gloria Iacoboni, a haematologist from University Hospital Vall d'Hebron, in Barcelona, Spain. Here are the key abstracts we discussed:
1. STARGLO: Glofit-GEMOX vs R-GEMOX in relapsed/refractory DLBCL
https://library.ehaweb.org/eha/2024/eha2024-congress/4136516
2. Epco-Pola-R-CHP for 1st line DLBCL (EPCORE NHL-5 study):
https://library.ehaweb.org/eha/2024/eha2024-congress/422343
3. 3-year follow-up of TRANSFORM (Liso-Cel vs CITàASCT in R/R DLBCL): https://meetings.asco.org/abstracts-presentations/232740
4. ECHO RCT: Acalabrutinib-BR vs Placebo-BR in previously untreated elderly MCL: https://library.ehaweb.org/eha/2024/eha2024-congress/4136515
5. HD21: escBEACOPP vs BrECADD in 1st line classical HL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01315-1/fulltext
6. Combination pirtobrutinib, venetoclax, and obinutuzumab in 1st line CLL: https://library.ehaweb.org/eha/2024/eha2024-congress/422268
7. Single-agent epcoritamab in Richter’s transformation: EPCORE CLL-1: https://library.ehaweb.org/eha/2024/eha2024-congress/422267