Excellent open-access #MMsm work in @AjHematology by Zabaleta @BrunoPaiva_UNAV et al! An important footnote for all the CAR-T vs bsAb efficacy debates: when stratified by MRD status, CAR-T and bsAbs do identically. Getting to MRD neg is what matters! onlinelibrary.wiley.com/doi/10.1002/... - ThreadSky

rahulbanerjeemd.bsky.social • 102 days ago

Excellent open-access #MMsm work in @AjHematology by Zabaleta @BrunoPaiva_UNAV et al!

An important footnote for all the CAR-T vs bsAb efficacy debates: when stratified by MRD status, CAR-T and bsAbs do identically.

Getting to MRD neg is what matters!

https://onlinelibrary.wiley.com/doi/10.1002/ajh.27526

Comments

wzbinchen.bsky.social•98 days ago

I hope to learn more about medicine from you in the future!

alexmenter.bsky.social•101 days ago

Still waiting for a study that proves long term QOL or OS outcomes are better due to MRD guided therapy changes. PFS is just not that helpful unless you are looking at PFS 2 with mandated crossover to the experimental therapy in question. And we are really nuking people’s immune systems.

rahulbanerjeemd.bsky.social•99 days ago

I’d counter-argue that MRD-guided discontinuation has been one of the best things for QOL I’ve ever done for a patient!

alexmenter.bsky.social•99 days ago

Based on Costa’s randomized phase II study? And only in pts with standard risk cytogenetics? At what time point do you allow discontinuation of maintenance therapy?

bbehin.bsky.social•101 days ago

Dr. Banerjee, how do you think this should affect clinical practice? If MRD+ is prognostic, will patients who are MRD+ post CART or BSAB but show no other signs of progression be treated differently?

rahulbanerjeemd.bsky.social•99 days ago

In the future, perhaps a combination (like adding a drug like pomalidomide or a second bispecific) may be the standard of care here - but for now, we don’t really know!

bbehin.bsky.social•99 days ago

Thank you!

stan219.bsky.social•99 days ago

I've been MRD- for the last 3 yrs. My MM doctor(Dr. Jagannath) said he doubts it will return. Started treatment in 2013. 5+ yrs maintenance(5Mg Rev). Relapsed 2019. Finished all treatments Mar. 2024. IgG Kappa. No SCT.

rahulbanerjeemd.bsky.social•99 days ago

Agreed with Dr. Jagannath on all fronts - this is wonderful news!

stan219.bsky.social•99 days ago

It is. And to think doctors would never utter the word “cure” a decade or so, ago.

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