IMWG Conference Series: ASCO & EHA 202

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IMWG Conference Series: Making Sense of Treatment June 15, 2023 1

Thank you to our sponsors!

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Topics to be covered

ASCO 2023 Annual Meeting – June 2-6, Chicago

IMWG Summit – June 7-8, Frankfurt

EHA 2023 Hybrid Congress – June 9-12, Frankfurt

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Notable Event: 2023 Kyle & Durie Achievement Awards

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Congratulations!
Maria-Victoria Mateos, MD, PhD Recipientof the 2023 RobertA. Kyle Lifetime AchievementAward Thomas Martin, MD Recipientof the 2023 Brian G.M.Durie Outstanding AchievementAward

Top Abstract

at ASCO and EHA (Plenary)

• Cilta-cel (CAR T) v SOC in Early Relapse presented duringthe Special CAR T Sessionat ASCO 2023

• Impressiveresults:Progressionrisk reducedby74%

• Companion NEJM Publication: Points to useof CAR T in Earlier Disease

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Discussion

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ASCO: Main Oral Session

Saturday, June 3

• Abstract #8000: KRd vs Elo KRd in NDMM

• Abstract #8001: KPd maintenance in High-risk MM

• Abstract #8002: Teclistamab + Talquetamab (RedirecTT-1)*****

• Abstract #8003: Talquetamab + Dara (TRiMM-2)

• Abstract #8004: Phase 1 CAR T: PHE 885

• Abstract #8005: Rapid CAR T dual target – Shanghai experience

• Abstract #8006: Bispecific Regeneron #5458 (LINKER-MM1)

• Abstract #8007: DREAMM-3 Bela versus Pom dex F/U

• Abstract #8008: Bispecific Elranatamab: MagnetisMM

*****Will be discussed infull

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Additional ASCO Presentations

SPECIAL POPULATIONS: Age/Disparities/Renal Compromise

Meet the Prof on Bispecifics: Moreau/Garfall

Wide range of topics

ORALS/POSTERS

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EHA 2023 Presentations

Over 200 interesting/important Myeloma Abstracts!

Some TOP ABSTRACTS are also from ASCO 2023

Many unique presentations that are impossible to summarize:

❑ Immune therapies (CAR T/Bispecifics)

❑ Combinations

❑ Real-world findings

❑ Patients’Preferences

❑ Infections

❑ QoL

❑ DREAMM studies

❑ Master Trial

❑ Selinexor combos

❑ Zometa 4 years

❑ Young outcomes

❑ Telomeres

❑ EMD

❑ Arginine Deprivation

❑ MRDSurrogacy

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Discussion

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Discussion

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Discussion

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Discussion

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Turning to IMWG Summit Key Discussions

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Smoldering Multiple Myeloma Committee Report

María-Victoria Mateos, MD, PhD

University of Salamanca, Spain

Shaji Kumar, MD Mayo Clinic

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Diagnosis

• Stress importance of confirmation of numbers – also confirms stability/opportunity to observe evolution

• Patients with risk of progression >=80% @ 2 years were reclassified as active MM in 2014

• New risk stratificationhas the highest risk group with progression risk of 72% at the highest, a small group of patients –reclassification?

• Distinction between MGUS and SMM – important form a clinical standpoint, biology is a continuum

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Endpoints for trials

• What would be the right endpoint for trials?

– Overall survival is the gold standard but will take many years to find the benefit

• Progression free survival?

• Sustained MRD negativity? If so, how long?

• HRQOL endpoints?

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Discussion

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Challenges for trial design: “Relapsed SMM”

• If we go with biochemical progression, are they still smoldering when they progress?

• Can they go on another smoldering trial?

• If we wait for CRAB features, then are they considered newly diagnosed MM for a clinical trial?

• Likely the easiest option would be to consider them as relapsed MM with one prior line – if they were treated with a MM type regimen

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Combined Mass Spectrometry & MRD Committee Report

Mass Spectrometry

Brian G.M. Durie, MD

International Myeloma Foundation

David Murray, MD, PhD

Mayo Clinic

MRD

Nikhil Munshi, MD

Dana-Farber Cancer Institute

Bruno Pavia, PhD

University of Navarra

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Mayo Update

• Performed over 200,000 tests by Mass Spec since 2018

– Retrospectivereviewof first20,000 tests published(Mayo ClinicProceedings)

• Urine Mass Spec is clinically available as of two weeks ago

– Equal sensitivityto urineIFE withoutconcentrating theurine

– Improvedspecificityasmass of lightchains consistentwithserum

• Eliminationof SPEP Dec 2023

Literature Update

• Several New Papers using a targetedCDR M-proteinpeptides for MRD

“EasyM”test from Universityof WashingtoninSt. Louis

Sebia/Erasmus UniversityMRD

• Detectionin Non-Secretory MM (Giles et al Blood)

• Low-Cost Method using MALDi-TOF (Mehra et al)

Commercialization Update

• Europe planned for August 2023

• USAplanned for Q1 2024

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Why Mass Spec could be routine in most labs

• Lab workflow/through put is significantly increased

Mayo has tripled the number of results per lab tech for IFE

– This will increase again on replacement of SPEP

• Current cost for U.S. Medicare patients is only 25% of a serum

rFLC determination

• Detection of other new entities and diseases

IgG4 RD patterns are recognizable by this method

– Replacement for oligoclonal banding for MS

M-protein light chain glycosylation

Amyloidosis

• Cold AgglutininDisease

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Guidelines to use MRD in clinical practice

Methods

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• Frequency • Sampling •
• Patients
Time points
• Etc.
Reporting
Interpretation

Discussion

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IMWG Summit Takeaways

❖ Many new projects (Registry/Biobank)

❖ Publications pending/planned

❖ New Areas of Focus:

o Infections

o QoL/Patients’ Perspective & Preferences

o Real-world role of MRD and Mass Spectrometry

o Many others for F/U before ASH Breakfast Meeting

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”The Plasma Cells” IMWG Band

Zamagni,

Zweegman,MD,PhD;Philippe Moreau,MD;PaulaRodríguez-Otero,MD,PhD

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Fromlefttoright:FrancescaGayMD,PhD;AlessandraLaRocca,MD,PhD;Elena MD,PhD;EnriqueOcio,MD,PhD;S.VincentRajkumar,MD;Sonja

Discussion

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We Want to Hear FromYou!

Feedback Survey

At the close of the meeting a feedback survey will pop up. Click “continue” to complete the survey.

This will also be emailed to you shortly after the workshop.

Please take a moment to complete this survey.

Thank you to our sponsors!

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