IMWG Conference Series 2021

Thank you to our sponsors!

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Virtual ASCO 2021 Total ASCO abstracts for 2021 = 4,782 Myeloma Abstracts = 282  Oral = 26  Poster Discussion = 32  Poster Session = 106  Publication Only = 118 3

Abstract #8005

https://www.myeloma.org/videos/ciltacabtagene-autoleucel-bcma-directed-cart-therapy-relapsed-refractory-multiple-myeloma-cartitude1

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CARTITUDE-1 Update • • • • •

Median follow-up – 18 months Overall response rate = 98% (!) sCR = 80% Response duration = 66% at 18 months Some newer concerns about delayed toxicities and how to mitigate.

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Abstract #8007

https://www.myeloma.org/videos/updated-phase-1-teclistamab-trial-results-relasped-refractory-multiple-myeloma

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Teclistamab Update • 40 patients • Response rate = 65% • Of responders: • VGPR = 58% • CR/ sCR = 30% • Toxicities acceptable/ manageable for this bispecific 7

Abstract #8006

https://www.myeloma.org/videos/efficacy-safety-elranatamab-bcma-cd3-bispecific-antibody-patients-relapsed-or-refractory

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What’s next for CAR T? • Rollout of approved products • Earlier use • Next generation CARs 9

Where will bi-specifics fit in?

• Ongoing IV/ SC • Course of therapy – 6 months?

• Toxicity concerns persist?

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Abstract #8004

https://www.myeloma.org/videos/daratumumab-maintenance-or-observation-after-treatment-vtd-asct-patients-cassiopeia

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CASSIOPEIA Update Key Point • Dara maintenance – no added benefit with Dara VTd induction/ consolidation • Does this change thinking about Dara maintenance?

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Abstract #8000

https://www.myeloma.org/videos/upfront-autologous-stem-cell-transplantation-versus-KCd-k-maintenance-cardamon-trial

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KCd +/- ASCT and K maintenance • KCd and ASCT consolidation equivalent • High risk patients continue to do more poorly

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Abstract #10507

Second primary malignancies (SPM) in African American (AA) and white patients with multiple myeloma in the National Veterans Affairs (VA) healthcare system. https://meetinglibrary.asco.org/record/197653/abstract

Nikhil Munshi Dana-Farber Cancer Institute Boston, MA, USA

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Key questions about induction • Will Quads take over?

• Dara or Isa with V/KRd or V/KTd

• Is frontline transplant now optional?

OR • Based upon MRD status?

• Is SPM occurrence important?

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Key questions about induction • Will new immune therapies become consolidation of choice?

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EHA Late Breaking Abstract

https://www.myeloma.org/videos/overall-survival-results-daratumumab-lenalidomide-dexamethasone-transplant-ineligible-MAIA

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Updated PFS 60-month PFS rate

% surviving without progression

100 80 52.5%

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D-Rd: median, NR 28.7%

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Rd: median, 34.4 months 20

HR, 0.53; 95% CI, 0.43-0.66; P <0.0001

0

0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 Months No. at risk Rd 369 333 307 280 255 237 220 205 196 179 172 155 146 133 123 113 105 94 63 36 12 4 D-Rd 368 347 335 320 309 300 290 276 266 256 246 237 232 222 210 199 195 170 123 87 51 17

2 5

0 0

• D-Rd continued to demonstrate a significant PFS benefit, with median PFS not reached with D-Rd • These data provide a new PFS benchmark in patients with NDMM who are transplant ineligible NR, not reached; CI, confidence interval.

OS 60-month OS rate

100

% surviving

80

66.3% D-Rd: median, NR

53.1%

60

Rd: median, NR 40

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HR, 0.68; 95% CI, 0.53-0.86; P = 0.0013

0 0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 72 Months No. at risk Rd 369 351 343 336 324 317 308 300 294 281 270 258 251 241 232 223 213 183 134 85 42 14 5 D-Rd 368 350 346 344 338 334 328 316 305 302 297 286 280 273 266 255 249 228 170 118 63 22 6

1 1

0 0

D-Rd demonstrated a significant benefit in OS, with a 32% reduction in the risk of death, in patients with NDMM who are transplant ineligible

Panel Discussion 21

Abstract #8009

MASS-FIX versus standard methods to predict for PFS and OS among multiple myeloma patients participating on the STAMINA trial. https://meetinglibrary.asco.org/record/196625/abstract

Angela Dispenzieri Mayo Clinic Rochester, MN, USA

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MASS-FIX Testing in STAMINA Trial • MASS-FIX excellent independent predictor of PFS and OS

• Compared with MRD Testing with NGF * Promising use of simple blood testing 23

Abstract #8010

Analysis of minimal residual disease in bone marrow by NGF and in peripheral blood by mass spectrometry in newly diagnosed multiple myeloma patients enrolled in the GEM2012MENOS65 clinical trial.

Noemi Puig University of Salamanca Salamanca, Spain

https://meetinglibrary.asco.org/record/195522/abstract

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Mass spectrometry in GEM (Spanish) Trial • Mass Spec and MRD by NGF found to be complementary in assessing outcomes

• Patterns of NGF +/- and Mass Spec +/being further studied 25

Abstract #8001

https://www.myeloma.org/videos/depth-response-minimal-residual-disease-status-ultra-high-risk-multiple-myeloma-muknine-study

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Key questions about Mass Spec • Can it provide good MRD monitoring?

• How easy will it be to switch from SPEP/ IFE? • Relapse • Early disease 27

Abstract #8012

https://www.myeloma.org/videos/prospective-comparison-whole-body-mri-fdg-pet-ct-detection-multiple-myeloma-correlation

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Key questions about imaging • Is WBLDCT (Whole Body Low Dose CT) the standard?

• What about PET/CT versus MRI?

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Abstract #8019

Survival among older patients with previously treated multiple myeloma treated with selinexor, bortezomib, and dexamethasone (XVd) in the BOSTON study. https://meetinglibrary.asco.org/record/195458/abstract

Thierry Facon Université of Lille, CHU Lille, Service des Maladies du Sang, Lille, France

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Selinexor in Elderly: Update • Patients over age 65 years • Excellent results with selinexor + Vd (BOSTON regimen) re: efficacy/ toxicity

• Both PFS and OS improved 31

Panel Discussion 32

Key questions from IMWG Summit • Several items already discussed • Additional points: • Diagnosis/ treatment for HR/ ultra HR SMM (2/20/20 system) • Immune therapy registry and virtual biobank 33

Key questions from IMWG Summit • Additional points: • Role of new MoAbs and new agents (ex. CelMods) • COVID-19 vaccination

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Panel Discussion 35

Thank you to our sponsors!

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