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Reposted by Joseph Mikhael MD

International Myeloma Foundation @imfmyeloma.bsky.social · 20/03/2026

Education changes lives. Join a free IMF seminar or workshop for trusted myeloma education and access to experts. Find an event near you or online at events.myeloma.org

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Reposted by Joseph Mikhael MD

International Myeloma Foundation @imfmyeloma.bsky.social · 08/01/2026

From #ASH25: We break down the 10 most impactful myeloma breakthroughs, including advances in CAR T-cell therapy and bispecific antibodies and what this latest research means for people living with myeloma. Watch now: mmsm.link/4qeZrlU #IMFASH25 #ASKTHEIMF @jmikhaelmd.bsky.social

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Reposted by Joseph Mikhael MD

International Myeloma Foundation @imfmyeloma.bsky.social · 18/12/2025

Pain is a reality for many people living with myeloma, but it can be managed. In this Myeloma in a Minute or Less video, Dr. Joseph Mikhael, Chief Medical Officer of the IMF, breaks down practical, patient-focused strategies to help manage myeloma-related pain. www.myeloma.org/node/12242

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Reposted by Joseph Mikhael MD

International Myeloma Foundation @imfmyeloma.bsky.social · 14/12/2025

This week! Join our free IMWG Conference Series webinar on December 17 when leading myeloma experts discuss the latest on myeloma research from the December 2025 American Society of Hematology Conference. RSVP >https://mmsm.link/4op7Q58 #mmsm #imfimwg #ASH25

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Reposted by Joseph Mikhael MD

International Myeloma Foundation @imfmyeloma.bsky.social · 03/12/2025

You won't want to miss this! Join us at our free IMWG Conference Series webinar on December 17 to hear from a panel of #myeloma specialists on frontline therapy, MGUS, CAR T-cell therapy, and many more topics! Register now before spots run out: mmsm.link/4op7Q58 #mmsm #imfimwg

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

21/ 1L in TE & TIE for NDMM 🔑 SUMMARY🔑 🎯Triplet WAS standard approach, but quad is🆕SOC 🎉Quad is preferred 1L for TE NDMM v triplet 🆕SOC: IsaRVd for TIE NDMM🎉 🎯MRD- emerging as a benchmark in🔬 & clin decision making 👏Great news for pts & Don't forget to claim #CME > bonumce.short.gy/NDMM-TW1-Post

bonumce.short.gy

NDMM ~ Tweetorial #1: Efficacy of Quad Therapies ***Post-Survey & Application for Credit***

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

20/MIDAS eval’d MRD-guided consolidatn post 1L IsaKRd in TE NDMM Post 1L, no 🔼 in MRD- rates for all pts Tailoring tx to MRD post 1L may not ➡️ MRD- If respond to 1L tx may not need tandem SCT to reach MRD-; cont anti-CD38 &PI 🤔High # pts w t(11;14): impact time to MRD- results?

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

19/ Looking across trials... e.g. 🔬CEPHEUS 🔬IMROZ 🔬GMMG-CONCEPT 🔬ADVANCE… 🥅 MRD negativity emerges as benchmark to create a level playing field Across🔬, regimens, & now✅ FDA approved as clinical trial endpoint April ‘25

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

18/ADVANCE🔑trial demonstrating dara+ standard KRd ➡️↑outcomes in NDMM independent of TE ↑MRD- rate: 59% v 36%, adjOR = 2.5; P<0.0007➡️ 2.5x ↑MRD- rate w/DKRd 👉No new safety concerns ❓Impact on EFS, PFS & OS TBD DKRd👉1L for all pts on KRd backbone regardless of TE status

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

17/📣GMMG-CONCEPT ASCO2025 update, TE pts: 73.2% MRD- post-consolidatn; p=1.91x10-13 86.8% MRD- @ any time 58.4% MRD- ≥CR 40.6% retained ≥2yr sust MRD- Med follow-up: 43m(0-90.2m) mPFS: 72.8m 5yr OS: 72% 6yr OS: 69% ⬆️2yr sustMRD-, ⬆️PFS, 69% OS @ 6yr IsaKRd:🆕SOC for HRNDMM

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

16/👏if you chose to treat to MRD- & cont maint GMMG-CONCEPT, largest cohort to eval MRD- in TE & TIE HRNDMM IsaKRd inductn & consolidatn➡️IsaKR maint➡️ ↑MRD- rate: 67.7% in TE & 54.2% in TIE Sustained ≥1yr: 62.6% in TE & 46.2% in TIE 🎉IsaKRd➡️↑deep remissions

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

15/ Based on results of GMMG-CONCEPT presented @ #ASCO2025, which treatment strategy should be used for pts w/ HR NDMM? 💬 reply/comment w/ your answer 💬 1️⃣ Initiate allogeneic SCT 2️⃣ Choose IV instead of subQ 3️⃣ Treat to MRD- then d/c tx 4️⃣ Treat to MRD- & cont maintenance

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

14/Unfortunately, pts w high-risk (HR) #NDMM have 👎poorer prognosis & shorter survival rates vs standard-risk

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

13/🆕SOC for pts w SCT-deferred or TIE #NDMM🎉 NCCN (preferred, cat 1) & EHA-EMN (1st optn) regimens: 🎯DRd ‘til progression; de-escalate prn 🎯DVRd ‘til progression; de-escalate prn(<80 yr old, not frail) 🎯IsaVRd ‘til progression; de-escalate prn(<80 yr old, not frail) #MMSM

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

12/BENEFIT eval'd wkly bortezomib (V) in TIE NDMM IsaVRd➡️IsaVR➡️IsaR v IsaRd➡️IsaR➡️IsaR ↑MRD- rate @ 12mo 51% v 21%; OR: 3.88; 95%CI: 2.27-6.62;P<0.0001 18mo 53% v 26%; OR: 3.16; 95%CI: 1.89-5.28;P<0.0001 🔑Wkly V in IsaRd=deep responses Supports IsaVRd as🆕SOC for TIE NDMM

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

11/Do results w isa show similar trends? IMROZ🔑trial IsaVRd ➡️ IsaRd v VRd ➡️ Rd in TIE pts w NDMM 👉IsaVRd ➡️↓time to MRD-: 14.7 v 32.8m 👉↑ PFS @ 60m: 63.2 v 45.2%; HR: 0.60; P<0.001 👉↑ CR: 74.7% v 64.1%; P=0.01 IMROZ results support IsaVRd as 🎉 🆕 SOC for TIE #NDMM pts

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

10/ CEPHEUS🔑 trial in TIE & SCT-deferrd pts DVRd ➡️ deeper, more durable MRD- rate TIE cohort: 👉Overall MRD- 63.2 v 41.4% 👉Sustained MRD @ ≥12m 48.7 v 26.3%; P<0.0001 👉CR 81.2 v 61.6%; P<0.0001 👉HR 0.57, 95% CI 0.41-0.79; P=0.0005 ↓D/C rate w quad 🎉DVRd new SOC for TIE NDMM🎉

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

9/CEPHEUS compared induction/consolidation w VRd ± daratumumab (D) followed by maintenance in transplant-ineligible (TIE) #NDMM The DVRd arm demonstrated which of the following outcomes? 💬 REPLY👇 1️⃣ Deep, more durable MRD- 2️⃣ ⬆️MRD- rates. No🔺in PFS 3️⃣ Similar efficacy, ⬆️VTE 4️⃣ ⬆️ D/C rate in DVRd arm

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

8/🔬Exciting news for #mmsm Quad tx as🆕SOC for #NDMM Current EHA-EMN (1st optn) & NCCN (pref,cat 1) regimens for TE pts w/NDMM: 🎯DaraVRd➡️SCT➡️len maint 🎯IsaVRd SCT➡️len maint 👏to quad as 1L for TE pts👏 …but what about pts who are TIE /SCT-deferred?

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

7/⚡️GMMG-HD7 #ASCO25 update w/ PFS benefit in all quad recipients ↑CR 43.5% w IsaVRd v 34% w VRd ↑MRD- rate 66.2% w quad v 47.7% w triplet 👉PFS at 3yr benefit: 83% v 75% w/IsaVRd v VRd ↑MRD- regardless of maint v MRD+ (HR 0.61; P=0.002) 🔮Maintenance w Isa-len v len is on-going

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

6/🙋🏻What about replacing dara- with isa- in a quad? GMMG-HD7: IsaVRd v VRd induction ➡️ isa-len v len maintenance in TE NDMM 👉↑ MRD- rate 50% v 36%; p =0.00017 👉IsaVRd had ↓AE rates & ↓d/c rates v RVd 🎉🆕 SOC 👉Results ➡️ addition of IsaVRd as induction regimen for TE NDMM

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

5/ PERSEUS #ASCO25: sustained MRD- in pts on quad maintenance median follow-up of 47.5m 👉 ↑ sustMRD- at ≥24m w DVRd v VRd: 55.8 v 22.6% 👉 Pts w ≥12m sustMRD-: ↑ 48m PFS, regardless of tx 👉 Only 3.1% progression at 18m w DVRd v 6.8% VRd 🔑 DVRd ➡️ 2.5x ⬆️ ≥24m sustMRD- & ½ progression risk at ≤18m tx

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

4/💃Quads are taking center stage in NDMM Let’s look @ the📈 on quad tx PERSEUS ~🔑 trial: SQ dara➕VRd ➡️ ↑outcomes in TE pts 👉↑PFS @ 48m 84.3 v 67.7%; HR: 0.42; P<0.001 👉↑MRD- rate 75.2 v 47.5%; P<0.001 👉↑CR rate 87.9 v 70.1%; P<0.001 🎉 🆕 SOC ~ quad instead of triplet 🎉

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

3/🥼In your practice, which regimen are you using most often for 1L therapy in pts w/ transplant eligible (TE) #NDMM? ☎️ #MedSky #HemeSky 💬 reply and let us know what you do in your practice? 1️⃣ DVRd quad 2️⃣ IsaVRd quad 3️⃣ DKRd or IsaKRd quad 4️⃣ VRd 5️⃣ other triplet

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

2/ Before we jump in, a few disclosures & important links🔗 1️⃣📖#CME info bonumce.short.gy/NDMM-TW1-CME 2️⃣Take the pre-survey 👉bonumce.short.gy/NDMM-TW1-Pre 3️⃣Get the latest NDMM quad tx efficacy data w/ 🧵👇 4️⃣🏆Claim🆓CME bonumce.short.gy/NDMM-TW1-Post Now, let's get started!

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Joseph Mikhael MD @jmikhaelmd.bsky.social · 24/09/2025

#MMSM #MultipleMyeloma ⚡️#MedSky join me & my friend Dr. Krina Patel In a #CME 🧵exploring efficacy of quad tx in #NDMM 🔬PERSEUS, GMMG-HD7 & CONCEPT, CEPHEUS, IMROZ, ADVANCE, MIDAS +++ 🆓 CME from @bonumce.bsky.social 🔗 to CME ℹ️ 👉🏼 bonumce.short.gy/NDMM-TW1-CME Supported by an edu grant from Janssen

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