Hi, I'm Mohamad Mohty from the Sorbonne University and Saint-Antoine hospital in Paris in France. And it is my great pleasure to be with this lovely crew of HealthTree University here in Orlando at ASH 2025 Annual Meeting.
It's a fantastic meeting, especially for multiple myeloma. Lots of excitement, lots of new data when it comes to newly diagnosed multiple myeloma. I think the treatment algorithm is becoming more and more well-established. Very robust.
This famous the so-called transplant eligible patient, I think quadruplet induction whether was daratumumab, bortezomib, lenalidomide, dexamethasone, dara-VRd or isatuximab vrd are now really considered the standard of care and the aim of this a quadruplet induction is to achieve a very deep response prior to high dose melphalan and auto transplant, especially if you are able to achieve MRD negativity.
And this has been shown actually in the PERSEUS trial in the GMMG-HD7 trial with such quadruplets. Even before transplant, you can achieve up to 60% of MRD negativity, which is something, unprecedented in the historically, we never achieved such level of response then high dose chemotherapy melphalan.
Maintenance is under debate. Should we use lenalidomide maintenance alone or should we use doublet, anti-CD38 monoclonal antibody plus lenalidomide. Well, again we are in a sort of a gray zone because daratumumab and lenalidomide have been approved in Europe for maintenance. It hasn't been approved, in the United States by FDA.
So I think at the end of the day, it will depend on the disease response, the patient features to figure out whether everybody will need the doublet, or not. Although I personally would think that, giving a doublet, especially if we try to aim for a limited duration of treatment, can bring some added value.
But I think the future is going also into some exciting, directions developments by incorporating the immune therapies in earlier lines, especially bringing bispecific and T-cell engagers as part of the induction, but also giving these T-cell engagers bispecific for maintenance, especially again for limited duration of time.
So I think besides the response rate, the very nice progression free survival data, the next step in the management of this patient is going to be able, in my opinion, and this is of great importance for patients for the quality of life to give a limited duration of a treatment.
For the nontransparent eligible patient, also, the results are very good. The backbone is about an anti-CD38 monoclonal antibody like daratumumab plus lenalidomide, dex dexamethasone. But then we are discussing now the quadruplets dara-Vrd or isatuximab-VRd as it has been shown in the EMERAS trial or the CEPHEUS trial.
And those patient who are not transplant eligible they are relatively old but fit enough can receive these kind of, this kind of quadruplets, which are very well tolerated.
But from a patient perspective, there are also some great advances. We know that moving from I.V. to sub-q is definitely something importance, of importance. And now we're moving to the so-called OBIs, the on body injectors, which are devices allowing even more autonomy for the patient and the sort of an, self administration, for a given drug.
And this is being now, done. for instance, was isatuximab, and it's proving to be very, interesting in terms of quality of life.
So you can see the treatment algorithm is well defined, well established, but we keep on, improving and adding in new tools. And this will lead for sure. And we can census through the current data to cure in a significant proportion of patient.
And that's exactly the goal. Cure is definitely the key word.
HealthTree • December 22, 2025