Hi, I'm Natalie Callender from the University of Wisconsin. We know that individuals based on some of the largest studies that have been presented here at ASH even last year, that those individuals who are going through particularly quadruplet induction, followed by a stem cell transplant, and then followed by maintenance, that many of those individuals should be in a complete remission or even MRD negative by the time they finish that transplant. We know that individuals who meet that criteria are going to do very well. But what we wanted to do is take a look at those patients who after that kind of very intensive treatment are actually not MRD negative. So what the Commander Trial is, it's a way to try to get more people to a minimal residual disease state after their transplant and as part of their maintenance therapy. So what we decided to do is use one of the newer CellMod drugs, Iberidamide, and we are asking individuals who've had any kind of induction, but most of them is going to be quadruplet followed by a stem cell transplant, will have an MRD assessment about roughly about 60, 100 days post transplant. And those individuals who are more than 10 to the minus fifth positive in terms of their MRD, and this has been being done by next generation sequencing, are asked to either receive the combination of Iberidamide, Deritumab, and Dexamethasone, or Iberidamide, Deritumab, and Carfilzomib and Dexamethasone. And we use these intensive blocks for about six months of either of those arms, and then Iberidamide is used as maintenance for up to two years. And what we're showing in this particular protocol is a couple of things that may be surprising may not be. One is that for the individuals who have had Iberidamide, Deridex as their treatment as part of this protocol, if they have had previous Deritumab, that does seem to influence the ability to convert with this particular recipe to MRD negativity. However, if you are receiving Iberidamide, Carfilzomib, Deritumab, and Dexamethasone, at least in this, and this is preliminary data, we have 29 patients, all of those individuals receiving that quadruplet have become MRD negative. And so we're very excited about that. So this is not going to be for every individual, and we know that kind of intensive maintenance is more complicated than say using single imid drugs like Lenalidomide, but for those individuals who we think are at a high risk of early progression, that we're hoping that this kind of intervention is going to end up yielding some very good results.
HealthTree • December 23, 2024