Age Is More Than Just a Number: Tailoring Treatment Across the Multiple Myeloma Journey for Our Older and/or Unfit Patients

Shaji Kumar, MD discusses multiple myeloma in this CME activity titled "Age Is More Than Just a Number: Tailoring Treatment Across the Multiple Myeloma Journey for Our Older and/or Unfit Patients." For the full presentation, please visit us at www.peervoice.com/HEF870.

1. PeerVoice

Age Is More Than Just a Number: Tailoring Treatment Across the
Multiple Myeloma Journey for Our Older and/or Unfit Patients

Learning Objectives

Recognise the heterogeneous issues faced by people with multiple myeloma
(MM) who are of advanced age or may have other factors that render them unfit
for conventional therapy

Assess the clinical relevance of trial data and real-world evidence assessing
different treatment approaches in the management of MM in older patients
Formulate individualised management plans for patients considered elderly
and/or unfit for conventional myeloma treatment approaches

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Part 1 of 4: Obstacles to Overcome: What Are the Challenges
for Older and/or Unfit Patients?

Shaji Kumar, MD

Professor of Medicine and Chair of Hematology Research
Mayo Clinic

Rochester, Minnesota, USA

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3. PeerVoice

Disclosures

Shaji Kumar, MD, has a financial interest/relationship or affiliation in the form of:
Consultant for work with personal payments from Antengene Corporation; Calyx;
and CVS Caremark.

Grant/Research Support from clinical trial work via his institution with AbbVie
Inc.; Amgen Inc.; Bristol Myers Squibb Company; CARsgenTherapeutics Co. Ltd.;
F. Hoffmann-La Roche Ltd.; Genentech, Inc.; GSK plc.; Janssen Inc.; Sanofi;
Takeda Pharmaceutical Company Limited; and Telo Genomics.

Consultant for work without personal payments from AbbVie Inc.; Amgen Inc.;
Arcellx; BeiGene; Bristol Myers Squibb Company; CARsgenTherapeutics Co. Ltd.;
F. Hoffmann-La Roche Ltd.; Genentech, Inc.; Glycostem Therapeutics B.V.; GSK
plc.; Ipsen Biopharmaceuticals, Inc.; K36 Therapeutics; Moderna, Inc.; Pfizer Inc.;
Regeneron Pharmaceuticals, Inc.; Sanofi; Takeda Pharmaceutical Company
Limited; Telo Genomics; The Menarini Group; and Window Therapeutics.

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Multiple Myeloma Is a Disease of Older People

Percent of New Cases
by Age Group
35 322
30 69: Median Age at Diagnosis
R25 225 E
a
2 20 =40% of multiple myeloma (MM)
Ô 15 patients in the real world are ineligible
H so 95 85 for the phase 3 RCTs on which
= therapy approvals are based
27
00 04
Dar
PPS SES SE À
Age, y

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What Impacts Outcomes in Older Patients?

PFS

F Median PFS, mo.
Agey (95% CI)

os M:60 383(343 428)

os MG-70 267(250 289)
m7-80 1720(161179)

a = 136 (113,184)

os
os
04
as
02
or
o

Log-Rank

0 3 6 925 w 21242730333639424548 5154576063666972

Time From Randomisation, mo

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os

os
os
or

Log-Rank

96] y= 249715

os | P<.0001

04 Median OS, mo.

os JAge-y (95% C1)
m:60 656 (640 Nm)

02 Jm 61-70 610(572 638)

71-80 475 (443,496)

9 Im »80 289(233 321)

0 3 6 9 25% 21242730333639424548 51 54576063666972

Time From Randomisation, mo

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Heterogeneity Amongst Older Patients: Who Do We Consider Unfit?

emerges during ageing, independently

Increased vulnerability to stressors that
of any specific disease or disability

Prevalence of Frailty
30 Cohort of 61,500 older people
2

6

16
9
10 7
51 4 |
M

65-69 70-74 75-79 80-84 >85
Age, y

Prevalence, %
a

Biological
ageing

hat may aris
ntly and be causally related

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How Do We Define “Fit” Patients With Myeloma?

4 Frailty/Outcome Group:
score varies Defined

Transplant Assessment Scoring Systems

HCT-CI Based on criteria reported by Sorror et al. 0/1-2/>2

Frailty Scoring/Outcome Scoring Systems for Transplant-Ineligible Patients

IMWG Age/CCI/IADL/ADL Fit/Non-frail/Frail
Simplified IMWG Age/CCI/ECOG PS Fit/Non-frail/Frail

R-MCI Age/eGFR/Lung disease/KPS/Frailty/Cytogenetics Fit/ntermediate-fit/Frail
UK MRP Age/PS/CRP/ISS Low-/Medium-/High-Risk
Mayo frailty Age/PS/NT-BNP 1/0/00/1V.

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Abbreviations and References

Multiple Myeloma Is a Disease of Older People
Abbreviation(s): RCT: randomised control trial.

Reference(s): Terpos E et al. Blood Cancer J. 2021,11(2):40.
What Impacts Outcomes in Older Patients?
Reference(s): Pawiyn C et al. Leukemia. 2020;34(2):604-612.

Heterogeneity Amongst Older Patients: Who Do We Consider Unfit?

Reference(s): Fried LP et al. Nat Aging. 2021;1:36-46.
Fried LP et al. J Gerontol A Biol Sci Med. 2004;5%(3): M255-M263.
Collard RM et al. J Am Geriatr Soc. 2012;60(8):1487-1492.

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Abbreviations and References (Cont'd)

How Do We Define “Fit” Patients With Myeloma?

Abbreviation(s): ADL: activities of daily living; CCI: Charlson Comorbidity Index; CRP: C-reactive protein;

ECOG: Eastern Cooperative Oncology Group Performance Status; eGFR: estimated glomerular filtration rate;

HCT-Ci: hematopoietic cell transplantation comorbidity index; IADL: instrumental activities of daily living;

IMWG: International Myeloma Working Group; ISS: International Scoring System; KPS: Karnofsky Performance Scale;
MRP: UK Myeloma Research Alliance Risk Profile; NT-BNP: B-natriuretic peptide; PS: performance status; R-MCt Revised
Myeloma Comorbidity Index.

Reference(s): Pawiyn C et al. Hematology Am Soc Hematol Educ Program. 2022:2022(1):337-348.

Cook G et al. Leukemia, 2020;34:2285-2294,

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Part 2 of 4: Individu ing Approaches for Initial Treatment:
What Should We Consider for Our Older and/or Unfit Patients?

Shaji Kumar, MD

Professor of Medicine and Chair of Hematology Research
Mayo Clinic

Rochester, Minnesota, USA

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11. PeerVoice

Disclosures

Shaji Kumar, MD, has a financial interest/relationship or affiliation in the form of:
Consultant for work with personal payments from Antengene Corporation; Calyx;
and CVS Caremark.

Grant/Research Support from clinical trial work via his institution with AbbVie
Inc.; Amgen Inc.; Bristol Myers Squibb Company; CARsgenTherapeutics Co. Ltd.;
F. Hoffmann-La Roche Ltd.; Genentech, Inc.; GSK plc.; Janssen Inc.; Sanofi;
Takeda Pharmaceutical Company Limited; and Telo Genomics.

Consultant for work without personal payments from AbbVie Inc.; Amgen Inc.;
Arcellx; BeiGene; Bristol Myers Squibb Company; CARsgenTherapeutics Co. Ltd.;
F. Hoffmann-La Roche Ltd.; Genentech, Inc.; Glycostem Therapeutics B.V.; GSK
plc.; Ipsen Biopharmaceuticals, Inc.; K36 Therapeutics; Moderna, Inc.; Pfizer Inc.;
Regeneron Pharmaceuticals, Inc.; Sanofi; Takeda Pharmaceutical Company
Limited; Telo Genomics; The Menarini Group; and Window Therapeutics.

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Outcomes of Frail Patients in Phase 3 Trials

SWOG SO777: OS 3 E
u Frailty Subgroup Frailty Subgroup
= Analysis of MAIA Analysis of ALCYONE
u 8 D-RA TNF) Eno
a se E D-VMP (TNF),
AAA E Da (trai) median: 457 mo
Time From Registration,mo @ à a =
ES Rian, 8 MP (rai,
Medianin 2 ® median: 417 mo À fan: 329 mo
Deaths/N Months Zi. Rd (tral), 5 MP (fra).
Rd<65y 57/19 98(67) À medion 304mo À VMP (TNF), median: 191 mo medien: 195 mo
Rd265y 68/106 $6 (45, 71) o REREETTE TENTE)
VRd «By 48/44 NR tererrrerrsr rrr?
VRd265y 54/91 65(54, 82) Months Months
‘Age <65 years: HR = 0.640 (0.421, 0.973); Total—non-trail Total—non-frail
stratified, two-sided P = 028 HR 0.48; 95% CL 034-068; P < 0001 HR, 0.36; 95% CL 0.28-0.47;P <.0001
Age 265: 0.769 (0.520, 1138); Frail Frail
stratified, two-sided 168 HR, 0.62; 95% Cl, 0.45-0.85; P = 003 HR, 0.51, 95% CL 0.39-0.68; P < .0001

Not head-to-head comparisons; for illustrative purposes only.

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Treatment Regimens for Transplant-Ineligible Patients

Probability of
Treatment Being

REF = Rd cont PFS HR CRLLL CRLUL Better Than Rd cont, %
D-Rd 0.53 0.43 0.66 100
D-VMP 0.58 0.37 0.93 98.9

VRd 0.77 0.55 108 93.2
MPR-R 100 0.55 179 501

VMP 139 0.92 21 6.0

Rdl8 143 1.23 1.66 o

MPT 1.45 125 168 o

CTD 198 152 259 o

MP 2.49 199 312 o

00 10 so
PFS (using simplified evidence network of main relevant comparators in Europe)

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Evolution of Front-Line Therapy Recommendations in NDMM

Yes No 2019
+
Fit patients <70 First option: 3 2018
years without D-Rd 3
comorbidities, D-VMP 2 2014
induction VRd Ss
therapy E
followed by Iffirst option < 2008
HDM and ASCT not available: °
recommended VMP 1989]
treatment Rd 3y ay Sy Sy Expected 7y

Median Overall Survival

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Ongoing Trial — Frailty-Adjusted Therapy in Transplant

Ineligible Patients With NDMM

Is IMWG FS predictive of outcome? Can it be used to direct care?

The UKMRA Myeloma XIV FiTNEss trial
Induction (12 cycles)

Maintenance (to
PD or intolerance)

STO - Ixazomib 4 mg di, 8,15 ‘domi,
(standard ee
dosing) pl
RI
Fit Unfit Frail Days
Adaptive (IMWG ; > s
frailty scoring Ixazomib amg 4mg 4mg 18,15 Lönalldeimids
adjusted dosing) MESA 25mg 15mg 10mg me
Dexar 40mg 20mg 10mg

Does doublet maintenance therapy (ixazomib + lenalidomide) improve outcomes, when compared

with single-agent lenalidomide, without prohibitive toxic effects?

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IMROZ: Isa-VRs vs VRd in Transplant-Ineligible NDMM

162 PFS events: 84 (31.7%) in Isa-VRd; 78 (43.1%) in VRd
— ise-VRd

— VRd
+ Censor

60-mo PFS rate: 632%
PFS: NR

+ 446 patients 1
- <80 years

HR, 0.596 (98.5% Cl, 0.406-0.876)

Log-Rank P = .0005

© 6 BR 18 24 30 36 42 48 54 60 66 72 78
Time, mo

on —
bombo 260 MANTA me |

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BENEFIT/IFM2020-05 Isa-VRd vs Isa-Rd

Primary Endpoint: MRD- Rate at 18 Months (ITT Population)

3 OR (95% Cl):
258 hed 3.16 (189-5.28)
60 P<.0001 P «.0001
OR (95% Cl):
50 OR(95% CI): | Bussen
2.97 (16-5.5) $ P= 0006

x 40 P=0005 | 8
rm 5 y
§ 30 a > 36
= Ss
ë E Misa-VRd
=> = m isa-Rd

10 A

o
10 10°

Rd was well tolerated, and the

of each agent; grade

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Abbreviations and References

Outcomes of Frail Patients in Phase 3 Trials

Abbreviation(s): D-Rd: daratumumab, lenalidomide, and dexamethasone; D-VMP: daratumumab, bortezomib,
melphalan, and prednisone; Rd: lenalidomide and dexamethasone; TNF: total—non-frail; VMP: bortezomib, melphalan,
and prednisone; VRd: bortezomib, lenalidomide, and dexamethasone.

Reference(s): Facon T et al. Leukemia. 2022:36(4):1066-1077.

Mateos MV et al. Clin Lymphoma Myeloma Leuk. 2021;21(N1):785-798.

Durie BGM et al. Blood Cancer J. 2020;10(5):53.

Facon T et al. Blood. 2021;137(26):3616-3628.

Treatment Regimens for Transplant-Ineligible Patients

Abbreviation(s): CRL: credible; CTD: cyclophosphamide, thalidomide and dexamethasone; LL: lower limit; MP: melphalan
and prednisone; MPR-R: melphalan, prednisone, and lenalidomide as induction with lenalidomide as maintenance;

MPT: melphalan, prednisone, and thalidomide; Rdl8: lenalidomide and dexamethasone, 18 cycles; REF: reference;

UL: upper limi

Reference(s):

‘acon T et al. Adv Ther. 2022;39(8):3868-3869.

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Abbreviations and References (Cont'd)

Evolution of Front-Line Therapy Recommendations in NDMM

Abbreviation(s): ASCT: autologous stem cell transplantation; HDM: high-dose melphalan; NDMM: newly-diagnosed
multiple myeloma.

Reference(s): Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann
Oncol. https://www.annalsofoncology.org/ems/10.1016/.annonc.2020.11.014/attachment/39e08551-cde2-4513-9810-
fe23db917647/mmcl pdf. Accessed 3 July 2024.

Facon T et al. Blood. 2024;143(3):224-232.

Ongoing Trial - Frailty-Adjusted Therapy in Transplant Ineligible Patients With NDMM

Abbreviation(s): FS: frailty score; IMWG: International Myeloma Working Group; PD: progressive disease; UKMRA: United
Kingdom Myeloma Research Alliance.

Reference(s): Coulson AB et al. BMJ Open. 2022;12(6):e056147.

Cook G et al. Lancet. 2022:3(11):E729-E730.

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Abbreviations and References (Cont'd)

IMROZ: Isa-VRd vs VRd in Transplant-Ineligible NDMM

Abbreviation(s): ECOG: Eastern Cooperative Oncology Group Performance Status; eGFR: estimated glomerular
filtration rate; Isa-VRd: isatuximab, bortezomib, lenalidomide, and dexamethasone; MDRD: modification of diet in renal
disease.

Reference(s): Facon T et al. European Hematology Association 2024 (EHA 2024). Abstract S100.

Facon T et al. N Engl J Med. 2024 Jun 3 [Epub ahead of print]. doi:l0.1056/NEJMoa2400712.

BENEFIT/IFM2020-05 Isa-VRd vs Isa-Rd
Abbreviation(s): Isa-Rd: isatuximab, lenalidomide, and dexamethasone; ITT: intent-to-treat; MRD: minimal residual
disease.

Reference(s): Leleu X et al. EHA 2024. Abstract $203.
Leleu X et al. Nat Med. 2024 Jun 3 [Epub ahead of print]. doi:10.1038/s41591-024-03050-2.

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Part 3 of 4: The Emerging Role of Maintenance Therapy in This Population:
What Do the Data Say?

Shaji Kumar, MD

Professor of Medicine and Chair of Hematology Research
Mayo Clinic

Rochester, Minnesota, USA

Copyright © 2010-2024, PeerVoice

22. PeerVoice

Disclosures

Shaji Kumar, MD, has a financial interest/relationship or affiliation in the form of:
Consultant for work with personal payments from Antengene Corporation; Calyx;
and CVS Caremark.

Grant/Research Support from clinical trial work via his institution with AbbVie
Inc.; Amgen Inc.; Bristol Myers Squibb Company; CARsgenTherapeutics Co. Ltd.;
F. Hoffmann-La Roche Ltd.; Genentech, Inc.; GSK plc.; Janssen Inc.; Sanofi;
Takeda Pharmaceutical Company Limited; and Telo Genomics.

Consultant for work without personal payments from AbbVie Inc.; Amgen Inc.;
Arcellx; BeiGene; Bristol Myers Squibb Company; CARsgenTherapeutics Co. Ltd.;
F. Hoffmann-La Roche Ltd.; Genentech, Inc.; Glycostem Therapeutics B.V.; GSK
plc.; Ipsen Biopharmaceuticals, Inc.; K36 Therapeutics; Moderna, Inc.; Pfizer Inc.;
Regeneron Pharmaceuticals, Inc.; Sanofi; Takeda Pharmaceutical Company
Limited; Telo Genomics; The Menarini Group; and Window Therapeutics.

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Continued Therapy Associated With Better Outcomes

2

3

3

2

2 n_Death
a

A — CT 47 M
° — FDT 410 143

HR, 0.69; 95% Cl, 0.54 to 0.88;
P=.003

2 24 36 48 60

Time, mo

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Continuous Lenalidomide

Median PFS,
mo
Continuous 25.5
“ — Ld (n= 535)
so: --- Ld18 (n = 541) 207
- MPT (n= 547) 21.2
À 6
2 HR: 7
S 40 Continuous Ld vs MPT,
5 0.72; P « 001

29 Continuous Ld vs Ldl8,
0.70; P < .001

+

O 6 2 18 24 30 36 42 48 54 60

Time, mo

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Daratumumab-Lenalidomide Duration

+ With a median follow-up
of 56.2 months, an OS 100
benefit was observed
for D-Rd patients who 80

D-Rd
218 mo

received treatment E

for 218 months vs 5 © Median. NR
<18 months (HR, 0.16; ES

95% Cl, 0.1-0.25; a 40 D-Rd

P «.0001) ” m 18 mo

HR, 016 (95% Cl, 01-0.25) MEIN ZONEN
P<.0001

r — — ——
0 6 12 18 24 30 36 42 48 54 60 66 72

Time, mo

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Ixazomib vs Placebo Postinduction Maintenance Therapy in

NDMM by Age and Frailty

TOURMALINE-MM4

bazomib 425 228 174
Placebo 281 198 94

2

Log-rank test P < 001
Median follow-up, 211 mo

2

2

2

24.1% (95% Cl,
18.5% to 30.2%) |

PFS, Probability

o

0 36 9 0582124273033 36 30 42 45 48

Time Since Random Assignment, mo

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[HR (95% C),0659(0542t0080) |

mPFS
Age HR (95% cl)
<65 years 0.576 (0299-1108)
65-74 years 0.615 (0467-0810)
275 years 0.740 (0537-100)

Fit 0.530 (0.387-0.727)

Intermediate-fit 0.746 (0.526-1058)

Frail 0.733 (0.481-1117)

Frailty

status 5 10 5 20
Tien’, mo I xazomib,
3 Placebo

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Abbreviations and References

Continued Therapy Associated With Better Outcomes
Abbreviation(s): CT: continuous therapy; FDT: fixed duration of therapy.
Reference(s): Palumbo A et al. J Clin Oncol. 2015;33(30):3459-3466.
Continuous Lenalidomide

Abbreviation(s): Ld: lenalidomide and dexamethasone; Ldl8: lenalidomide and dexamethasone, 18 cycles;
MPT: melphalan, prednisone, and thalidomide.
Reference(s): Benboubker L et al. N Engl J Med. 2014;371:906-917.

Daratumumab-Lenalidomide Duration

Abbreviation(s): D-Rd: daratumumab, lenalidomide, and dexamethasone.
Reference(s): Benboubker L et al. N Engl J Med. 2014;371:906-917.

Ixazoı vs Placebo Postinduction Maintenance Therapy in NDMM by Age and Frailty

Abbreviation(s): NDMM: newiy-diagnosed multiple myeloma.
Reference(s): Dimopoulos MA et al. J Clin Oncol. 2022;40(8):919.
Bringhen S et al. Clin Lymphoma Myeloma Leuk. 2023;23(7):491-504.

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Part 4 of 4: Responding to Progression to Relapsed/Refractory
Multiple Myeloma: What Are Our Options for These Patients?

Shaji Kumar, MD

Professor of Medicine and Chair of Hematology Research
Mayo Clinic

Rochester, Minnesota, USA

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29. PeerVoice

Disclosures

Shaji Kumar, MD, has a financial interest/relationship or affiliation in the form of:
Consultant for work with personal payments from Antengene Corporation; Calyx;
and CVS Caremark.

Grant/Research Support from clinical trial work via his institution with AbbVie
Inc.; Amgen Inc.; Bristol Myers Squibb Company; CARsgenTherapeutics Co. Ltd.;
F. Hoffmann-La Roche Ltd.; Genentech, Inc.; GSK plc.; Janssen Inc.; Sanofi;
Takeda Pharmaceutical Company Limited; and Telo Genomics.

Consultant for work without personal payments from AbbVie Inc.; Amgen Inc.;
Arcellx; BeiGene; Bristol Myers Squibb Company; CARsgenTherapeutics Co. Ltd.;
F. Hoffmann-La Roche Ltd.; Genentech, Inc.; Glycostem Therapeutics B.V.; GSK
plc.; Ipsen Biopharmaceuticals, Inc.; K36 Therapeutics; Moderna, Inc.; Pfizer Inc.;
Regeneron Pharmaceuticals, Inc.; Sanofi; Takeda Pharmaceutical Company
Limited; Telo Genomics; The Menarini Group; and Window Therapeutics.

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Relapsed Mul

ple Myeloma Studies in Frail Patients

Intervention vs
pes tome SonttolAnm | rs | ime See

OPTIMISMM
(2022; n = 559)

CANDOR
(2022; n = 446)

BOSTON
(2021; n = 402)

ICARIA
(2021,n = 307)

ASPIRE
(2020; n = 792)

ENDEAVOR
(2020; n = 929)

ARROW
(2020; n = 478)

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Pom/Bort/Dex vs
Bort/Dex

Dara/Car/Dex vs
Car/Dex

Seli/Bort/Dex vs
Bort/Dex

Isa/Pom/Dex vs
Pom/Dex

Car/Len/Dex vs
Len/Dex

Car/Dex vs
Bort/Dex

Car/Dex,
70 vs 27 mg/m?

9.7 vs 51,
P=.0006

18.5 vs 9.3,
HR 0.66, 0.38-114

13.93 vs 9.46,
HR 0.69, P =.081

9.0 vs 45,
HR 0.81, P = 493

241 vs 15.9,
HR 0.78, P=.085

18.7 vs 6.6,
HR O55, P <.01

10.3 vs 6.6,
HR 0.76, P = .098

79.6% vs 41.9%, P <.001

75% vs 54%, PNA

69.7% vs 60.9%, P =.148

52.1% vs 34.2%, P =.048

84% vs 64%, PNA

76% vs 54%, PNA

56% vs 41%, PNA

Grade 23 TEAE
(96.8 vs 87.9%)

Grade 23 TEAE
(91% and 90%)

Serious TEAE
(59.1% vs 48.4%)

Grade 3 TEAE
(91.7% vs 80.6%)

Grade 23 TEAE
(93% vs 94%)

Grade 23 TEAE
(85% vs 79%)

Grade 23 TEAE
(81% vs 70%)

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How to Choose Treatment

+» Prior drug exposure/refractory status
+ High risk versus standard risk Geriatric

= ne assessment
+ Age, frailty, and comorbidity
+ Toxicity with prior drugs

+ Transplant eligibility/prior transplant Myeloma Treatment

tati di
+ Patient preference/goals of care a" =

+ Logistics of drug administration

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Real-World REMIX Study in RRMM

Ixazomib combined with lenalidomide and dexamethasone

+ Cansored 2 + Censored
Go
E E
3 3
à 05 & 05
E E
E 02 302
5 5
a a
o o
0369115182124 30 36 42 48 036911518 2124 30 36 42 48
PFS in Months PFS in Months
(Disease Progression or Death) (Disease Progression or Death)
Group age —1:280y — 2:<80y Simplified frailty scale — Frail — Non-frail

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All-Oral Triplet Iberdomide Ixazomib and Dexamethasone in

Elderly Patients at First Relapse

New possibility
post D-Rd or Isa-
VRd, older patients

Age 270,
29% >80 years

50% >2 IMWG frailty

score
RRMM; 1 prior line
ECOG 0-2
CrCl 230 mL/min
ANC >1000 G/L
Plt >75 G/L

IFM Phase 2 Study 12D

mFU 14 mo
ORR 65% (36%
VGPR/CR)
12-mo PFS 52%
12-mo DOR 76%
12-mo OS 86%

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Treatment Algorithms in RRMM

Relapsed Myeloma: First Relapse
{ y

Refractory to lenalidomide

Alternative: K-Rd
Frail: I-Rd, E-Rd

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35. PeerVoice

Abbreviations and References

Relapsed Multiple Myeloma Studies in Frail Patients

Abbreviation(s): AE: adverse event; Bort: bortezomib; Car: carfilzomib; Dara: daratumumab; Dex: dexamethasone;
Isa: isatuximab; Pom: pomalidomide; Seli: selinexor; TEAE: treatment-emergent adverse event.

Reference(s): Mian H et al. Blood Cancer J. 2023;13(6). doi:10.1038/s41408-022-00779-2.

Facon T et al. Blood Adv. 2020;4(21):5449-5459.

Grant SJ et al. Hematology Am Soc Hematol Educ Program. 2021;1:46-54,

Nathwani N et al. Am Soc Clin Oncol Educ Book. 2021;41:358-375.

How to Choose Treatment

Reference(s): Dimopoulos MA et al. J Clin Oncol. 2022;40(8):919.
Dimopoulos MA et al. J Clin Oncol. 2020;38(34):4030-4041.
Bringhen S et al. Clin Lymphoma Myeloma Leuk. 2023;23(7):491-504.

Real-World REMIX Study in RRMM

Abbreviation(s): RRMM: relapsed refractory multiple myeloma.
Reference(s): Macro M et al. Ann Hematol. 2023;102(8):2137-2151.

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Abbreviations and References (Cont'd)

All-Oral Triplet Iberdomide Ixazomib and Dexamethasone in Elderly Patients at First Relapse

Abbreviation(s): ANC: absolute neutrophil count; CR: complete response; CrCl: creatinine clearance; DOR: duration of
response; D-Rd: daratumumab, lenalidomide, and dexamethasone; ECOG: Eastern Cooperative Oncology Group
Performance Status; IFM: Intergroupe Francophone du Myélome; IMWG: International Myeloma Working Group;
Isa-VRd: isatuximab, bortezomib, lenalidomide, and dexamethasone; mFU: median follow-up; Pit: platelet count;
VGPR: very good partial response.

Reference(s): Touzeau C et al. EHA 2024. Abstract P9I6.

Treatment Algorithms in RRMM

Abbreviation(s): D-Kd: daratumumab, carfilzomib, and dexamethasone; D-Pd: daratumumab, pomalidomide, and
dexamethasone; D-Vd: daratumumab, bortezomib, and dexamethasone; E-Pd: elotuzumab, pomalidomide, and
dexamethasone; E-Rd: elotuzumab, lenalidomide, and dexamethasone; I-Pd: ixazomib, pomalidomide, and
dexamethasone; I-Rd: ixazomib, lenalidomide, and dexamethasone; Isa-Pd: isatuximab, pomalidomide, and
dexamethasone; K-Pd: carfilzomib, pomalidomide, and dexamethasone; K-Rd: carfilozomib, lenalidomide, and
dexamethasone; V-Cd: bortezomib and cyclophosphamide.
Reference(s): Rajkumar SV, Kumar S. Blood Cancer J. 2020;10:94.

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