Ben Derman @bdermanmd Twitter profile

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Ben Derman

@bdermanmd

3 years

The @UChicago campus is simply stunning right now! Reminded of this beautiful short story by O. Henry “The Last Leaf” about the sacrifices people make for the ones they love.

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Ben Derman

@bdermanmd

2 years

What a difference 4 cycles of quadruplet induction can make in myeloma. Before (left) and after (right). Brings me so much joy! Next stop: MRD-negativity please. #mmsm

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Ben Derman

@bdermanmd

4 years

A bit of personal news: I have joined the faculty @UCCancerCenter as part of the plasma cell disorders program. I am incredibly grateful to the many influential mentors who have guided me along the way & I will continue working toward making the lives of myeloma pts better!

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Ben Derman

@bdermanmd

2 years

Are we curing myeloma? I think we are in some cases. Maybe this patient is on their way! Off therapy for 2 years now and MRD negative by NGS since then! What do you think? #mmMRD #mmsm

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Ben Derman

@bdermanmd

6 months

In anticipation of #ASH23 , I have scoured the conference abstracts. Here's what I think are 10 important abstracts on myeloma! A little bit of everything - newly diagnosed myeloma, CAR T/BsAb, and diganostics! Let’s go! #mmsm

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Ben Derman

@bdermanmd

2 years

What does a 'cure' mean in multiple myeloma? Is it even possible? In this review, we first try to define a cure and then provide the evidence for why some patients may actually reach this milestone. First: our definition (see below).

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Ben Derman

@bdermanmd

3 years

A liquid biopsy for myeloma may be closer than we think! Excited to share our work on MRD in the peripheral blood using mass spectrometry! We found mass spec may exceed the sensitivity of bone marrow based methods w/superior prognostication #mmsm #mmMRD

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Ben Derman

@bdermanmd

1 year

Are you ready for an #ASCO23 myeloma megathread? Here are 10 important abstracts to tune into to learn more (esp. with so little data in the abstract!). Let's go! #mmsm

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Ben Derman

@bdermanmd

1 year

So many excellent #ASH22 abstracts to choose from. Sharing my thoughts on 11 important works, with more to come as we get closer to the meeting! In order of abstract number (not merit)...let's go! #mmsm

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Ben Derman

@bdermanmd

3 months

"Maybe you can't drive this CAR?" - my thoughts on the thought-provoking letter about the true reach of CAR T in advanced heme malignancies. Using cancer-specific death data as a stand-in for eligibility, authors found 'real-world' ORR to be only 3.4%.

Maybe you can’t drive this CAR?

In this issue of Blood Advances, Haslam et al1 have written a provocative article describing the true reach of chimeric antigen receptor T-cell therapy (CA

ashpublications.org

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Ben Derman

@bdermanmd

1 year

Results of ALLO-715, an allogeneic BCMA-targeting CAR T cell therapy are published. Novel features to this product: ‼️ Has rituximab kill switch ‼️ Knockout of the T cell receptor alpha constant (TRAC) to reduce GVHD risk ‼️ Knockout CD52 /1 #mmsm

Allogeneic BCMA-targeting CAR T cells in relapsed/refractory multiple myeloma: phase 1 UNIVERSAL...

Nature Medicine - In an interim phase 1 trial analysis, escalating doses of off-the-shelf allogeneic anti-BCMA CAR T cells, in combination with an anti-CD52 antibody-containing lymphodepletion...

www.nature.com

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Ben Derman

@bdermanmd

10 months

Sayonara myeloma! MRD-negative for at least 3 years running since stopping lenalidomide maintenance. Amazing!! #mmMRD #mmsm

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Ben Derman

@bdermanmd

6 months

How I treat with Dara-VRd: 28-day cycles - Dara weekly C1-2, q2wk C3-6, q4wk - Bortezomib 1.3 mg/m2 weekly - Len 25 mg D1-21 (adjust for renal fxn) - Dex 20-40 mg D1/8/15/22 If goes to ASCT (usually after 4 cycles): Std-risk/good response: Len High-risk: PI, Len +/- Dara

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Ben Derman

@bdermanmd

2 years

In anticipation of a multifaceted education program at #ASCO22 on monoclonal gammopathies that AREN'T multiple myeloma, here is our collaboration in the ASCO ed book on smoldering MM, amyloidosis, & waldenstrom's/LPL. #mmsm #amyloidosis #lymsm @mbeksac56

When a Monoclonal Gammopathy Is Not Multiple Myeloma

Our knowledge of monoclonal gammopathies is continuously evolving. Once accepted as a possible precursor condition to multiple myeloma, monoclonal gammopathies as an entity are now associated with...

ascopubs.org

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Ben Derman

@bdermanmd

1 year

We are excited to have presented initial data from MRD2STOP. A short summary of what we're doing & what we've found: - We are stopping maintenance therapy for patients with multimodal MRD-negativity (10^-6) - Piloting a CD138-enrichment strategy to achieve MRD 10^-7 #mmMRD #mmsm

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Ben Derman

@bdermanmd

5 years

Elevated PTT is one of my favorite types of consults, but I think there are a few things that every clinician should assess before consulting: (1) Is the patient on heparin? If yes, there's your answer :) (2) No, really, is the patient receiving heparin? Hep Lock, etc. ... #MedEd

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Ben Derman

@bdermanmd

5 months

Excited to share our review on MRD and decision-making in myeloma. We cover the latest in tech, incl. mass spec, and we delve into the case for MRD to guide decision-making. Was great to work with @Rfonsi1 on this! #mmsm #mmMRD (free link)

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Ben Derman

@bdermanmd

2 years

If I could give you a quarter of your year to do whatever you want, how would you spend it? Some of my patients spend it getting chemotherapy. This is a story of how a patient with myeloma helped me explore the time demands of treatment. #mmsm

Around the World in 80 Days

It started out earnestly, I promise: “For each of the first two cycles of chemotherapy, you will have to come to clinic seven times and…

medium.com

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Ben Derman

@bdermanmd

3 years

Friday good news: 2 myeloma patients this week have recovered their renal function and come off dialysis, one of them 4 months and the other 6 months after diagnosis! Amazing!

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Ben Derman

@bdermanmd

1 year

We summarized the recent hypercalcemia of malignancy guidelines. It’s a nice manuscript. I disagree with rec of denosumab over bisphosphonates w/out evidence from RCT. Hypocalcemia is common with anti-resorptives in CKD and not considered in recs

Endocrine Society Hypercalcemia of Malignancy Guidelines

This guideline synopsis summarizes the Endocrine Society guidelines for hypercalcemia of malignancy in adults.

jamanetwork.com

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Ben Derman

@bdermanmd

3 months

Out in @Bloodneoplasia ! For those with myeloma who did not receive frontline Dara, which Dara-regimen is best? Dara-Vd? Dara-Pd? Dara-Kd? We tried to answer this question in a fun collaboration with COTA using their real world database. A #mmsm 🧵

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Ben Derman

@bdermanmd

4 years

Phase 2 study of KRd + ASCT in newly diagnosed #mmsm by @jagoda_jasielec is out in Blood. This is important in light of the ENDURANCE trial showing no diff. btwn VRd and KRd in std-risk ASCT-ineligible pts? (Disclosure: I am an author on this study) /1

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Ben Derman

@bdermanmd

5 years

Patient presented to clinic with mental fogginess and abnormal lab results. Here is the smear. Got the diagnosis? #meded 1/

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Ben Derman

@bdermanmd

2 months

Should MRD negativity be accepted as a surrogate endpoint for clinical trials in myeloma? What should be part of the FDA discussion tomorrow about MRD? #mmsm #mmMRD 🧵

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Ben Derman

@bdermanmd

2 years

If you are going to treat smoldering myeloma, please consider the following: 1) Are you going to collect stem cells? (You should) 2) Are you going to achieve CR? (You will not) 3) What to do at 'progression' (len-refractory)? 4) Are we curing smoldering MM? Not more than MM

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Ben Derman

@bdermanmd

3 years

In reference to the abstracts yesterday on 1st relapse in myeloma. Tried to summarize in digestible format. Any comments/corrections? #mmsm

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Ben Derman

@bdermanmd

1 year

📢CARTITUDE-4: Cilta-cel vs SOC (DPd, VPd) for 1-3 prior lines RRMM by @bhemato 👉median f/u 15.9 mos. Primary endpt PFS #⃣419 pts, 208 to cilta-cel, 211 to SOC ⚠️32 (15%) did not receive cilta-cel after apheresis 👍60% high-risk cyto! ⚠️ 15% triple-class ref #mmsm #ASCO23

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Ben Derman

@bdermanmd

10 months

Talquetamab approved and package insert shares some similarities with tec: 1) Same REMS program for clinicians. 2) Step up dosing language similar One of the big differences is the option for biweekly dosing. Supportive care also key (more on that)

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Ben Derman

@bdermanmd

1 year

If you're reading some news today & 💭 "What about KPd?", check out our just-published phase I/II study of KPd and Dara-KPd in R/R MM. ☀️KPd ORR 86%, mPFS 13 mos, mOS 44 mos. ☀️Dara-KPd ORR 89%, MRD-neg (10^-5) 65%, mPFS NR @ 26 months #mmsm

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Ben Derman

@bdermanmd

3 years

Everything you ever wanted to know abt high risk MM is in our new review: "Knowing the Unknowns in High Risk Multiple Myeloma". Definitions, induction, transplant x 1-2, post-transplant therapies, & more. Summary tables & graphics galore.

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Ben Derman

@bdermanmd

2 years

What happens if you stop treatment in patients with myeloma with sustained MRD-neg? Looking forward to sharing our early data from the MRD2STOP experience! We will also present on a strategy to potentially deepen MRD sensitivity to 10^-7!

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Ben Derman

@bdermanmd

1 year

The GMMG-Concept trial w/Isa-KRd for high risk MM. Amazing that 45% had del17p! High MRD-neg (10^-5) rates for both transplant eligible and ineligible (68% and 54%). Validates the approach of extended anti-CD38 + KRd for high-risk. There may not be any shortcuts for HRMM! #ASH22

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Ben Derman

@bdermanmd

1 month

5-year follow-up from the LEGEND-2 study of cilta-cel ⏳ 5-year PFS 21% and OS 49% (despite variable LD). 3 progressions after 5 years. No plateau! 🧠No delayed neurotox 🩸No 2nd heme malignancies 🏋️T cells persisted >1 year for VGPR+ (1 at 5.6 years!)

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Ben Derman

@bdermanmd

1 year

I get asked all the time: Can MRD status guide treatment decision in myeloma? 📜A separate thread dedicated to #ASH22 studies investigating #mmMRD -guided management in myeloma. I will post lots more about our MRD2STOP study as we get closer to the conference! #mmsm

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Ben Derman

@bdermanmd

2 years

🧵📢Out in @JAMAOnc : Phase 2 MRD-adapted Elo-KRd without ASCT in newly diagnosed MM. 🗓12 cycles EloKRd; MRD guided de-escalation of K N=46 -48% w/high risk cyto -Rate of sCR and/or MRD neg by NGS (10^-5) after 8 cycles: 58% - Best response: MRD neg 70%

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Ben Derman

@bdermanmd

3 years

WOW: CARTITUDE-1. ORR 97%, sCR 67%, sCR+MRD-neg 34%. 12-month PFS 76.6%, 12-month OS 89%. CRS G3+ 5%, ICANS G3+ 2% with add'l neurotoxicities. #mmsm

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Ben Derman

@bdermanmd

1 year

@Dr_RShatsky So many great responses here. Similarly, I like to communicate that we need both faith AND science to treat cancer. Not faith OR science, but AND!

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Ben Derman

@bdermanmd

4 years

FDA ODAC voted 12-0 in favor of belantamab mafodotin for relapsed/refractory myeloma. The keratopathy with belamaf is real but manageable, and patients should be able to determine whether they accept this risk during consent process.

FDA Panel Supports Belantamab Mafodotin for Relapsed/Refractory Myeloma

The FDA’s Oncologic Drugs Advisory Committee voted 12 to 0 in favor of approving belantamab mafodotin for the treatment of patients with relapsed/refractory multiple myeloma who have previously...

www.onclive.com

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Ben Derman

@bdermanmd

1 year

A 🧵 on BCMA-directed therapies that are approved thru a comparative lens: Ide-cel: In phase 2 karMMa, ORR 73% and mPFS 8.8 months. These were high-risk pts! -39% extramedullary dz -35% HR cyto (70% if include 1q amp) -84% triple class refractory/26% Pentafractory #mmsm

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Ben Derman

@bdermanmd

2 years

As always, a beautiful and thoughtful discussion by @jmikhaelmd summarizing implications of DETERMINATION. We need to meet patients where they are at! #ASCO22 #mmsm

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Ben Derman

@bdermanmd

9 months

How about this for some friday good news! A lovely octogenarian with 4 prior lines of therapy and a t(11;14). Started venetoclax-based regimen, and here are the results after 1 week! Now let's hope it's a durable response! #mmsm

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Ben Derman

@bdermanmd

3 years

One of the great joys of treating myeloma - with quick action we can make a difference quickly. Ex. Patient with primary plasma cell leukemia AND hyperviscosity syndrome. No HD, just good therapy and excellent supportive care! We have more work to do! #mmsm

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Ben Derman

@bdermanmd

3 years

Kudos to @ASCO for again highlighting excellent myeloma abstracts. Here are my top 10 most intriguing, in order by abstract number. Many other excellent abstracts as well not included! #mmsm #ASCO21

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Ben Derman

@bdermanmd

4 years

Find this fascinating. 9% of Myeloma ASCT recipients without maintenance had >8 year PFS. This is why we need to identify patients post transplant on maintenance who are deep responders so we spare them extended/indefinite maintenance #mmsm

Characteristics of exceptional responders to autologous stem cell transplantation in multiple...

Blood Cancer Journal - Characteristics of exceptional responders to autologous stem cell transplantation in multiple myeloma

www.nature.com

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Ben Derman

@bdermanmd

2 years

Think about this myeloma-ologists: For every 30 patients we start on lenalidomide with absolutely no intention to stop, 1 will receive that horrible news one day that they now have a second blood cancer.

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Ben Derman

@bdermanmd

5 years

Exciting to see results of lenalidomide in smoldering myeloma. It’s clear that lenalidomide prolongs time to progression and to symptomatic disease. I will point out reasons why I am not ready to use this regimen for smoldering myeloma. [thread] #mmsm

Randomized Trial of Lenalidomide Versus Observation in Smoldering Multiple Myeloma

PURPOSE Observation is the current standard of care for smoldering multiple myeloma. We hypothesized that early intervention with lenalidomide could delay progression to symptomatic multiple myeloma....

ascopubs.org

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Ben Derman

@bdermanmd

6 years

Ruxolitinib for myelofibrosis is not without significant toxicities. Think twice before starting? #ASHMHM18

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Ben Derman

@bdermanmd

6 months

Great presentation by @SusanBal9 on BMS-986393 - longer term follow-up confirms high ORR with a median DOR of 13 months in a heavily pretreated population. I was hoping we might see some long-term responders but not quite yet! #ASH23

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Ben Derman

@bdermanmd

2 years

Amidst the #ASH21 excitement, I wanted to share some of the work that I am involved in. 1) Phase 2 Extended Dara-KRd without ASCT. 24 cycles. Young fit group, nearly half w/high-risk dz. Will present updated MRD data that will make you think! #mmsm #mmMRD

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Ben Derman

@bdermanmd

2 years

This is one of the more important slides I have seen from @End_myeloma - even quadruplet + ASCT doesn't work very well for ultra high-risk patients. And stopping treatment in those with deep responses led to early relapse. This is tough!

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Ben Derman

@bdermanmd

2 years

An impassioned argument against the use of MRD to guide decision making in myeloma by @SagarLonialMD . His concerns below. Hard to refute all points at once. But curious to know how you might be using or not using MRD in certain clinical situations:

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Ben Derman

@bdermanmd

3 years

I am in need of some important myeloma history: How did the increase of M-spike/light chains of 25% (e.g., at least 0.5 g/dL or 10 mg/dL) come to be the standard for biochemical progression in myeloma? Was this based on expert opinion or some analyses? @VincentRK @myelomaMD

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Ben Derman

@bdermanmd

4 months

Wow - DreaMM-7 results look pretty great from efficacy standpoint! 36.6 months mPFS (vs 13.3 months for Dara-Vd) & OS benefit may be shown as well! Will need to see post protocol therapies but encouraging interim analysis. Now we need to see what toxicity looks like. #mmsm

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Ben Derman

@bdermanmd

7 months

One of those days...

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Ben Derman

@bdermanmd

1 year

KarMMa-3: Phase 3 Ide-cel vs SOC (DaraVd, DaraPd, EloPd, IRd, Kd), 2:1 random (my 💭 at the end) 👉2-4 prior LOT, triple class exposed ⚠️n=254 Ide-cel. 19 (8%) didn't receive b/c of death/manufac failure/withdrawal by MD ⚠️n=132 SOC. No antiCD38/Kd #mmsm

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Ben Derman

@bdermanmd

1 year

Big question from this year’s #ASH22 : can multiple bcma-directed therapies be used in the same patient over time? Data on sBCMA levels returning to baseline after relapse from belamaf suggests that we probably can effectively target bcma again.

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Ben Derman

@bdermanmd

2 years

Looking forward to #ASCO22 and hearing more about the latest and greatest in myeloma #mmsm . Here are my top abstracts, focusing on novelty and applicability to practice, in no particular order....

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Ben Derman

@bdermanmd

2 years

Anyone want to get into the weeds with MRD in myeloma? Has the 10^-x designation confused you? What is the significance of these designations anyhow? Can we use this clinically? #mmMRD 1/x

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Ben Derman

@bdermanmd

1 year

OPTIMUM MUK9 @MyMKaiser : Extended 'kitchen sink' approach for ultra high risk #mmsm . Amazing effort & it's paying off. 30-month PFS is 77%. MRD(-) rates sustained from post-ASCT to subsequent time points. Even OS signal very encouraging. #ASH22

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Ben Derman

@bdermanmd

3 years

Lenalidomide-related muscle cramps - any good suggestions from #MedTwitter and #mmsm ? I often recommend trials of tonic water with quinine, pickle juice, and magnesium. A patient mentioned yellow mustard today (never heard that one).

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Ben Derman

@bdermanmd

17 days

🚨Out now in @BloodJournal led by @t_kubicki We studied blood mass spec (EXENT) as an MRD tool post-transplant in myeloma. What made this analysis unique is that IgG M-proteins persist after destruction of the culprit cells due to recycling /1 #mmMRD

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Ben Derman

@bdermanmd

3 years

Great presentation by @BenDiamondMD on impact of maintenance lenalidomide on MRD. Greatest impact on MRD is in first year. Sustained MRD-neg at 2 years --> no progressions thus far. So is indefinite maintenance really needed? #mmMRD #mmsm

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Ben Derman

@bdermanmd

4 years

Dr Nicole Gormley discusses limitations of MRD and other surrogate endpoints as means for drug approval. Checkpoint inhibitors and venetoclax BELLINI trials serve as cautionary tales. #mmMRD #mmsm #ash19

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Ben Derman

@bdermanmd

2 years

Mass spec is a great monitoring tool...but as a screening tool in myeloma it is flawed: it is too sensitive! In almost all cases, a trivial M-protein detected by mass spec won't be relevant until it at least registers on SPEP/IFIX. Nice work on this here:

Prevalence of heavy chain MGUS by race and family history risk groups using a high-sensitivity...

Key Points. The mass spectrometry assay found over threefold numbers of individuals with MGUS than gel-based assays across 3 risk groups.Relative differenc

ashpublications.org

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Ben Derman

@bdermanmd

3 years

A tour de force by @ninashah33 on state-of-the-(C)AR T and bispecifics in myeloma. Check it out here:

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Ben Derman

@bdermanmd

6 months

IsKia the way to go? MRD as the primary endpoint: 1️⃣ precludes reg approval for isakrd - maybe IMROZ will get Isa into frontline? 2️⃣ sets the stage for understanding how change in MRD corresponds w/change in PFS/OS 3️⃣ will show how outcomes differ for 10^-5 and 10^-6 neg #ASH23

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Ben Derman

@bdermanmd

3 years

Thank you to the @UCHemOncFellows and to @Anand_88_Patel for the kind words. I hope this means I have made SPEPs, light chains, and proteasome inhibition interesting to our future hematology/oncology leaders!

University of Chicago Hem/Onc Fellows

@UCHemOncFellows

3 years

A huge congratulations to @bdermanmd for being the recipient of the 2020-2021 Fellowship Education Award as selected by our fellows! Myeloma clinic is a highlight of the outpatient experience given the amazing teaching fellows get with Dr. Derman!

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Ben Derman

@bdermanmd

2 years

The #ASCO22 meeting is this week! Come in-person or virtually to our education session on Monday June 6 at 1:15 PM CST in room E350. I’ll be discussing smoldering myeloma - To treat or not to treat (maybe not when and how)

Ben Derman

@bdermanmd

2 years

In anticipation of a multifaceted education program at #ASCO22 on monoclonal gammopathies that AREN'T multiple myeloma, here is our collaboration in the ASCO ed book on smoldering MM, amyloidosis, & waldenstrom's/LPL. #mmsm #amyloidosis #lymsm @mbeksac56

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Ben Derman

@bdermanmd

4 years

So many great abstracts to peruse for #ASCO20 . Some themes: weekly regimens, anti-BCMA therapies, MRD, & high-risk disease. By abstract #, here are 10(ish) #ASCO20 abstracts that stood out to me for their clinical relevance and intrigue. Long thread incoming! #mmsm #ASCO20BD /1

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Ben Derman

@bdermanmd

2 months

Things are about to get interesting- that’s for sure! Great news that Carvykti approved for second line and beyond! Who should get in second line is a big question - Will be a nuanced discussion!

Legend Biotech’s CARVYKTI® (ciltacabtagene autoleucel) Becomes the First and Only BCMA-Targeted...

Legend Biotech Corporation (NASDAQ: LEGN) (Legend Biotech), a global leader in cell therapy, announced today the U.S. Food and Drug Administration (FD

www.businesswire.com

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Ben Derman

@bdermanmd

8 months

Amidst the excitement of #IMS23 we saw the publication of the final report of the MASTER trial (though I hope we get to see longer follow-up some day!). It is the culmination of the excellent work of @End_myeloma and the COMMIT team. Bravo! A brief 🧵

Minimal residual disease response-adapted therapy in newly diagnosed multiple myeloma (MASTER):...

This approach provided positive outcomes and a pathway for treatment cessation in most patients with newly diagnosed multiple myeloma. Outcomes for patients with ultra-high-risk multiple myeloma,...

www.thelancet.com

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Ben Derman

@bdermanmd

3 years

Never have I felt that one manuscript captures what makes treating patients with myeloma so rewarding and so challenging better than this one - great work @rajshekharucms @BldCancerDoc

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Ben Derman

@bdermanmd

1 year

Forimtamig - a gprc5d x cd3 bispecific antibody - shows similar efficacy to other bispecifics. CRS rates seem high to me, esp grade 3-4. #ash22 #mmsm

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Ben Derman

@bdermanmd

2 years

I've been looking for an outlet to share my clinical experiences and will be giving this a whirl. The first installment is in part about the bonds we form with patients and my transition from fellowship to attending. Hope you enjoy. #mmsm

Thicker Than Water

Since Jerry’s* diagnosis with multiple myeloma, nothing has been easy for him except perhaps his demeanor and spirit. He was the first new…

link.medium.com

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Ben Derman

@bdermanmd

10 months

Skin, nail, & taste changes are important side effects of talquetamab. For skin changes, which can be desquamating: Ammonium lactate lotion works great. For nail changes: haven’t found anything but time off treatment to work. For dysgeusia: biotene(?) & treat thrush? Add below!

Ben Derman

@bdermanmd

10 months

Talquetamab approved and package insert shares some similarities with tec: 1) Same REMS program for clinicians. 2) Step up dosing language similar One of the big differences is the option for biweekly dosing. Supportive care also key (more on that)

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Ben Derman

@bdermanmd

3 years

Alright stop, vaccinate and listen Pfizer’s back with a brand new invention Something grabs a hold of me tightly Think it’s antibodies daily and nightly Will it ever stop? Yo, I don't know Ribosomes translate and then the proteins go #IGotMyShot

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Ben Derman

@bdermanmd

6 months

Sharing work from our group at #ASH23 in #mmsm ! Dara-KRd x 24 cycles (without ASCT) for newly diagnosed myeloma. The schema is simple: 24 cycles of Dara-KRd. K reduced to Days 1/2/15/16 with cycle 9. Primary endpoint: composite of sCR and/or MRD-neg (10^-5) by NGS after C8 /1

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Ben Derman

@bdermanmd

1 year

Age is but a number (and so is MRD)! An octogenarian patient who received ide-cel and has sustained MRD negativity by NGS (10^-6)! Beautiful! #mmMRD

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Ben Derman

@bdermanmd

4 months

Surprised it took this long for boxed warning on densoumab. I generally refrain from anti-resorptive agents in myeloma with advanced CKD due to severe hypocalcemia. I have used 60 mg but this might not be sufficient reduction.

Osteoporosis drug Prolia increases the risk of severe hypocalcemia

Patients on dialysis or with mineral and bone disorder at highest risk

www.fda.gov

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Ben Derman

@bdermanmd

3 years

I’ve learned people really like fall photos, so here are some more of the @uchicago campus!

Ben Derman

@bdermanmd

3 years

The @UChicago campus is simply stunning right now! Reminded of this beautiful short story by O. Henry “The Last Leaf” about the sacrifices people make for the ones they love.

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Ben Derman

@bdermanmd

9 months

"With so many risk factors identified, it may start to feel like every patient has high risk MM. Soon we may be asking a better question: Who actually has standard-risk disease?”. For @ASCO news...Risky Business: The Challenge With Defining High-Risk MM

Risky Business: Examining the Challenge With Defining High-Risk and Ultra High–Risk Multiple Myeloma

Although high-risk MM typically presents itself with time, there is great interest in identifying the clinical and genomic features of high-risk MM before starting therapy so that we may intervene...

dailynews.ascopubs.org

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Ben Derman

@bdermanmd

3 years

Kudos to the investigators, patients, and sponsor on publication of the ANDROMEDA study. Dara-CyBorD for the win! The organ response rate advantage is the major appeal to me. OS still immature. So where does melphalan/ASCT fall into this paradigm now?!

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Ben Derman

@bdermanmd

4 months

DreaMM-7: Bela-Vd vs Dara-Vd mPFS 36.6 vs 13.4 months Only 33% Len refractory Very few Dara-exposed 34% grade 3 ocular AEs 19% vs 9% discontinuation rate Would ocular AEs be mitigated by different dosing? Could bela-Vd be a good option for post Dara-Rd relapse?

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Ben Derman

@bdermanmd

29 days

This is an excellent piece summarizing what is known about CAR T cell therapy and T cell lymphomas. And with an appearance from @Rfonsi1 !

Do cutting-edge CAR-T-cell therapies cause cancer? What the data say

Nature - Regulators have identified around 30 cases of cancer linked to this blockbuster treatment. But is CAR T to blame? The hunt is on for answers.

www.nature.com

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Ben Derman

@bdermanmd

9 months

The final GRIFFIN analysis is out! What (else) is there to say that hasn't been? 📜Reminder: Randomized phase 2 design, Dara-VRd/ASCT/Dara-R vs VRd/ASCT/R. #⃣n=207 🥇endpoint: sCR after consolidation (1 sided alpha=0.1) Mid-trial: Dara maintenance moved from q8w-->q4w.

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Ben Derman

@bdermanmd

1 year

BMS-986354 presented beautifully by @End_myeloma - A BCMA-directed CAR T cell therapy designed to shorten manufacturing time and enhance durability of response through selection of specific T cell phenotypes. Implications for further CAR t-cell development! #ash22

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Ben Derman

@bdermanmd

10 months

Heavily pretreated patient including prior investigational bcma directed therapy with short response. Now day +60 after cilta-cel. 👍good sample (3.6 mil cells). Tracking 3 highly unique sequences 🙌MRD neg by NGS at 10^-6 My favorite ☎️ to make!

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Ben Derman

@bdermanmd

3 years

Still thinking about this data from ENDURANCE presented by @MyelomaDrKapoor . Those with 1q gain had superior OS with KRd vs VRd. Important bc these were most of the ‘high risk’ pts allowed on study! 1q amp remains a challenge! Evidence mounting for KRd in high risk

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Ben Derman

@bdermanmd

9 months

And another one! Cilta-cel Day +60. Amazingly deep responses - hope it continues! #mmMRD

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Ben Derman

@bdermanmd

5 years

...In summary: for elevated PTT: (1) On Heparin? (2) No, really, on heparin? Thrombin time if not sure. (3) PTT mixing study (3a/b) Factor levels 8, 9, 11 and/or lupus anticoagulant (4) Get into the weeds... #MedEd

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Ben Derman

@bdermanmd

2 years

I know there are some hold-outs for allo-SCT in myeloma, but I can't come to terms with the rates of GVHD and TRM. Here's just the latest of a tandem auto/allo approach in young/high-risk pts: 🙄5-yr PFS 41%, OS 80% 😩NRM 12% 😩cGVHD 57% #mmsm

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Ben Derman

@bdermanmd

6 months

All the caveats of press releases but belantamab-Vd appears to be a/w superior PFS vs Dara-Vd in DREAMM-7. The toxicity not reported - notably this is with belamaf 2.5 mg/kg q3weeks which likely needs to be lower for balancing toxicity and efficacy.

GSK announces positive results from DREAMM-7 head-to-head phase III trial for Blenrep in relapsed...

Blenrep plus BorDex showed statistically significant progression-free survival (PFS) benefit versus daratumumab plus BorDex.

www.gsk.com

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Ben Derman

@bdermanmd

5 months

Her light chains melt! Day +60 bone marrow biopsy: MRD-neg at 10^-6! Persistent paid off! It's anybody's guess how long response will be but so grateful to have tools like CAR T available for our toughest cases. Gotta celebrate the wins!

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Ben Derman

@bdermanmd

3 years

We see/cause a bit of neuropathy. We summarized the ⁦ @asco & ⁦ @myESMO ⁩ recs for prevention & management of chemo-induced neuropathy in ⁦⁦ @JAMA_current ⁩. 🔑🥡: duloxetine 1st line; pregabalin has efficacy. Lots to learn about alt methods!

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Ben Derman

@bdermanmd

1 year

Investigational BCMA-directed CAR T. Investigational GPRC5DxCD3 bsAb. Carvykti. "Doc, it's been a long time since I felt as good as I do now". Now that's saying something!! Time away from clinic is such a blessing. Much work to be done, but the future is bright!

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Ben Derman

@bdermanmd

2 years

Recent patient was collected for CAR T-cell therapy. Given rapid dz prog, gave bridging therapy and had incredible response - should we wait for disease burden to increase or can we treat even if disease burden is not detectable by conventional means?

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Ben Derman

@bdermanmd

3 years

Not prone to hyperbole but cilta-cel might be the fabled ‘game-changer’ that we want in CAR T in myeloma. ✅ 67% sCR ✅ 54% MRD negativity (10^-5) ✅ mPFS at least 22.8 mos. (per ASCO abstract) 😬 21% neurotox (not just ICANS). Mitigation strategies ⬇️

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Ben Derman

@bdermanmd

6 months

So very proud of @t_kubicki who presented work on peripheral blood mass spec (EXENT) as an MRD tool post-transplant in myeloma. What made this analysis challenging (and unique) is that IgG M-proteins persist even after destruction of the culprit cells due to recycling /1 #ASH23

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Ben Derman

@bdermanmd

2 months

Briefing documents from the FDA suggest that they accept the arguments laid forth by the i2TEAMM initiative and would accept MRD neg as an intermediate clinical endpoint to support AA

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Ben Derman

@bdermanmd

1 year

Abstract 8009: Final results of CARTITUDE-1 (cilta-cel) ( @YiLinMDPhD ) ‼️ 18/97 (19%) MRD-neg + CR at 24 months 👍 median PFS now 34.9 months; 30yr PFS 47.5% ⚠️6 new SPM, incl. 1 MDS and 1 lymphoma. 💭This is the real deal. Amazing advance for pts.

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