Oral Abstract Session - Session Chairs: Jae Hoon Lee/Elizabet Manasanach

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OAB-050 - OCEAN (OP-103): A Phase 3, Randomized, Global, Head-to-Head Comparison Study of Melflufen and Dexamethasone (Dex) Versus Pomalidomide (Pom) and Dex in Relapsed Refractory Multiple Myeloma (RRMM)

Fredrik Schjesvold, Meletios-Athanasios Dimopoulos, Sosana Delimpasi, et al.

Conclusion: Melflufen had superior PFS vs pom, suggesting that melflufen + dex may be an alternative treatment option with a novel mechanism of action for pts with RRMM with len-refractory disease and 2-4 prior LoTs. Analyses of factors impacting OS are ongoing. * Grouped term.


OAB-051 - Daratumumab, Carfilzomib, Lenalidomide and Dexamethasone (Dara-KRd), Autologous Transplantation and MRD Response-Adapted Treatment Duration and Cessation in Newly Diagnosed Multiple Myeloma (NDMM)

Luciano Costa, Saurabh Chhabra, Eva Medvedova, et al.

Conclusion: Monoclonal antibody-based quadruplet therapy, AHCT and MRD response- adapted consolidation therapy leads to high rate of MRD negativity in NDMM. For most patients with NDMM, MRD-directed adaptive treatment offers the prospect of confirmed deep responses and investigation of MRD surveillance as an alternative to indefinite maintenance.


OAB-052 - Impact of chromosome 1 abnormalities on newly diagnosed multiple myeloma treated with proteasome inhibitor, immunomodulatory drug, and dexamethasone: analysis from the ENDURANCE ECOG-ACRIN E1A11 trial

Prashant Kapoor, Timothy Schmidt, Susanna Jacobus, et al.

Conclusion: Gain1q or amp1q portends poor outcome among NDMM pts treated with either VRd or KRd. Specifically, pts with amp1q as a sole high-risk abnormality have distinctly poor outcomes with KRd. By contrast, KRd, but not VRd, appears to abrogate the adverse impact of del1p. Given the limitations of the trial design and post hoc subset analyses, longer follow up and confirmatory studies are warranted for definitive conclusions.


OAB-053 - Clinical outcomes of relapsed/refractory multiple myeloma patients after BCMA-targeted CAR T therapy

Oliver Van Oekelen, Tarek Mouhieddine, Darren Pan, et al.

Conclusion: Studying the prognosis of patients after relapse and the response to subsequent therapy will provide important clinical insights for salvage, especially as CAR T moves to an earlier treatment setting. At the meeting, we will compare and contrast more mature data on the CAR T cohort with >50 patients that relapsed after bispecific Ab therapy.


OAB-054 - Single-cell RNA-sequencing identifies immune biomarkers of response to immunotherapy in patients with high-risk Smoldering Myeloma

Romanos Sklavenitis-Pistofidis, Ankit Dutta, Sylvia Ujwary, et al.

Conclusion: We used single-cell RNA- sequencing to profile the immune microenvironment of patients with high-risk SMM in a Phase II trial of Elotuzumab, Lenalidomide and Dexamethasone and developed immune biomarkers of response to treatment. Our study may usher in a next generation of clinical assays that assess both tumor biology and immune state, as well as common clinical biomarkers, in the marrow or blood, to accurately predict who may benefit from early treatment, monitor response and improve patient outcomes.



Oral Abstract Session - Session Chairs: Mariateresa Fulciniti/Nicolo Bolli/Maria-Theresa Krauth

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OAB-055 - Gain and Amplification of 1q Induce Transcriptome Deregulation and Worsen the Outcome of Newly Diagnosed Multiple Myeloma Patients

Mattia D'Agostino, Angelo Belotti, Elena Zamagni, et al.

Conclusion: Amp1q universally predicts poor PFS and OS, despite the use of new drug combinations. A gene network centered on Myc may contribute to the high-risk behavior of these pts. The study of DEGs associated with Gain and Amp1q can identify new ‘druggable’ targets to be further tested in this high-risk patient population.


OAB-056 - A machine learning model based on tumor and immune biomarkers to predict undetectable measurable residual disease (MRD) in transplant-eligible multiple myeloma (MM)

Camila Guerrero, Noemi Puig, María Teresa Cedena, et al.

Conclusions: We demonstrated that selecting a regimen based on probable MRD outcomes, and confirming soon after if that probability was accurate, is a possible new approach towards individualized treatment in MM. The model is available at www.MRDpredictor.com to facilitate its use in clinical practice.


OAB-057 - Temporal-weight estimation of the copy number alterations of 1384 multiple myeloma patients defines an ancestrality index impacting patient survival

Andrea Poletti, Vincenza Solli, Gaia Mazzocchetti, et al.

Conclusions: By means of whole genome analysis and dataset harmonizing, the temporal order of acquisition of MM CNAs has been confidently described. A score reflecting the disease ancestrality of MM pts at diagnosis was generated and associated to survival outcomes. Overall, these findings support the evidence that MM pts at diagnosis carrying an excess of ancestral alterations, expected to likely be drivers, are prone to have a dismal prognosis.


OAB-058 - Predictive relevance of sustained MRD negativity and of early loss of MRD negativity during maintenance therapy after transplant in newly diagnosed Multiple Myeloma patients

Angelo Belotti, Rossella Ribolla, Marco Chiarini, et al.

Conclusion: we confirm the predictive value of MRD assessment after ASCT and therefore the importance of achieving sustained MRD negativity regardless of different treatment strategies. Moreover, the detection of early loss of MRD negativity can help the physician to identify pts with particularly poor prognosis


OAB-059 - Towards a comprehensive multimodal minimal residual disease assessment in multiple myeloma: the role of circulating cell-free DNA to define the extent of
disease spreading

Marina Martello, Andrea Poletti, Enrica Borsi, et al.

Conclusions: although only few cases showed genomic evidence of spatial heterogeneity, in pts with high cfDNA TF, imaging data overall suggested a propensity to a metastatic spread of the disease.


OAB-060 - Prospective comparison of contemporary whole body MRI and FDG PET/CT for disease detection and correlation with markers of disease burden in myeloma: Results
of the iTIMM trial

Martin Kaiser, Nuria Porta, Bhupinder sharma, et al.

Conclusions: Contemporary WB MRI is more sensitive regarding detection of focal and diffuse disease compared with FDG PET/CT; together with its capability to assess response proposing it as a standard for tumor imaging in MM. In addition, measurability of diffuse disease and its association with higher disease burden and high- risk molecular profiles supports WB MRI radiomic biomarker development.