Al Garfall

355 posts

Al Garfall

Al Garfall

@AlGarfall

Oncologist @PennMedicine @PennCancer specializing in multiple myeloma and cellular immunotherapy.

Philadelphia, PA Katılım Temmuz 2014
541 Takip Edilen755 Takipçiler
Rahul Banerjee, MD, FACP
Rahul Banerjee, MD, FACP@RahulBanerjeeMD·
Great to see in @BloodPortfolio Neoplasia since it's a question our #MMsm patients ask all the time. "Can I get MMR 💉 on dara-len maintenance?" Short answer: 💯%, it seems! Long answer: Kudos to our PharmD colleagues within 🇺🇸 MM Consortium for leading the charge on this!
Rahul Banerjee, MD, FACP tweet media
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Al Garfall retweetledi
Penn Medicine
Penn Medicine@PennMedicine·
Congratulations to Robert Vonderheide, MD, DPhil, director of @PennCancer's Abramson Cancer Center, who has been elected to become the 2026-2027 President-Elect of @AACR. spr.ly/6019B6rtMT
Penn Medicine tweet media
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Al Garfall
Al Garfall@AlGarfall·
@neilymon @Papa_Heme Anyone know if this trial has been published? ASH abstract from 2022 and had 68 month f/u at that time. Would like to read a full report.
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Papa Heme
Papa Heme@Papa_Heme·
We still do way too many transplants for myeloma. I still discuss transplant for young and high risk patients. For all others they can do without the 200 mg/m2 of melphalan in my opinion.
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Al Garfall
Al Garfall@AlGarfall·
@Taxkourel @End_myeloma Though I understand this concern, I’m more worried about CAR tox. When you add up all the rare but serious tox (MNT, SPM, enterocolitis, unresolved neuropathy), it’s substantial risk to take-on due to concern about not being able to get CART likely 5y+ later.
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Taxiarchis Kourelis
Taxiarchis Kourelis@Taxkourel·
My issue with tec in perpetuity second line is that you are effectively throwing the (BCMA) CAR option out the window. For an 80 year old/standard risk this may not be an issue for a 50year old/high risk I am afraid it is. It will be a discussion with patients for sure.
Rahul Banerjee, MD, FACP@RahulBanerjeeMD

Brilliantly written by @Rfonsi1 about CARTITUDE-4 MajesTEC-3 in myeloma #MMsm. With cross-trial ⚠️, tec-dara 3-yr PFS 83% hard to beat. But as noted below, early PFS dropoff with cilta-cel from pre-infusion PD… not as big of issue in non-CART4 setting. Plus time off Tx!

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Al Garfall
Al Garfall@AlGarfall·
@Taxkourel I understand the concern. Those late line bs->car data are too often cited without caveats however. Very few pts, usually pts who failed bs early or didn’t respond, selected for pts less likely to respond to CAR. Hard to base an early-line cilta vs Tec decision on these data.
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Taxiarchis Kourelis
Taxiarchis Kourelis@Taxkourel·
@AlGarfall I don’t think we are disagreeing. I won’t be suggesting it either. The trial continued till progression. Alternative strategies not well studied (yet). No one knows impact on subsequent CART with most data in later line consistently suggesting lower responses hence my concern.
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Al Garfall
Al Garfall@AlGarfall·
@Taxkourel The duration of response on Tec3 was so long. The landscape will be different when these pts progress. Safer CARs, new tech (in vivo CARs, etc). Need to be careful with cilta-cel that risk is justified and worry less about options 5-10y down the road.
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Al Garfall
Al Garfall@AlGarfall·
@Taxkourel I respectfully disagree. We will not be giving Tec until disease progression in early line setting. Rate of antigen loss is likely lower. Many non TCE options after Tec to permit T cell recovery after Tec and more coming (celmods).
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Al Garfall
Al Garfall@AlGarfall·
Outcomes of radiation integrated with T-cell–engaging bispecific antibodies in relapsed/refractory multiple myeloma ashpublications.org/bloodadvances/… Congrats and thanks to our superstar resident Heta Patel for leading this analysis!
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Rahul Banerjee, MD, FACP
Rahul Banerjee, MD, FACP@RahulBanerjeeMD·
Felt like I was reading a suspense novel! Tour de force @NatureMedicine by Penn group re: MNTs, IEC-EC, etc after BCMA CAR-T #MMsm. 1️⃣ Peak ALC matters, but so does CD4 predominance 2️⃣ Maraviroc (HIV Rx) blocked CD4+ driven processes (pre-clinical)! #downwithdex #trymaravirocinstead? [Not yet, but will be fascinating to see more data!]
Rahul Banerjee, MD, FACP tweet media
Ruella Lab@RuellaLab

Excited to share our new paper in @NatureMedicine uncovering the role of CD4⁺ CAR T cells in CirAEs after BCMA CAR T therapy. @MatthewHoMD @paruzzol @jh_noll @JoeFraietta @MarcoRuella @CohenAd_MMdoc @PennMedicine @PennCancer nature.com/articles/s4159…

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