@RahulBanerjeeMD @SLentzsch @H_Einsele @COMyCongress Case series of this approach @BCD_AACR pubmed.ncbi.nlm.nih.gov/41810881/
English
Al Garfall
363 posts
Al Garfall
@AlGarfall
Oncologist @PennMedicine @PennCancer specializing in multiple myeloma and cellular immunotherapy.
Philadelphia, PA Katılım Temmuz 2014
555 Takip Edilen757 Takipçiler
#COMy2026 still one of the most fascinating cases I’ve ever seen, now being presented by @H_Einsele:
Primary refractoriness to teclistamab reversed purely by plasmapheresis to knock down sBCMA and give bsAbs a chance to work. Fascinating correlative work by 🇩🇪 group!
English
Al Garfall retweetledi
Excellent summary of CAR-PRISM by @HadidiSamer: “For an asymptomatic condition with a risk to progress to a condition that has excellent treatment options and outcomes (and despite the deep responses) those toxicities reported are really concerning”!
Samer Al Hadidi, MD,MS,FACP@HadidiSamer
6️⃣What is the efficacy ? This is a secondary goal (the most important Q in this study was safety) ✅ median follow up: 15 months ✅ MRD negativity 10−6 by 2 months: 100% Deep responses , short follow up to assess durability Bottom line For asymptomatic condition with a risk to progress to a condition that has excellent treatment options and outcomes (and despite the deep responses) those toxicities reported are really concerning End 🧵
English
Al Garfall retweetledi
Fascinating - albeit a little terrifying - @LeukemiaJnl work by 🇩🇪
How does GPRC5D loss affect surviving myeloma #MMsm clones? Here, remaining cells appear to be more aggressive.
Will be important to validate / rebut as talquetamab moves into earlier lines... hopefully soon!
English
Al Garfall retweetledi
Nonsense-mediated mRNA decay inhibition reshapes the cancer immunopeptidome @ImmunityCP
cell.com/immunity/fullt… @CharlesSwanton @TheCrick @RobertVendramin @ucl @kevlitchfield @squezadd
English
Al Garfall retweetledi
Excited to share our new medRxiv preprint on oncology data visualization with R. This collaborative atlas includes 62 reproducible templates for clinical trials and real-world evidence, with simulation-based examples throughout. @drjgauthier @YeinJ_StatML medrxiv.org/content/10.648…
English
Al Garfall retweetledi
Congratulations @MattReesMD! More evidence to support the use of CAR-T in appropriately selected patients with MM/AL
Rahul Banerjee, MD, FACP@RahulBanerjeeMD
🙏🏽 @AjHematology: 🇺🇸 Myeloma Immunotherapy Consortium analysis of CAR-T in AL amyloidosis n=28 (n=6 with ❤️ 3A dz at infusion). Yes CRS, yes IEC-HS (rare), but no TRM... And yes very deep responses 🤩 Some day this may be default answer for fixing outcomes gap if ≤hemVGPR
English
@RahulBanerjeeMD @BloodPortfolio @thisisJamesD @kczmj @AJPortuguese @AtrashShebli Helpful report, but would be careful claiming “100%” based on 46 pts. Rare but potentially serious event. Dara label says avoid live vaccine. Measles risk still very low. Another reason to avoid dara maint for which current evidence is quite weak.
English
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!
English
Al Garfall retweetledi
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
English
CSF-1R inhibition and lenalidomide synergize to promote myeloma control after autologous stem cell transplantation ashpublications.org/blood/article/…
English
@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.
English
@Papa_Heme still lots of mel140 autos despite evidence that it’s no better than rev maintenance, and that was in the pre dara era
ashpublications.org/blood/article/…
English
@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.
English
@End_myeloma @AlGarfall In other words PFS2/OS is what I am worried not PFS1.
English
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!
English
@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.
English
@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.
English
@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.
English
@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).
English
Al Garfall retweetledi
@venkmurthy He was not always so rigorous, Venk.
cancerletter.com/the-cancer-let…
forbes.com/sites/matthewh…
English
We are honored to have this support from Blood Cancer United and the Riney Foundation, which supports our LimiTec trial of fixed-duration bispecific antibody therapy for multiple myeloma #mmsm.
Blood Cancer United@BloodCancerUtd
We were honored to spend time together recognizing a $1M gift from the Paula & Rodger Riney Foundation supporting our Academic Clinical Trial (ACT) grant, an innovative clinical trial for people living with multiple myeloma. ❤️ This generous investment fully supports the ACT grant led by Alfred Garfall, M.D. at the Perelman School of Medicine at the University of Pennsylvania, advancing a new treatment approach designed to reduce burden and improve quality of life for myeloma patients. “We are honored to partner with the Paula & Rodger Riney Foundation—true leaders in advancing myeloma research—at this pivotal moment,” said E. Anders Kolb, M.D., President and CEO of Blood Cancer United. “Their investment reflects the spirit of Blood Cancer United: rallying together to drive breakthroughs that give every patient the chance for a longer, fuller life.” Learn more about this partnership and the research it’s helping move forward 👉 bcutd.org/4b164lf
English
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!
English
Al Garfall retweetledi
Colchicine reduces competitive advantage of clonal hematopoiesis (esp TET2) in COLCOT ahajournals.org/doi/abs/10.116… @CircAHA
Similar to LoDoCo2 jacc.org/doi/10.1016/j.… @JACCJournals
Our prior work in mice & human biobanks suggests that colchicine may be effective in reducing TET2 CHIP-associated CVD risk academic.oup.com/eurheartj/arti… @ESC_Journals
English