Caitlin Costello, MD

Doctor, not provider. @ACPIMPhysicians @AnnalsofIM acpjournals.org/doi/10.7326/AN…

Polling question from @OncLine® Bridging the Gaps: Leukemia, Lymphoma, & Multiple #Myeloma meeting happening now (February 24-25, 2026). How close do you think we are to the cure for multiple myeloma?

Treatment of Multiple Myeloma: ASCO–Ontario Health (Cancer Care Ontario) Living Guideline | Journal of Clinical Oncology @JCO_ASCO @ASCO #mmsm ➡️ ascopubs.org/doi/10.1200/JC…

@VincentRK Walking patients through the decision to enroll is also extremely time consuming. Trials are complicated. Risks are sometimes unknown. The consenting process is a huge barrier. I often have to block or an hour to discuss a RCT with patients, and discuss alternatives.

Why do many regulatory oncology phase III trials not accrue sufficient US patients? This issue came up repeatedly at today’s ODAC for belantamab for myeloma. And I can address it at least for myeloma. 1) In our healthcare system, opening a trial in a timely manner is a major issue. It’s the overwhelming bureaucracy. From budget to contracts to reviews. By the time a trial opens here, it is already half or more accrued around the world. 2) Our EHR is already a huge time consuming burden for physicians reducing actual patient care time. Trying enroll patients on a clinical trial needs an even great amount of time and effort. On busy days this may just not be possible. This is also a feedback loop. As accrual is low, medical centers become hesitant to open trials that don’t accrue well thus limiting the number of trials available. Less sites open for a given trial, less accrual. 3) We are a big and vast country. When trials are open in a center, they may be 100s of miles away from the patient. Trials require frequent visits to the enrolling site which is often not possible for patients in terms of logistics, affordability, or time. So while we want to enroll more patients, it just may not be feasible for patients to participate even if there is reimbursement for lodging and travel. 4) Here is the main reason: In many countries access to even the drugs on control arm is difficult outside of a trial due to cost/reimbursement/HTA reasons. The clinical trial often offers the best chance for world class therapy regardless of the arm. In the US access to modern drugs and regimens is excellent and is usually ahead of other countries. What we consider “substandard” control arm is a highly desirable therapy in other countries. So both arms of the trial are attractive to patients and are often available only on trial. Enrolling on the trial and entering patients on the trial is thus sought after. In the US the control arm can be usually given off study easily. And we can even do better than the control arm off study. Even the experimental arm may be possible off label. That makes a randomized trial less appealing. No excuses. We need to fix these problems. This is just the current reality. We are trying to overcome these problems.

Grateful to #curebound and @Padres for supporting so many people with cancer. We will find the cure! @eltonofficial @UCSDCancer

@bdermanmd At least vgpr. We need to prove disease response first.

For patients with AL amyloidosis and being evaluated for organ transplantation (for damage caused by amyloid), what is your criteria to give the green light? (Respond with other suggestions below!)

Glad to share our upcoming interactive educational program ‘Paving the Way for Optimal Utilization of Early CAR T-Cell Therapy in Relapsed/Refractory Multiple Myeloma’

What a fantastic panel this was! How to improve patient access and experience? Who cares for the caregivers? Thank you to @All4Cure and @HealthTree for improving patient lives and supporting investigator research and trial enrollment.

The great debate begins between @nsc_natalie and @DoctorAKrishnan moderated by @RahulBanerjeeMD - to transplant or not to transplant in NDMM? Let the greatest debater win! @NashvilleHeme

The NHC Debate Club at #NashvilleHeme25 is ready to bring the heat! Get ready for an "after-school" style showdown where our expert debaters will tackle the hottest topics in hematologic malignancies. You won't want to miss these engaging discussions! Join us at the 2-day CE accredited conference, Feb 20-22, 2025, in Nashville, TN—register now! hubs.la/Q0351JJ90 @DoctorAKrishnan @nsc_natalie, @Ccostello7, @DrKrinaPatel, @AjaiChari, @RahulBanerjeeMD

Really looking forward to co-chairing this with @AaronGoodman33 this weekend. Come join us!

🚨 Last Call! One week away! Join us at San Diego for #BTFHemBreast25 🚨Register NOW: buff.ly/40r1YxG 🌟8.50 ABIM MOC II / AMA PRA Category 1 Credit™ / Nursing Contact Hours ☕Network in-person with hematology & breast cancer experts from @UCSDCancer @OHSUKnight @tiffytanaka @AntiheroMD @ManniMD1 @Ccostello7 @ErinReidMD @AutumnJeong @Dr_RShatsky @DrAsonaLui @SarahLBlairMD @chikarebeccaN #meded #oncologist #SanDiego #MedX #MedTwitter

AURIGA study results: - D-R maintenance improved MRD-conversion rate in NDMM patients who were MRD+ after transplant vs R maintenance. - PFS favored D-R maintenance, with an improved 30-month PFS rate vs R alone; D-R was well tolerated @PlasmaCellPete @Ccostello7 #mmsm

CONGRESS | #ASH24 | POSTER Caitlin Costello @Ccostello7, UCSD Moores Cancer Center, shares results from the optimized lymphodepletion cohort (N = 21) of a phase I study of P-BCMA-ALLO1, a BCMA-directed CAR-T in RRMM. P-BCMA-ALLO1 demonstrates a promising ORR and favorable safety profile when administered with optimized LD. It is highly active, regardless of prior exposure to BCMA-targeted autologous CAR-T or TCE therapy. Follow our live feed for more updates: multiplemyelomahub.com/medical-inform… #mmsm #myeloma #MedicalCongress

If you think physicians are overpaid, maybe you should take the necessary course work in undergrad, take and pass the MCAT, apply for med schools, pay hundreds of thousands for tuition, learn for 4 years in a very high pressure learning environment, then pay thousands more to apply for a training job that you may or may not get, then if you do get it, you get to work 80 hours a week making $15/hour for 3 - 9 years wherein more than one day off in a row is a rarity, all the while many normal life events and processes get pushed to the side, then you FINALLY get a “real” job that’ll pay very well but you’ll realize your patients are not your customers (the insurance companies are), they are the product, and you’ll realize you have a lot to learn about the business of medicine in order to advocate for your patients and for yourself in order to be okay. Then YOU can say “no thanks I don’t deserve to make that much.” Or you can just skip all of that, realize now that the insurance and hospital system complexes are trying to hoodwink you, and appreciate the life work and care physicians commit to all of us, recognizing that while all things in medicine play a role in what we see today, physicians themselves are not the villain. They are on our side.

A wonderful morning to kick off ASH. Myeloma treatment 101 in an hour! Wonderful to be alongside @RahulBanerjeeMD. Welcome to America’s Finest City - my home! @UCSDHealth

Come join us in Hall 6B for some #MyelomaMusings at the Bridging Gaps in Multiple Myeloma Care. Ready to 🎸 with @RahulBanerjeeMD. Who brought the ☕️?

Come join me and @VincentRK with @OncBrothers at #ash24 with an evening of #MyelomaMusings

@erastourticketz Trying to get two tickets for my brother and his fiancé as a wedding present. They haven’t been yet!

**SELLING** 🩶(2) tickets for Vancouver @ BC Place on 12/6/2024; TOTAL: $39 CAD + PayPal G&S fee 🩶If this would be your first show, let us know in the comments! 🩶Ticket(s) and price have been verified. Will help with the sale once available for transfer! *Please no DMs! 🫶🏻

@amoodiepeacock @inmygreatwarera Same!

@inmygreatwarera It's telling me it's a protected queue 😭😭😭 even though I'm verified for Vancouver

GO VANCOUVER