Mac Finlayson

@HiraSMian @JoshuaRichterMD @RahulBanerjeeMD @OncLive @TischCancer Man. That really needs to change. It makes absolutely no sense to withhold drugs which would almost certainly help them for patients who have a disease with no cure. No sense, whatsoever…

@FinlaysonMac @JoshuaRichterMD @RahulBanerjeeMD @OncLive @TischCancer I hear you and many of the new cevo trials are all more upfront so no chance for my patient who is potentially just like you to get it.

🤔Looking for clinical answers about multiple myeloma and the oncology field? Good news, COMMENT on this post with any questions you have and @JoshuaRichterMD of @TischCancer will answer them in OncLive's new #AskMeAnything series‼️ 💥 From bispecific antibodies to previewing #EHA2026, NOTHING is off the table! Drop your questions in the comments section of this post by May 25th‼️ #mmsm #oncology #cancer #medtwitter @MountSinaiNYC

@BethMooreLPM Truth!

I’ve never pastored a church. Couldn’t pay me a jillion dollars to. Never been ordained. Have no desire to. The only paid staff position I’ve ever held in a church was as an aerobics teacher in our church gym. But how in heaven’s name a woman discussing a sermon on a podcast could be objectionable to some is beyond me and what I believe to be beyond scripture. If you have no idea what I’m talking about, good. Stay sane. If you do, I’ve lived a long time and this has been my observation: Extremism, whether in conservatism or liberalism, whether in politics or religion, is never satisfied. It will always inch a little bit further. It’s a constant test of the purists.

@HiraSMian @JoshuaRichterMD @RahulBanerjeeMD @OncLive @TischCancer Absolutely the truth! What can possibly be taking so long? Same for the celmods. My wife has had BCMA CAR and BSAB and GPCR5D BSAB. She often is excluded from trials. Started tal 9/24 and it’s still working great! But we need options and we need them quickly.

@JoshuaRichterMD @RahulBanerjeeMD @OncLive @TischCancer Cevo I personally think is a great non bcma alternative with less toxicity than gprc5d, we just need it to move faster and get it into our clinics

@rajshekharucms We need more inclusive trials for this or, better yet, a second arm for those who are excluded. What if we find it works great for those w/ prior BCMA exposure, for example? There are more and more of these patients who need options.

6. Updated results from inMMyCAR [in vivo BCMA CAR T-cell therapy]: Median time from consent to infusion ~2 weeks! 6/6 patients MRD-negative [all but one at 10^-6]. No ICANS/DNTs observed yet. 1 patients with EMD had complete resolution by 1 month. My take: Exciting results, especially if it continues to hold up with longer follow-up and higher n. Short brain-to-vein time!

With #ASCO26 approaching, here are the potentially practice-changing abstracts in plasma cell disorders that caught my attention. I will update my thoughts as simultaneous publications are released for some of them🧵#MultipleMyeloma #Amyloidosis

@NWSTallahassee We are getting none of this rain in NE Jefferson County.

Another wet day for much of the region. Some locations could see heavy rain, especially across the Panhandle and into southeast Alabama and southwest Georgia. These amounts could lead to localized flooding with localized 3 to 5 inch rainfall totals possible. #FLwx #ALwx #GAwx

@matt_gottshall Always helped me to better judge distances when I walked.

One of the most underrated parts of playing golf… walking the course Any chance I get to walk I will, I think it makes the experience so much better, more conversation, see every hole (and good exercise) And not just walk, take caddies. Blessed to be at a club with a great caddy program, and it was my first job when I was in 8th grade If you’re on the fence, just do it

@VincentRK @JanakiramMurali Please design all trials with a 2nd arm for patients who are excluded, such as PCL and oligosecretory. These patients are often left behind and often have great need. If it works for these excluded patients, you will know you really have something.

How are clinical trial leaders picked? No one can or will hand you a principal investigator role on a platter. You have to work for it. Some things you can do if you are interested in leading a clinical trial. 1) Become a disease expert. Really understand the disease well. When you speak or write colleagues should recognize your talent and depth. The more you speak and write the more you will be noticed and sought out. Social media helps raise your visibility but it has no value if others think you are superficial. You must be credible. This is the most important step. There are no short cuts except to really understand the disease, what is known, and what remains to be known. It’s hard work. 2) Volunteer to be co-investigators on trials and help with trial design, development, and accrual. 3) Network. Most senior investigators will be more than happy to help you succeed. 4) Study trial protocols in depth to understand the elements and how it’s formatted. Better still write out protocol concepts and protocols. Clinical trial workshops help. There is an awful lot of detail. 5) Identify important questions that others are not thinking of. The question should be original, authentic, and important. If you have a great question, and you are credible, you are on your way to leading a trial. (The process from that point on is still very long and arduous — see second tweet in thread. But you have made it to being the PI). Clinical trial leadership is not transferable. When you are asked to be a lead investigator it’s not in your power to hand it over. If you don’t want it, that spot will go to the next most credible person not the one you anoint. As it should be.

@GatorDave_GB Congratulations! Happy anniversary! I’m coming up on 38!

17 years married to this lovely lady!

@GatorsScott @denverparler Yes. I graduated from UF in spring ‘87. Those guys were great and that was a great team! Barely lost to a Syracuse team that barely lost to Indiana in the championship game…

Cool to see M&M Boys inducted into UF Athletic HOF. First UF MBK team I really remember getting into was that '87 team. Info from @denverparler -- floridagators.com/news/2026/5/22…

@RahulBanerjeeMD @fredhutch @UWMedicine Congratulations!

Grateful to my @fredhutch @UWMedicine mentors for the privilege to work and learn here, and to my family for putting up with my Epic logons & manuscript revisions at all hours 🙏🏽 Now I have no excuses for getting lost in building basements or stairwells anymore...

@CD3Gator @JacquezGreen @GatorsFB @DannyWuerffel @ChrisDoering @FloridaGators Not…a…chance. Gone really early and I was glad to see him go. They dreaded that game. I live near Ga and got the tix on Thurs. nite by calling a friend up there who happened to be at a bar. Took him about 10 seconds to find me 2 tix. None of them wanted to go. 😂

@FinlaysonMac @JacquezGreen @GatorsFB @DannyWuerffel @ChrisDoering @FloridaGators 😂🤣 Please tell me he stayed the whole game too⁉️

#TBT In 1995 the @GatorsFB traveled to Athens, GA & hung half a hundred on the Bulldogs between the hedges. @DannyWuerffel was 14 for 17 for 242 yards & 5 TDs. @ChrisDoering led the @FloridaGators offense with 3 receiving TDS. Go Gators 🐊

@FAMOGANG365 Born into it. Grandfather went there. Father went there. Uncle went there, then taught there. I went there and met my wife there in 1985. We watched Gators whip Vols then went on our 1st date, 10/12/85. Happily married for 38 years.

When or what moment did you become a GATOR? And what is your greatest Gator experience?? 🐊💯😤👑 I wanna know! GMFG!

@GatorsScott I’m the 6th generation to live on the same land and currently manage our family farm. That is an awesome book! I don’t know how those early Florida pioneers did it…

Cool ... read "A Land Remembered" for first time last year and really enjoyed it ...

@SIDELINES_LIVE @buddyshow Yes! And leave Thursday nights to junior varsity football.

Sankey Says Leave Friday Nights To High School Football x.com/i/broadcasts/1…

@JanakiramMurali @HiraSMian She is the strongest person I’ve ever known.

@FinlaysonMac @HiraSMian Very good to hear she is doing well and I agree these treatments have truly changed the lives of so many patients. It is also awesome to know she was on top of all the toxicities

Thanks @HiraSMian. One of the largest international cohorts [US MM consortium] -median f/v 12 mo. median PFS- 7 mo. [which is impressive considering the median LOT and 75% prior BCMA] -only platelets <50 predicted for inferior PFS -ALC <0.4 and prior BCMA status did not impact PFS -Paper will be open access soon

@Myeloma_Doc @RahulBanerjeeMD My wife, UHR, dx 2018, did tal out patient w/ prophylactic toci Sept 2024. Still sCR, MRD-. She was 100% on all toxicities & they continue. She has maintained wt, says this is better than nausea. Once a month since the 90 day mark.

#Myeloma Paper of the Day: IMWG real-world analysis of talquetamab for RRMM finds skin tox 39.7%, nail 75.5%, dysgeusia 60.4%, oral tox 62.9%; platelets <50 (HR 1.8, 95% CI 1.15-2.83) assoc w/ inferior PFS; ORR 67.6%, PFS 7 months, 12-month OS 65%: pubmed.ncbi.nlm.nih.gov/42157444/. #mmsm

@kansagraMD Thank you for your reply, sir! That is very good to know! And thank you for saying that! She is doing great right now! Out patient tal w/ prophylactic toci in Sept 2024. Still SCR, MRD-.

@FinlaysonMac On Phase 1 studies there are more options to navigate the scenarios you ar describing esp like create mini cohorts etc. Hopijg your wife gets the best option to take care of her myeloma

The reason bispecific responses fade in myeloma — T-cell exhaustion — may have a fixable epigenetic switch. New Blood paper (Chiu, Zhao et al, BMS) makes the mechanistic case for mezigdomide + TCE. Preclinical but kinda neat. Ex vivo Tex model. The exhaustion phenotype they reproduce is brutal: • IL2 ↓, CCL17 ↓ • TOX/PD-1/TIM3/CD39 all climbing • IKZF1 redistributes • Tex kills BCMA-K562 with Alnuctamab far worse than Tact What mezigdomide does in Tex: • Degrades IKZF1/IKZF3 deeper than lena or pom in this system • Reopens chromatin — Tact-like programming • Cytokine genes (CCL17, CCL1/2, IFNγ) re-engage; • >4-fold increase in target cell killing with Alnuctamab — EC50 back to Tact levels • Same effect carries with teclistamab, talquetamab, and elranatamab If you remember the how Iber works - Iberdomide degrades IKZF1 too (Tay, Cell Rep Med 2024), but iberdomide's registration program is + daratumumab. Mezig is going the TCE direction — phase 1 with elranatamab is enrolling (NCT06645678), and the companion clinical paper (Chen et al,) already shows PD-1 and TIGIT down on patient T cells in vivo after mezig. Very intriguing indeed. If a short course of mezi can put exhausted T cells back into a functional state, "progression on bispecific" may not have to mean "switch agent." Are headed toward CELMoD pulses to extend TCE durability, instead of cycling drug classes? @BloodJournal @sparekh4 @szusmani @bmsnews @RahulBanerjeeMD @HiraSMian @bhemato #Myeloma #mmsm #HemOnc

@kansagraMD My wife would not qualify for this trial as she is oligosecretory & has had BCMA therapy. This is a perfect example of a trial that may benefit from a 2nd arm for those excluded. They may find it works great even for those who have had BCMA therapy.

Paper: doi.org/10.1182/blood.… Companion clinical paper (Chen et al) tracking PD-1/TIGIT on patient T cells submitted concurrently. Trial: NCT06645678 (mezigdomide + elranatamab).