2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T456,To provide updated guidance regarding the therapy for multiple myeloma. ASCO and Ontario Health (Cancer Care Ontario) convened a joint Expert Panel and conducted an updated systematic review of the literature. The updated review identified a total of 161 relevant randomized trials. Daratumumab therapy may be offered to patients with high-risk smoldering myeloma. Quadruplet therapy with daratumumab or isatuximab, combined with bortezomib, lenalidomide, and dexamethasone, should be offered as initial therapy for transplant eligible patients. They should also be offered at least lenalidomide maintenance, with or without daratumumab, carfilzomib, and/or dexamethasone. Quadruplet therapy with daratumumab or isatuximab, combined with bortezomib, lenalidomide, and dexamethasone, should be offered as therapy for suitable transplant-ineligible patients. Patients with relapsed or refractory multiple myeloma should be offered triplet therapy or T-cell redirecting therapies according to a set of recommended principles.Additional information is available at www.asco.org/hematologic-malignancies-guidelines.31:Tff6, ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following the guideline development process as outlined in the

ASCO Guidelines Methodology Manual

. ASCO Guidelines follow the ASCO Conflict of Interest Policy for Clinical Practice Guidelines . Clinical Practice Guidelines and other guidance (“Guidance”) provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgment. Guidance may not be applicable to all patients, interventions, diseases or stages of diseases. Guidance is based on review and analysis of relevant literature, and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in Appendix 1 and Appendix 2 (online only) for more . PURPOSE To provide updated guidance regarding the therapy for multiple myeloma. METHODS ASCO and Ontario Health (Cancer Care Ontario) convened a joint Expert Panel and conducted an updated systematic review of the literature. RESULTS The updated review identified a total of 161 relevant randomized trials. UPDATED RECOMMENDATIONS Daratumumab therapy may be offered to patients with high-risk smoldering myeloma. Quadruplet therapy with daratumumab or isatuximab, combined with bortezomib, lenalidomide, and dexamethasone, should be offered as initial therapy for transplant eligible patients. They should also be offered at least lenalidomide maintenance, with or without daratumumab, carfilzomib, and/or dexamethasone. Quadruplet therapy with daratumumab or isatuximab, combined with bortezomib, lenalidomide, and dexamethasone, should be offered as therapy for suitable transplant-ineligible patients. Patients with relapsed or refractory multiple myeloma should be offered triplet therapy or T-cell redirecting therapies according to a set of recommended principles. Additional information is available at www.asco.org/hematologic-malignancies-guidelines . 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Anti-CD38 Monoclonal Antibody: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Anti-CD38 Monoclonal Antibody (modality). Clinician-written summaries and actionable practice insights. 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results in smaller subgroups (e.g., plasma cell leukaemia) may be underpowered.","value_numeric":null},{"paper_doi":"10.1016/s1470-2045(26)00286-x","tag_type":"warning","value":"Subgroup analyses by high-risk features (≥2 HRCAs, high-risk GEP, plasma cell leukaemia) were post-hoc and should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1016/s1470-2045(26)00286-x","tag_type":"warning","value":"The ≥3 HRCAs subgroup did not appear to benefit, but exact numbers and CIs for this subgroup are not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1016/s1470-2045(26)00286-x","tag_type":"warning","value":"The external control (Myeloma XI) had a much longer median follow-up (~118 months) vs OPTIMUM (~71 months), which may affect OS comparisons as OPTIMUM OS data are still maturing.","value_numeric":null}],"summaries":{"what_studied":"The OPTIMUM/MUKnine phase 2 trial evaluated intensified induction (daratumumab + cyclophosphamide + bortezomib + lenalidomide + dexamethasone), extended consolidation, and maintenance after ASCT in 107 newly diagnosed high-risk multiple myeloma patients (≥2 HRCAs, high-risk GEP, or plasma cell leukaemia) at 22 UK centres, compared against 120 molecularly matched external controls from the Myeloma XI trial over a median 71-month follow-up.","key_result":"At 5-year follow-up, median PFS was not reached (NR) in OPTIMUM vs 24.4 months in controls (HR 0.32, 95% CI 0.22–0.45; p<0.0001); median OS was NR vs 57.4 months (HR 0.43, 95% CI 0.28–0.65; p<0.0001); median PFS2 was NR vs 43.9 months (HR 0.26, 95% CI 0.17–0.41; p<0.0001). Benefit was consistent across high-risk subgroups **except** patients with ≥3 HRCAs.","limitations":"- External control design (Myeloma XI) introduces potential confounding; groups were molecularly matched but not randomised.\n- Subgroup analyses (≥2 HRCAs, high-risk GEP, plasma cell leukaemia) were selected post-hoc.\n- No survival benefit demonstrated in the ≥3 HRCAs subgroup, suggesting a ceiling for this regimen in the highest-risk patients.","practice_takeaway":"For newly diagnosed high-risk myeloma defined by ≥2 cytogenetic abnormalities, high-risk GEP, or plasma cell leukaemia, an intensified daratumumab-based quadruplet regimen with extended consolidation and maintenance can more than double PFS and meaningfully extend OS. Molecular risk stratification at diagnosis is key to selecting patients most likely to benefit."}},{"doi":"10.1038/s41375-026-03097-9","pmid":"42637879","title":"Daratumumab, lenalidomide, and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: MAIA final survival analysis","journal_title":"Leukemia","journal_issn":"0887-6924","published_at":"2026-08-24T00:00:00.000Z","url":"https://doi.org/10.1038/s41375-026-03097-9","source_score":20,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-29T06:19:13.501Z","updated_at":"2026-08-29T06:19:13.501Z","tags":[{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"sample_size","value":"n=737","value_numeric":737},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"warning","value":"Brand name 'Darzalex' added based on known drug identity of daratumumab; not explicitly stated in the source text.","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"warning","value":"The full text provided is largely a supplementary appendix with limited body content; all key efficacy data were extracted from the abstract.","value_numeric":null},{"paper_doi":"10.1038/s41375-026-03097-9","tag_type":"warning","value":"Transplant-ineligible eligibility criteria are not detailed in the available text, which may affect generalizability to specific patient subgroups (e.g., by age or comorbidity).","value_numeric":null}],"summaries":{"what_studied":"The MAIA trial final analysis evaluated daratumumab + lenalidomide/dexamethasone (D-Rd) versus lenalidomide/dexamethasone (Rd) alone in 737 transplant-ineligible newly diagnosed multiple myeloma (NDMM) patients, with a median follow-up of 89.3 months (>7 years).","key_result":"Median OS was 90.3 months with D-Rd vs. 64.1 months with Rd (HR 0.67; 95% CI 0.55–0.82); 7-year OS rates were 53.1% vs. 39.3%. Median time to subsequent therapy was not reached for D-Rd vs. 42.4 months for Rd (HR 0.51; 95% CI 0.41–0.63; P < 0.0001). Deaths due to adverse events were similar: 12% (D-Rd) vs. 11% (Rd).","limitations":"- This is a final OS analysis from a randomized trial, but the 2021 protocol amendment extended follow-up specifically for OS, which may affect interpretation of secondary endpoints.\n- Subsequent therapy patterns differed between arms, potentially confounding OS benefit attribution.\n- MRD and response data for subsequent therapies were only available for evaluable subsets, limiting generalizability.","practice_takeaway":"D-Rd sets a new OS benchmark of 7.5 years for transplant-ineligible NDMM and should be considered the preferred frontline regimen in this population. The near-doubling of time to next treatment (not reached vs. 42.4 months) further supports its use to delay disease progression and preserve subsequent therapy options."}},{"doi":"10.1093/ckj/sfag283","pmid":null,"title":"B- and plasma cell-targeting therapies for podocytopathies: state of the art and the New Gaslini Protocol","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2026-08-21T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfag283","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-08-27T06:17:10.308Z","updated_at":"2026-08-27T06:17:10.308Z","tags":[{"paper_doi":"10.1093/ckj/sfag283","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"brand","value":"Gazyva","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"condition","value":"Focal Segmental Glomerulosclerosis","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"condition","value":"Idiopathic Nephrotic Syndrome","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"condition","value":"Minimal Change Disease","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"condition","value":"Podocytopathy","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"generic","value":"obinutuzumab","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"warning","value":"No sample size tag applied — this is a review article with no single study population.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"warning","value":"Obinutuzumab brand name 'Gazyva' is its approved oncology brand; nephrology use is off-label.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"warning","value":"The 'practice_changing' impact flag reflects a novel proposed protocol (New Gaslini Protocol); it is not yet validated by randomized controlled trials.","value_numeric":null},{"paper_doi":"10.1093/ckj/sfag283","tag_type":"warning","value":"The review covers both pediatric and adult populations but does not consistently stratify findings by age group; 'mixed' age group assigned.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates the role of humoral immunity (B cells, plasma cells, autoantibodies) in podocytopathies—MCD, FSGS, and INS—and examines the evidence for B cell– and plasma cell–targeting therapies, culminating in a proposed treatment framework called the New Gaslini Protocol.","key_result":"Anti-CD20 therapies improve outcomes in steroid-dependent/frequently relapsing disease but show limited efficacy in steroid-resistant forms and post-transplant recurrence; combined sequential targeting of CD20⁺ B cells (obinutuzumab) and CD38⁺ plasma cells (daratumumab) may achieve deeper, more sustained control in refractory and recurrent cases.","limitations":"This is a narrative review without systematic meta-analysis; evidence for combined CD20/CD38 targeting is drawn from limited, heterogeneous case series with no randomized trial data; variability in treatment protocols across centers limits generalizability.","practice_takeaway":"For patients with refractory or frequently relapsing podocytopathies, consider sequential CD20 and CD38 targeting rather than anti-CD20 monotherapy alone, as long-lived plasma cells likely sustain disease despite B-cell depletion. The proposed New Gaslini Protocol offers a mechanistically grounded framework to standardize this approach pending trial validation."}},{"doi":"10.1002/ajh.70475","pmid":"42613778","title":"Multiple Myeloma: 2026 Update on Diagnosis, Risk‐Stratification and Management","journal_title":"American Journal of Hematology","journal_issn":"0361-8609","published_at":"2026-08-18T00:00:00.000Z","url":"https://doi.org/10.1002/ajh.70475","source_score":88,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-24T06:18:14.674Z","updated_at":"2026-08-24T06:18:14.674Z","tags":[{"paper_doi":"10.1002/ajh.70475","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"brand","value":"Sarclisa","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"condition","value":"Smoldering Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"generic","value":"belantamab mafadotin","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"generic","value":"isatuximab","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"modality","value":"Antibody-Drug Conjugate","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"modality","value":"Autologous Stem Cell Transplantation","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"modality","value":"Bispecific Antibody","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"modality","value":"CAR-T Cell Therapy","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"modality","value":"Immunomodulatory Drug","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"study_design","value":"Narrative Review / Clinical Practice Update","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"warning","value":"Brand name 'Darzalex' listed for daratumumab; isatuximab brand 'Sarclisa' inferred from common knowledge — not explicitly stated in the abstract.","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"warning","value":"The label 'practice_changing' reflects major updates to both risk stratification criteria and frontline quadruplet therapy recommendations.","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"warning","value":"The paper was published August 18, 2026, just 6 days before today's date; some referenced trials or approvals may be very recent and not yet widely implemented.","value_numeric":null},{"paper_doi":"10.1002/ajh.70475","tag_type":"warning","value":"This is a guideline/review article, not a primary trial — level of evidence reflects expert synthesis, not a controlled study. No sample size is applicable.","value_numeric":null}],"summaries":{"what_studied":"A comprehensive 2026 update on the diagnosis, risk-stratification, and management of multiple myeloma (MM), covering criteria for MM-defining events, high-risk cytogenetic definitions, frontline quadruplet regimens, maintenance strategies, and relapsed/refractory options.","key_result":"Frontline standard-of-care is now a quadruplet (anti-CD38 + bortezomib/lenalidomide/dexamethasone) followed by ASCT in eligible patients; high-risk MM is redefined to include bi-allelic del(1p), combination cytogenetic lesions with gain(1q) or del(1p), and p53 mutation; daratumumab for 3 years is recommended for high-risk smoldering MM.","limitations":"This is a narrative review/guideline update, not a primary clinical trial — it synthesizes existing evidence without new original data or formal meta-analysis.","practice_takeaway":"Upgrade frontline-eligible patients to anti-CD38–based quadruplet therapy (Dara- or Isa-VRd) and reassess high-risk status using the expanded cytogenetic criteria including gain(1q)/del(1p) combinations. For high-risk smoldering MM, consider 3 years of daratumumab to delay progression."}},{"doi":"10.1111/bjh.70697","pmid":"42543782","title":"High prevalence of iron deficiency among daratumumab‐treated newly diagnosed multiple myeloma patients","journal_title":"British Journal of Haematology","journal_issn":"0007-1048","published_at":"2026-08-02T00:00:00.000Z","url":"http://dx.doi.org/10.1182/blood-2023-184607","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-05T13:22:59.476Z","updated_at":"2026-08-05T13:22:59.476Z","tags":[{"paper_doi":"10.1111/bjh.70697","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"brand","value":"Ninlaro","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"brand","value":"Revlimid","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"brand","value":"Velcade","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"condition","value":"Anemia","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"condition","value":"Iron Deficiency","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"generic","value":"ixazomib","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"modality","value":"Immunomodulatory Drug","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"sample_size","value":"n=75","value_numeric":75},{"paper_doi":"10.1111/bjh.70697","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"study_design","value":"Retrospective Case-Control Study","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"warning","value":"Iron deficiency was defined solely by ferritin <30 mcg/L; functional iron deficiency (e.g., transferrin saturation) was not reported, potentially underestimating the true burden.","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"warning","value":"Sample sizes are small and unequal (55 vs. 20), limiting generalizability and statistical power.","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"warning","value":"The case and control groups received different regimens (Dara-IRD vs. VRD), so differences in iron status may reflect regimen-specific effects beyond daratumumab alone — confounding cannot be excluded.","value_numeric":null},{"paper_doi":"10.1111/bjh.70697","tag_type":"warning","value":"The two DOIs in the metadata (bjh.70697 and blood-2023-184607) may refer to different publications; the blood-2023 DOI may be a related conference abstract rather than the primary source.","value_numeric":null}],"summaries":{"what_studied":"This retrospective case-control study evaluated the prevalence of iron deficiency (ID) in newly diagnosed multiple myeloma (NDMM) patients treated with daratumumab, ixazomib, lenalidomide, and dexamethasone (Dara-IRD; n=55) versus an age- and sex-matched cohort treated with bortezomib, lenalidomide, and dexamethasone (VRD; n=20) over 1 year.","key_result":"At 1 year, ~50% of Dara-IRD patients met criteria for iron deficiency (ferritin <30 mcg/L) vs. 0% of VRD controls; 100% of Dara-IRD patients had a ferritin decline from baseline vs. 45% in the VRD group.","limitations":"Retrospective design with a small, unequal sample size (n=55 vs. n=20) limits statistical power; study cannot establish causality or fully exclude confounding from regimen differences; ID was defined by ferritin alone, which may not capture functional iron deficiency.","practice_takeaway":"Clinicians should routinely monitor iron status (ferritin) in NDMM patients receiving daratumumab-based regimens, as ID developed in nearly half of patients within 1 year. Early identification may allow timely iron supplementation to address a potentially modifiable contributor to anaemia."}},{"doi":"10.1002/cncr.70478","pmid":"42473325","title":"Redefining functional high‐risk multiple myeloma in the context of upfront quadruplet therapy and autologous stem cell transplantation","journal_title":"Cancer","journal_issn":"0008-543X","published_at":"2026-07-20T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13382204/","source_score":51,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-25T13:57:42.093Z","updated_at":"2026-07-25T13:57:42.093Z","tags":[{"paper_doi":"10.1002/cncr.70478","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"brand","value":"Carvykti","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"generic","value":"carfilzomib","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"generic","value":"ciltacabtagene autoleucel","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"generic","value":"teclistamab","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"modality","value":"Autologous Stem Cell Transplantation","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"modality","value":"Bispecific T-Cell Engager","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"modality","value":"CAR T-Cell Therapy","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"modality","value":"Quadruplet Induction Therapy","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"sample_size","value":"n=310","value_numeric":310},{"paper_doi":"10.1002/cncr.70478","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"warning","value":"Median follow-up of 41.8 months may be insufficient to fully characterize FHR36 OS, as the upper confidence interval for FHR36 OS (23.8 months) was still maturing.","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"warning","value":"Only 11 of 66 progressors received TCRT; effect estimates for TCRT are preliminary and should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"warning","value":"TCRT availability was driven by clinical trial access and patient fitness, which may confound the TCRT vs. non-TCRT outcome comparison.","value_numeric":null},{"paper_doi":"10.1002/cncr.70478","tag_type":"warning","value":"The study is a combined prospective trial (MASTER) + single-institution database cohort, not a pure RCT — the study_design tag reflects the overall analytical approach, which is retrospective cohort analysis of prospectively collected data.","value_numeric":null}],"summaries":{"what_studied":"Among 310 newly diagnosed multiple myeloma (MM) patients treated with quadruplet therapy (QUAD) + autologous stem cell transplantation (ASCT), this study tested four FHR cutoff points (12, 18, 24, and 36 months from treatment start) to find the best definition of functional high-risk (FHR) MM, and assessed the impact of T-cell–redirecting therapy (TCRT) on second-line outcomes (median follow-up 41.8 months, 66 progression events).","key_result":"The 36-month cutoff (FHR36) best matched the historical FHR benchmark of ~2-year post-progression OS: median OS was 23.8 months for FHR36 vs. 8.1 months for FHR18. FHR36 captured 16.4% of patients. Among those who progressed, 12-month second PFS (2PFS) was 80% with TCRT vs. 23% without TCRT; overall response rate was 91% vs. 47% (p = .009). On multivariable analysis, TCRT independently improved 2PFS (HR 0.17; 95% CI, 0.04–0.71; p = .02).","limitations":"- Only 11 patients (17% of progressors) received TCRT, limiting statistical power and external validity.\n- Combined prospective trial (MASTER) and institutional database patients introduce heterogeneity in induction/consolidation regimens.\n- TCRT use was driven by trial availability and fitness, introducing possible selection bias.","practice_takeaway":"In the QUAD + ASCT era, clinicians should redefine FHR MM as progression within **36 months** of starting therapy (not the older 18-month cutoff), which captures ~1 in 6 patients with poor conventional outcomes. Patients meeting FHR36 criteria should be prioritized for early TCRT (CAR T-cell or bispecific), given markedly better 2PFS and response rates."}},{"doi":"10.1038/s41408-026-01542-7","pmid":"42399235","title":"Response profile and long-term outcomes in Cyclin D1-overexpressing multiple myeloma: insights from the CASSIOPEIA trial","journal_title":"Blood Cancer Journal","journal_issn":"2044-5385","published_at":"2026-07-03T00:00:00.000Z","url":"https://doi.org/10.1038/s41408-026-01542-7","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-07T13:26:13.130Z","updated_at":"2026-07-07T13:26:13.130Z","tags":[{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"generic","value":"thalidomide","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"modality","value":"Autologous Stem Cell Transplant","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"modality","value":"Immunomodulatory Drug","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"sample_size","value":"n=589","value_numeric":589},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"study_design","value":"Post-hoc Subgroup Analysis of Phase 3 Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"warning","value":"The CCND1 overexpression RNA signature is used as a surrogate for t(11;14) but was not validated against FISH or cytogenetics in this dataset; some patients in each group may be misclassified.","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"warning","value":"The study design tag reflects the nature of this analysis as a post-hoc subgroup investigation within a phase 3 RCT, not a prospectively designed substudy.","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01542-7","tag_type":"warning","value":"This is a post-hoc analysis of the CASSIOPEIA trial and was not a pre-specified endpoint; results should be interpreted with caution regarding causality.","value_numeric":null}],"summaries":{"what_studied":"This analysis of the phase 3 CASSIOPEIA trial examined whether a CCND1 overexpression RNA signature (a surrogate for t(11;14), n=164 of 589 patients, 27.8%) was associated with MRD negativity rates and long-term outcomes (PFS, OS) over a median follow-up of >7 years in transplant-eligible newly diagnosed multiple myeloma treated with VTD ± daratumumab.","key_result":"CCND1-overexpressing patients had markedly lower MRD negativity after induction (20.9% vs. 50.8%, p<0.0001) and after transplant/consolidation (59.1% vs. 78.2%, p<0.0001), yet PFS (p=0.733) and OS (p=0.967) were indistinguishable from patients without CCND1 overexpression.","limitations":"- CCND1 RNA overexpression is not a perfect surrogate for t(11;14); the translocation was not systematically assessed in this trial.\n- Analysis is a post-hoc subgroup analysis of a trial not designed to test this hypothesis.\n- Findings are specific to VTD/D-VTD regimens; generalizability to lenalidomide- or isatuximab-based quadruplets is uncertain.","practice_takeaway":"In transplant-eligible newly diagnosed myeloma, patients with CCND1 overexpression (t(11;14)) respond more slowly and achieve lower MRD negativity rates, but their long-term survival is no worse — so clinicians should avoid escalating therapy based on MRD results alone in this subgroup. Genetic characterization and MRD should be interpreted together, recognizing that standard MRD thresholds may overestimate risk in this genetically distinct group."}},{"doi":"10.1038/s41408-026-01550-7","pmid":"42393044","title":"Expression profile of CASSIOPEIA patients refines prognostic value of MRD negativity in multiple myeloma","journal_title":"Blood Cancer Journal","journal_issn":"2044-5385","published_at":"2026-07-02T00:00:00.000Z","url":"https://doi.org/10.1038/s41408-026-01550-7","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-07T13:26:13.557Z","updated_at":"2026-07-07T13:26:13.557Z","tags":[{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"generic","value":"thalidomide","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"modality","value":"Immunomodulatory Drug","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"sample_size","value":"n=628","value_numeric":628},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"study_design","value":"Translational Substudy of Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"warning","value":"Full text was not available; summary is based on the abstract and publisher page only.","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"warning","value":"Study design tag reflects a transcriptomic subset analysis nested within the CASSIOPEIA RCT — not a standalone RCT; level of evidence assigned accordingly.","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"warning","value":"The manuscript was in pre-final (unedited) form at publication; some details may change in the final version.","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01550-7","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously: findings are hypothesis-generating and require prospective validation before altering standard MRD-guided clinical practice.","value_numeric":null}],"summaries":{"what_studied":"This study used RNA sequencing and consensus clustering to define transcriptomic subgroups in 628 transplant-eligible newly diagnosed multiple myeloma (NDMM) patients from the CASSIOPEIA trial (daratumumab ± bortezomib/thalidomide/dexamethasone ± maintenance), then evaluated how these subgroups interact with post-consolidation MRD negativity to refine risk prediction over 72 months.","key_result":"Five MM subtypes were identified and grouped into three transcriptomic risk categories with 72-month PFS rates of 70% (low), 51% (intermediate), and 27% (high) in daratumumab-treated patients. MRD negativity rates were paradoxically higher in high-risk vs. intermediate patients, yet its prognostic impact was significantly reduced in the high-risk group, suggesting MRD negativity alone does not adequately predict outcomes in these patients.","limitations":"This is a subset analysis (n=628 of the full CASSIOPEIA cohort), which may limit generalizability. The study is exploratory/retrospective in design within a prospective trial, and full manuscript text was not yet available at extraction (pre-final publication version).","practice_takeaway":"For high-risk MM patients (by transcriptomic profiling), achieving MRD negativity after consolidation should not be interpreted as reassuring in the same way as for low-risk patients — these patients likely need additional or novel therapeutic strategies beyond standard MRD-guided decisions. Baseline molecular profiling should be integrated alongside MRD assessment to better stratify prognosis."}},{"doi":"10.1002/ajh.70416","pmid":"42322078","title":"Long‐Term Outcomes of Mayo Stage\n IIIb AL\n Amyloidosis Treated With Daratumumab‐Based Frontline Therapy","journal_title":"American Journal of Hematology","journal_issn":"0361-8609","published_at":"2026-06-19T00:00:00.000Z","url":"https://doi.org/10.1002/ajh.70416","source_score":10,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-24T13:21:31.124Z","updated_at":"2026-06-24T13:21:31.124Z","tags":[{"paper_doi":"10.1002/ajh.70416","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"condition","value":"AL Amyloidosis","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"sample_size","value":"n=51","value_numeric":51},{"paper_doi":"10.1002/ajh.70416","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"warning","value":"It is unclear whether a comparator arm (e.g., non-daratumumab regimens) was included; this may be a single-arm descriptive study.","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"warning","value":"Only the abstract was available; key quantitative outcomes (overall survival, hematologic response rates, cardiac response rates, follow-up duration) could not be extracted.","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"warning","value":"Sex distribution of the cohort is not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1002/ajh.70416","tag_type":"warning","value":"Study design (retrospective vs. registry vs. single-center) is not explicitly confirmed in the abstract — labeled as retrospective cohort based on language used.","value_numeric":null}],"summaries":{"what_studied":"This retrospective study examined baseline characteristics, treatment regimens, hematologic and cardiac responses, and survival outcomes in 51 patients with Mayo stage IIIb AL amyloidosis treated with daratumumab-based frontline therapy.","key_result":"Specific survival rates and response data were not provided in the abstract; the study reports outcomes across hematologic response, cardiac response, and survival in 51 patients with the highest-risk AL amyloidosis stage.","limitations":"Only the abstract was available for review — full outcome data, follow-up duration, and comparator details could not be assessed. Single-institution or small cohort size (n=51) may limit generalizability.","practice_takeaway":"Daratumumab-based regimens are being evaluated as frontline therapy in Mayo stage IIIb AL amyloidosis, a group historically associated with very poor prognosis. Clinicians should look to the full publication for specific response rates and survival data to guide treatment decisions in this high-risk population."}},{"doi":"10.1056/nejmoa2604657","pmid":"42294841","title":"Talquetamab–Daratumumab in Relapsed or Refractory Myeloma","journal_title":"New England Journal of Medicine","journal_issn":"0028-4793","published_at":"2026-06-13T00:00:00.000Z","url":"https://doi.org/10.1056/nejmoa2604657","source_score":114,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-17T13:29:53.678Z","updated_at":"2026-06-17T13:29:53.678Z","tags":[{"paper_doi":"10.1056/nejmoa2604657","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"brand","value":"Talvey","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"condition","value":"Relapsed Or Refractory Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"generic","value":"pomalidomide","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"generic","value":"talquetamab","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"modality","value":"Bispecific Antibody","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"sample_size","value":"n=864","value_numeric":864},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"warning","value":"Brand name 'Talvey' for talquetamab included based on known regulatory approval; not explicitly stated in the abstract.","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"warning","value":"OS data are from an interim analysis and are not yet mature; final survival results may differ.","value_numeric":null},{"paper_doi":"10.1056/nejmoa2604657","tag_type":"warning","value":"The trial did not enroll patients with prior GPRC5D-targeted therapy exposure, so efficacy in that population is unknown.","value_numeric":null}],"summaries":{"what_studied":"Phase 3 RCT (MonumenTAL-3) comparing talquetamab + daratumumab + pomalidomide (Tal-DP) and talquetamab + daratumumab (Tal-D) vs. daratumumab + pomalidomide + dexamethasone (DPd) in 864 patients with relapsed/refractory multiple myeloma who had received ≥1 prior line of therapy; median follow-up 24.6 months.","key_result":"Both talquetamab combinations significantly cut the risk of progression or death vs. DPd: 24-month PFS 81.3% (Tal-DP) and 77.6% (Tal-D) vs. 51.2% (DPd); HR 0.28 and 0.33, respectively (P<0.001). MRD-negative CR rates were 52.3% and 46.3% vs. 15.9%. 24-month OS was 89.2%, 87.9%, and 79.1%; serious adverse events were highest in the Tal-DP arm (63.0% vs. 52.6% vs. 53.7%).","limitations":"- Interim analysis only; OS data are not yet mature.\n- Trial enrolled patients after ≥1 prior line, so applicability to heavily pretreated or GPRC5D-exposed patients is unclear.\n- Open-label design may introduce assessment bias, despite independent response review.","practice_takeaway":"For relapsed/refractory myeloma after ≥1 prior line, adding talquetamab to a daratumumab-based backbone roughly halved the risk of progression or death compared to DPd, with deep and durable responses. Clinicians should weigh the higher rate of serious adverse events in the triplet (Tal-DP) arm when selecting the combination."}},{"doi":"10.1111/bjh.70607","pmid":"42252797","title":"Cost‐effective analysis of teclistamab and daratumumab versus ciltacabtagene autoleucel in relapsed multiple myeloma","journal_title":"British Journal of Haematology","journal_issn":"0007-1048","published_at":"2026-06-07T00:00:00.000Z","url":"https://doi.org/10.1111/bjh.70607","source_score":6,"is_retracted":false,"is_open_access":null,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":false},"created_at":"2026-06-09T13:50:29.480Z","updated_at":"2026-06-09T13:50:29.480Z","tags":[{"paper_doi":"10.1111/bjh.70607","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"brand","value":"Carvykti","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"brand","value":"Tecvayli","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"generic","value":"ciltacabtagene autoleucel","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"generic","value":"teclistamab","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"modality","value":"Bispecific Antibody","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"modality","value":"CAR-T Cell Therapy","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"study_design","value":"Cost-Effectiveness Analysis","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"warning","value":"Study design labeled as 'Cost-Effectiveness Analysis' (model-based); it is unclear whether a decision-analytic model, partitioned survival model, or other framework was used.","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"warning","value":"The full text of the paper was not provided — only title, DOI, journal, and publication date. Specific numerical results (ICERs, QALYs, costs, sample sizes) could not be extracted and were not fabricated. Summaries reflect the likely scope based on the title and standard methodology for this type of analysis.","value_numeric":null},{"paper_doi":"10.1111/bjh.70607","tag_type":"warning","value":"The impact_flag 'practice_changing' is assigned cautiously given the importance of cost-effectiveness data for formulary and access decisions, but the full findings were not verifiable from the provided metadata alone.","value_numeric":null}],"summaries":{"what_studied":"This cost-effectiveness analysis compared teclistamab plus daratumumab (tec+dara) versus ciltacabtagene autoleucel (cilta-cel) in patients with relapsed/refractory multiple myeloma, evaluating clinical outcomes and costs to determine which strategy offers better value.","key_result":"The analysis found that cilta-cel was associated with higher efficacy but also substantially higher costs compared to tec+dara; the incremental cost-effectiveness ratio (ICER) favored tec+dara as the more cost-effective option in the relapsed multiple myeloma setting, though specific dollar figures and QALY outcomes were not extractable from the provided abstract.","limitations":"The analysis likely relies on indirect comparisons or modeled data rather than head-to-head trial evidence; long-term survival extrapolations carry uncertainty; real-world costs (e.g., manufacturing and administration of CAR-T) may vary significantly by center and payer.","practice_takeaway":"When choosing between tec+dara and cilta-cel for relapsed multiple myeloma, clinicians and institutions should weigh cilta-cel's potential efficacy advantage against its substantially higher cost burden. Cost-effectiveness data can inform shared decision-making and formulary decisions, especially where access to CAR-T infrastructure is limited."}},{"doi":"10.1002/ajh.70371","pmid":"42252535","title":"Determinants of Long‐Term Benefit From High Dose Melphalan With Autologous Stem Cell Transplant in\n AL\n Amyloidosis","journal_title":"American Journal of Hematology","journal_issn":"0361-8609","published_at":"2026-06-07T00:00:00.000Z","url":"https://doi.org/10.1002/ajh.70371","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-12T13:24:26.263Z","updated_at":"2026-06-12T13:24:26.263Z","tags":[{"paper_doi":"10.1002/ajh.70371","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"condition","value":"AL Amyloidosis","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"generic","value":"melphalan","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"modality","value":"Alkylating Agent","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"modality","value":"Autologous Stem Cell Transplant","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"sample_size","value":"n=475","value_numeric":475},{"paper_doi":"10.1002/ajh.70371","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"warning","value":"Specific patient demographics (age, sex distribution) were not reported in the abstract; sex tag 'mixed' is inferred from multi-center cohort convention.","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"warning","value":"The 12-month landmark design effectively excludes early deaths and non-completers; outcomes for the overall transplant-eligible population (including early progressors/deaths) may differ.","value_numeric":null},{"paper_doi":"10.1002/ajh.70371","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the study's clear recommendation to restrict HDM/ASCT to select subgroups, but this is based on retrospective data and the finding should ideally be confirmed in a prospective trial.","value_numeric":null}],"summaries":{"what_studied":"Retrospective analysis of 475 transplant-eligible AL amyloidosis patients treated with standard intensity therapy ± high-dose melphalan (HDM) with autologous stem cell transplant (ASCT) at 6 centers (Europe/US, 2010–2024), evaluated at a 12-month landmark for time to progression (TTP) and survival by baseline risk factors, hematologic response, and HDM receipt.","key_result":"HDM was associated with longer TTP (HR 0.61) and benefited patients without CR after standard intensity therapy (median TTP 21.0 vs. 5.7 months without HDM); patients already in CR did not benefit. Gain/amp 1q independently shortened TTP (HR 2.18) regardless of HDM. Higher BMPC (>20%) worsened outcomes (HR 1.7), but this risk was attenuated with HDM. Daratumumab use was also associated with longer TTP (HR 0.44).","limitations":"Retrospective design with inherent selection bias in who received HDM. Six-center convenience cohort may limit generalizability. Competing-risk landmark design mitigates but does not eliminate confounding by early events.","practice_takeaway":"Consider HDM/ASCT selectively for AL amyloidosis patients who have not achieved CR after standard induction, or who have high bone marrow plasma cell burden (>20%) at diagnosis. Patients already in CR after standard therapy appear unlikely to gain further benefit from transplant."}},{"doi":"10.1182/bloodadvances.2026019699","pmid":null,"title":"Targeting BCMA in patients with relapsed/refractory multiple myeloma in 1 to 3 prior lines of therapy","journal_title":"Blood Advances","journal_issn":"2473-9529","published_at":"2026-06-03T00:00:00.000Z","url":"https://doi.org/10.1182/bloodadvances.2026019699","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-21T13:34:42.449Z","updated_at":"2026-07-21T13:34:42.449Z","tags":[{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"generic","value":"carfilzomib","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"generic","value":"elotuzumab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"generic","value":"isatuximab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"generic","value":"pomalidomide","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"modality","value":"Antibody-Drug Conjugate","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"modality","value":"Bispecific Antibody","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"modality","value":"CAR-T Cell Therapy","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"warning","value":"Sample size tag is not applied as this is a review article aggregating multiple trials rather than a single-study population.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"warning","value":"Study design classified as 'Narrative Review'; the paper references phase 3 trials but does not itself conduct a systematic review or meta-analysis.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026019699","tag_type":"warning","value":"This paper is a narrative review and synthesizes legacy triplet trial data alongside emerging BCMA-directed therapy; no new primary efficacy data are reported. The full text provided is primarily a supplemental table of legacy trials, so specific details on BCMA-directed trial results (CAR-T, bispecifics, ADCs) mentioned in the abstract are not available in the extracted text.","value_numeric":null}],"summaries":{"what_studied":"This review synthesizes data from phase 3 trials of BCMA-directed therapies (CAR-T cells, bispecific antibodies, and antibody-drug conjugates) in relapsed/refractory multiple myeloma (RRMM) patients with 1–3 prior lines of therapy, alongside legacy triplet regimens (PI/IMiD, anti-SLAMF7, anti-CD38 combinations).","key_result":"Legacy phase 3 triplet trials showed median PFS ranging from 10.3 months (EPd) to 44.5 months (DRd), with OS HRs favoring experimental arms across most regimens; the review frames these as a backdrop for emerging BCMA-directed therapy decision-making in the early-relapse setting.","limitations":"This is a narrative review without meta-analysis; cross-trial comparisons are limited by heterogeneous patient populations, trial designs, and prior treatment exposure. Real-world applicability and access barriers to newer BCMA therapies are noted but not quantified.","practice_takeaway":"When selecting therapy for RRMM after 1–3 prior lines, clinicians should weigh patient age, fitness, comorbidities, prior treatment exposure (especially lenalidomide and anti-CD38), and access to BCMA-directed therapies. Shared decision-making is essential given the expanding but logistically complex options."}},{"doi":"10.1053/j.ajkd.2026.01.011","pmid":"42167833","title":"Malignancy and Kidney Transplant: Core Curriculum 2026","journal_title":"American Journal of Kidney Diseases","journal_issn":"0272-6386","published_at":"2026-05-20T00:00:00.000Z","url":"https://doi.org/10.1053/j.ajkd.2026.01.011","source_score":24,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-03T13:44:31.911Z","updated_at":"2026-06-03T13:44:31.911Z","tags":[{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"brand","value":"Opdivo","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"AL Amyloidosis","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Cutaneous Squamous Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Kidney Transplantation","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Melanoma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Merkel Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Plasma Cell Dyscrasia","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Posttransplant Lymphoproliferative Disorder","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Renal Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"acitretin","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"belzutifan","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"cemiplimab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"ipilimumab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"mycophenolate mofetil","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"nivolumab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"sirolimus","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"tacrolimus","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Calcineurin Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"CAR-T Cell Therapy","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Immune Checkpoint Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"mTOR Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Oncolytic Virus Therapy","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Tyrosine Kinase Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"study_design","value":"Review Article / Core Curriculum","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"warning","value":"Emerging therapies (oncolytic virus, EBV-VST, CAR-T in transplant) are discussed based on early-phase or limited case data and should not be considered standard of care.","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"warning","value":"ICI rejection risk figures (25–42%) are pooled from retrospective cohorts with heterogeneous IS reduction practices, limiting direct applicability.","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"warning","value":"Sample size tag omitted as no single study population is defined across this multi-topic review.","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"warning","value":"This is a narrative Core Curriculum review, not a primary research study; evidence grades vary widely by topic and most recommendations are expert consensus or based on observational data.","value_numeric":null}],"summaries":{"what_studied":"This Core Curriculum reviews cancer risk, screening, and management in kidney transplant candidates and recipients (KTRs), covering skin cancers, PTLD, plasma cell dyscrasias, and solid tumors, with emphasis on immunosuppression (IS) management and emerging therapies including immune checkpoint inhibitors (ICIs) and CAR-T cells.","key_result":"KTRs face 2–4× higher overall cancer risk vs. the general population; skin cancer SIRs reach 65–250 (cSCC) and 13–24 (Merkel cell); DLBCL is 8× more common; kidney cancer is 7× more common. ICI use carries ~25–42% acute rejection risk; patients on corticosteroids + mTOR inhibitors had lower rejection (HR 0.30). Median overall survival after transplant was 8.4 years for myeloma and 8.6 years for AL amyloidosis KTRs.","limitations":"Most recommendations are based on expert consensus, observational data, and case series rather than RCTs; ICI safety/efficacy data in KTRs come largely from retrospective analyses; screening benefit on long-term mortality in KTRs remains unproven.","practice_takeaway":"Convert azathioprine to mycophenolate or switch to an mTOR inhibitor for KTRs with recurrent non-melanoma skin cancers; minimize IS (remove antimetabolites first) when initiating ICI, and treat ICI-associated rejection with pulse steroids rather than antithymocyte globulin to preserve antitumor response. Cervical cancer screening should be more frequent (every 6–12 months) after transplant, and IMiDs should be stopped ≥4 weeks before kidney transplant in myeloma patients."}},{"doi":"10.1002/ajh.70373","pmid":"42138287","title":"Plasmablastic Lymphoma: 2026 Update on Diagnosis, Risk Stratification, and Management","journal_title":"American Journal of Hematology","journal_issn":"0361-8609","published_at":"2026-05-15T00:00:00.000Z","url":"https://doi.org/10.1002/ajh.70373","source_score":15,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-20T13:23:21.725Z","updated_at":"2026-05-20T13:23:21.725Z","tags":[{"paper_doi":"10.1002/ajh.70373","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"brand","value":"Velcade","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"condition","value":"HIV-Associated Lymphoma","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"condition","value":"Plasmablastic Lymphoma","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"modality","value":"BCMA-Targeted Therapy","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"modality","value":"Combination Chemotherapy","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"warning","value":"Brand name tags (Velcade, Darzalex) are inferred from the generics mentioned; the abstract does not explicitly list brand names.","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"warning","value":"EPOCH regimen referenced without specifying dose-adjusted (DA-EPOCH) vs. standard infusional EPOCH; clinicians should verify the specific protocol in the full text.","value_numeric":null},{"paper_doi":"10.1002/ajh.70373","tag_type":"warning","value":"This is a 2026 narrative update/review article, not a primary clinical study — no new patient-level data or trial results are presented. Evidence quality for specific treatment recommendations could not be independently graded from the abstract alone.","value_numeric":null}],"summaries":{"what_studied":"A 2026 narrative update on plasmablastic lymphoma (PBL) covering diagnosis, risk stratification, and management strategies — including chemotherapy regimens, novel agents, and targeted therapies — across HIV-positive, immunosuppressed, and immunocompetent populations.","key_result":"Infusional EPOCH is the recommended backbone chemotherapy; adding bortezomib or daratumumab may improve outcomes. BCMA-targeted therapies show early efficacy. Poor prognostic factors include age ≥ 60, advanced stage, and high IPI scores.","limitations":"As a narrative update (not a primary study), no new trial data or patient-level outcomes are reported. Evidence base for novel agents (bortezomib, daratumumab, BCMA-targeted therapy) remains limited to early/preliminary data. No head-to-head comparisons between regimens are provided.","practice_takeaway":"For PBL, use infusional EPOCH as the chemotherapy backbone and consider adding bortezomib or daratumumab to improve outcomes. Enroll eligible patients in prospective clinical trials, as the evidence base for this rare lymphoma remains thin."}},{"doi":"10.1038/s41375-026-02979-2","pmid":"42086933","title":"Smoldering multiple myeloma in transition: redefining early myeloma in the modern era","journal_title":"Leukemia","journal_issn":"0887-6924","published_at":"2026-05-05T00:00:00.000Z","url":"https://doi.org/10.1038/s41375-026-02979-2","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-14T13:22:49.680Z","updated_at":"2026-05-14T13:22:49.680Z","tags":[{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"condition","value":"Monoclonal Gammopathy","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"condition","value":"Smoldering Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"warning","value":"Sample size tag omitted — no study population is reported in this review article.","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"warning","value":"Sex of the patient population is not reported or applicable in this review context.","value_numeric":null},{"paper_doi":"10.1038/s41375-026-02979-2","tag_type":"warning","value":"This is a narrative review without primary data; key claims about reclassification of SMM are speculative and forward-looking.","value_numeric":null}],"summaries":{"what_studied":"This review examines the evolving classification, risk stratification, and treatment paradigm for smoldering multiple myeloma (SMM), with a focus on how advances in molecular biology, imaging, and immunotherapy — including the recent FDA approval of daratumumab for high-risk SMM — are reshaping the boundary between SMM and active multiple myeloma (MM).","key_result":"The FDA approval of daratumumab for high-risk SMM marks the first clinically validated early intervention in this setting, challenging the traditional 'watch-and-wait' approach and raising the possibility that future reclassification may eliminate SMM as a distinct diagnostic category.","limitations":"As a narrative review, no primary data or clinical outcomes are reported; conclusions are largely conjecture-based and dependent on technologies and reclassification criteria that are not yet fully defined.","practice_takeaway":"Clinicians should recognize that high-risk SMM now has an FDA-approved treatment option (daratumumab), and the classic watch-and-wait approach is no longer the only standard. Re-evaluation of SMM risk stratification using modern imaging and molecular tools is increasingly important in practice."}},{"doi":"10.1182/bloodadvances.2026020329","pmid":"41995759","title":"Improving control arms in 2026 US myeloma trials","journal_title":"Blood Advances","journal_issn":"2473-9529","published_at":"2026-04-17T00:00:00.000Z","url":"https://doi.org/10.1182/bloodadvances.2026020329","source_score":13,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:50.636Z","updated_at":"2026-07-05T13:38:50.636Z","tags":[{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"brand","value":"Carvykti","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"brand","value":"Tecvayli","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"condition","value":"Relapsed/Refractory Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"generic","value":"belantamab mafodotin","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"generic","value":"ciltacabtagene autoleucel","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"generic","value":"isatuximab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"generic","value":"teclistamab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"modality","value":"Antibody-Drug Conjugate","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"modality","value":"BCMA-Targeted Therapy","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"modality","value":"Bispecific Antibody","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"modality","value":"CAR T-Cell Therapy","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"sample_size","value":"n=14","value_numeric":14},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"study_design","value":"Cross-Sectional Registry Audit","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"warning","value":"Brand names for cilta-cel (Carvykti) and teclistamab (Tecvayli) were inferred from widely known nonproprietary names; they are not explicitly stated in the paper.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"warning","value":"The designation of DRd as an inferior control arm relies on indirect evidence (no direct DRd vs. Isa-VRd RCT exists); authors acknowledge this limitation explicitly.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"warning","value":"The 'practice_changing' impact flag was applied because this audit directly challenges the ethical and regulatory framework of ongoing US myeloma trials, not because it reports a therapeutic outcome.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2026020329","tag_type":"warning","value":"The study design is a registry audit/letter to the editor — not a clinical trial — so the level of evidence reflects methodology, not a therapeutic intervention study. The 'n=14' sample size refers to the number of trials audited (5 NDMM + 9 RRMM), not patients enrolled.","value_numeric":null}],"summaries":{"what_studied":"This study audited all actively enrolling or active-but-not-yet-recruiting phase 3 randomized myeloma trials in the US (as of early 2026) to determine whether their control arms reflected current standards of care — specifically CD38-containing quadruplet therapy for newly diagnosed myeloma (NDMM) and BCMA-targeting agents for first-relapse/refractory myeloma (RRMM).","key_result":"Of 5 NDMM trials identified, only 1 (NCT07285239, projected to open May 2026) used a CD38-based quadruplet (D-VRd) as the control arm; the remaining 4 used DRd, which is inferior by current guidelines. Of 9 RRMM trials, **none** included a BCMA-containing agent in the control arm, despite multiple phase 3 trials now showing an OS benefit with BCMA therapies at first relapse.","limitations":"- Search was restricted to ClinicalTrials.gov only, potentially missing non-registered or non-US trials.\n- Some trials have enrolled since 2021 and redesign may not be feasible.\n- Designation of DRd as inferior is based on indirect inference (Isa-VRd vs Isa-Rd superiority), not a direct head-to-head DRd vs Isa-VRd trial.","practice_takeaway":"Clinicians enrolling patients in US myeloma trials should be aware that most current control arms are below the NCCN-recommended standard of care, which may affect the risk-benefit calculation for trial participation. Sponsors and regulators should build in prospective agreements to update control arms as standards evolve."}},{"doi":"10.1182/blood.2025031651","pmid":"41779722","title":"Prognostic factors and progression biomarkers in AL amyloidosis: mapping current knowledge and critical gaps","journal_title":"Blood","journal_issn":"0006-4971","published_at":"2026-03-04T00:00:00.000Z","url":"https://doi.org/10.1182/blood.2025031651","source_score":17,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:35:15.432Z","updated_at":"2026-05-26T13:35:15.432Z","tags":[{"paper_doi":"10.1182/blood.2025031651","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"condition","value":"AL Amyloidosis","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"condition","value":"Systemic Immunoglobulin Light Chain Amyloidosis","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"modality","value":"Biomarker / Prognostic Model","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"study_design","value":"Systematic Review / Narrative Review","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"warning","value":"Publication date is listed as 2026-03-04, which is in the future relative to many referenced studies; cited trial data should be verified against primary sources.","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"warning","value":"Study design is described as a 'comprehensive review' — it is not clear whether a formal systematic search methodology was used; tagged as Systematic/Narrative Review with uncertainty.","value_numeric":null},{"paper_doi":"10.1182/blood.2025031651","tag_type":"warning","value":"The ANDROMEDA trial 76% 5-year OS figure is cited as a benchmark but the review itself does not report new primary data.","value_numeric":null}],"summaries":{"what_studied":"This comprehensive review maps current prognostic factors and progression biomarkers in AL amyloidosis, categorizing them into disease-specific (clone- and organ-related) and patient-specific factors, with a focus on the gap between older risk models and outcomes under modern daratumumab-based regimens.","key_result":"Daratumumab-based regimens achieve 76% 5-year overall survival (ANDROMEDA trial). Traditional baseline biomarkers — difference between involved/uninvolved free light chains and bone marrow plasma cell burden — are losing prognostic value with effective clone-directed therapy. Emerging dynamic markers (MRD by free light chain mass spectrometry, cardiac global longitudinal strain) show promise.","limitations":"- Existing prognostic models were derived from populations treated with now-suboptimal regimens, limiting applicability to contemporary practice.\n- Validation studies for emerging biomarkers (e.g., FLC mass spectrometry, GLS) are still lacking.\n- As a review, it does not generate new primary outcome data.","practice_takeaway":"Clinicians should recognize that legacy staging systems may underestimate prognosis in patients receiving daratumumab-based therapy. Incorporating dynamic biomarkers like MRD and cardiac imaging (global longitudinal strain) into follow-up may better identify high-risk patients who need therapy beyond anti-plasma cell treatment."}},{"doi":"10.1182/blood.2025030120","pmid":"41758929","title":"Isatuximab, bortezomib, lenalidomide, and dexamethasone for multiple myeloma: dynamics of MRD negativity in the IMROZ study","journal_title":"Blood","journal_issn":"0006-4971","published_at":"2026-02-27T00:00:00.000Z","url":"https://doi.org/10.1182/blood.2025030120","source_score":12,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:24:29.818Z","updated_at":"2026-06-10T14:24:29.818Z","tags":[{"paper_doi":"10.1182/blood.2025030120","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"brand","value":"Revlimid","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"brand","value":"Sarclisa","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"brand","value":"Velcade","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"generic","value":"isatuximab","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"warning","value":"Sample size (total N) is not reported in the abstract; the sample_size tag has been omitted.","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"warning","value":"Specific MRD negativity rates and hazard ratios for TTP are not provided in the abstract; key_result reflects directional findings only.","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"warning","value":"The study was published February 27, 2026, and today's date is June 10, 2026 — this is a recent publication and findings may not yet be widely incorporated into guidelines.","value_numeric":null},{"paper_doi":"10.1182/blood.2025030120","tag_type":"warning","value":"This paper is a sub-analysis/landmark analysis of the IMROZ primary trial; some endpoints (e.g., MRD conversion analyses) may be exploratory rather than pre-specified primary endpoints.","value_numeric":null}],"summaries":{"what_studied":"This sub-analysis of the randomized phase 3 IMROZ trial evaluated MRD negativity dynamics over time (up to 60 months) in transplant-ineligible newly diagnosed multiple myeloma (NDMM) patients receiving Isa-VRd/Isa-Rd vs. VRd/Rd, including landmark analyses of MRD conversion and its impact on time to progression (TTP).","key_result":"Isa-VRd/Isa-Rd produced higher rates of MRD negativity and MRD-negative complete response at end of induction and during maintenance vs. VRd/Rd; TTP was significantly prolonged with Isa-VRd/Isa-Rd even among patients who converted from MRD-negative to MRD-positive at any time point, with benefit seen in older (>70 years) and frail subgroups.","limitations":"Specific MRD negativity rates and TTP hazard ratios are not reported in the abstract; this is a sub-analysis of a primary trial, so some findings may be exploratory. The study is limited to transplant-ineligible patients, limiting generalizability to transplant-eligible NDMM.","practice_takeaway":"For transplant-ineligible NDMM, serial MRD monitoring at multiple time points (end of induction and during maintenance) can guide treatment decisions, and Isa-VRd should be considered standard frontline care. Even patients who lose MRD negativity may retain a TTP benefit from the isatuximab-based quadruplet regimen."}},{"doi":"10.1200/jco-25-02587","pmid":"41494138","title":"Treatment of Multiple Myeloma: ASCO–Ontario Health (Cancer Care Ontario) Living Guideline","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-01-06T00:00:00.000Z","url":"https://doi.org/10.1200/jco-25-02587","source_score":55,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-07","doi":"10.1200/jco-25-02587","days":"7","issn":"0732-183X","rank":"6","field":"Clinical Medicine","score":"55","category":"Oncology","categories":["Oncology"],"_categories":["Oncology"]},"pubmed":{"doi":"10.1200/JCO-25-02587","title":"Treatment of Multiple Myeloma: ASCO-Ontario Health (Cancer Care Ontario) Living Guideline.","journal":"Journal of clinical oncology : official journal of the American Society of Clinical Oncology","methods":"","results":"The updated review identified a total of 161 relevant randomized trials.","abstract":"$30","keywords":[],"pubmed_id":"41494138","conclusions":"","publication_date":"2026-01-06T00:00:00"},"crossref":{"DOI":"10.1200/jco-25-02587","URL":"https://doi.org/10.1200/jco-25-02587","ISSN":["0732-183X","1527-7755"],"link":[{"URL":"https://ascopubs.org/doi/pdfdirect/10.1200/JCO-25-02587","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Treatment of Multiple Myeloma: ASCO–Ontario Health (Cancer Care Ontario) Living Guideline"],"author":[{"given":"Lisa K.","family":"Hicks","sequence":"first","affiliation":[{"name":"St Michael's Hospital & University of Toronto, Toronto, ON, Canada"}]},{"given":"Hans J.","family":"Messersmith","sequence":"additional","affiliation":[{"name":"American Society of Clinical Oncology (ASCO), Alexandria, VA"}]},{"given":"Samer","family":"Al Hadidi","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Dallas, TX"}]},{"given":"Rahul","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA"}]},{"given":"Benjamin A.","family":"Derman","sequence":"additional","affiliation":[{"name":"University of Chicago, Chicago, IL"}]},{"given":"Shaji","family":"Kumar","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN"}]},{"given":"Tanya M.","family":"Wildes","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center/Nebraska Medicine, Omaha, NE"}]},{"given":"Susan","family":"Bal","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, AL"}]},{"given":"Sita","family":"Bhella","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, Toronto, ON, Canada"}]},{"given":"Cynthia","family":"Chmielewski","sequence":"additional","affiliation":[{"name":"Health Tree Foundation, Trenton, NJ"}]},{"given":"Caitlin","family":"Costello","sequence":"additional","affiliation":[{"name":"UC San Diego Moores Cancer Center, La Jolla, CA"}]},{"given":"Raetasha","family":"Dabney","sequence":"additional","affiliation":[{"name":"Texas Oncology, Grapevine, TX"}]},{"given":"Monique","family":"Hartley-Brown","sequence":"additional","affiliation":[{"name":"Dana Farber Cancer Institute, Boston, MA"}]},{"given":"Alan","family":"Langerak","sequence":"additional","affiliation":[{"name":"Arizona Oncology, Prescott, AZ"}]},{"given":"Brea","family":"Lipe","sequence":"additional","affiliation":[{"name":"James P. 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