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\":\"Immunomodulatory Agent: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Immunomodulatory Agent (modality). Clinician-written summaries and actionable practice insights. 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the meta-analysis is substantially underpowered and results should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"Publication bias could not be formally assessed due to the small number of included studies.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"Race and ethnicity data were inconsistently reported across trials, preventing subgroup analyses by demographic factors.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"The Judson 2014 trial included both golimumab and ustekinumab arms with a shared placebo group; the authors split the placebo arm proportionally to avoid unit-of-analysis errors, which introduces analytical uncertainty.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"The level of evidence tag '1' reflects the meta-analysis of RCTs study design, but GRADE certainty was rated 'very low' due to risk of bias, imprecision, and heterogeneity — the clinical confidence in the pooled estimates is therefore much lower than the design hierarchy alone implies.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis of 6 double-blind, placebo-controlled RCTs (n=156 adults) evaluated the efficacy and safety of pharmacological add-on therapies — including infliximab, adalimumab, golimumab, ustekinumab, thalidomide, sirolimus (topical mTOR inhibitor), and the CLEAR antimycobacterial regimen — for cutaneous sarcoidosis, with all trials permitting concomitant corticosteroids.","key_result":"No pharmacological therapy significantly improved clinical response over placebo (OR 2.24; 95% CI 0.73–6.90; p=0.16). A non-significant trend toward better quality of life was seen (OR 2.23; 95% CI 0.87–5.73; p=0.09). Serious adverse events were similar between groups (OR 0.97; 95% CI 0.48–1.96; p=0.93). Overall certainty of evidence was very low (GRADE).","limitations":"- Only 6 RCTs with 156 total participants; severely underpowered for definitive conclusions.\n- Risk of bias was moderate-to-high in 4 of 6 studies, mainly due to missing outcome data and inadequate allocation concealment.\n- All trials allowed concurrent corticosteroids without standardized dosing or tapering, which may have blunted detection of treatment benefit. Publication bias could not be assessed.","practice_takeaway":"Current RCT evidence does not support a statistically significant benefit of steroid-sparing add-on therapies for cutaneous sarcoidosis; individualize treatment based on disease severity, comorbidities, and patient preferences. Emerging agents (JAK inhibitors, mTOR inhibitors) show promise in case reports but lack controlled trial data — do not use as standard care yet."}},{"doi":"10.1080/10428194.2026.2723847","pmid":"42702057","title":"MRD-guided induction-intensification with daratumumab–carfilzomib-based regimen followed by ASCT in patients with newly diagnosed multiple myeloma","journal_title":"Leukemia & Lymphoma","journal_issn":"1042-8194","published_at":"2026-09-06T00:00:00.000Z","url":"https://doi.org/10.1080/10428194.2026.2723847","source_score":5,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-11T06:20:08.418Z","updated_at":"2026-09-11T06:20:08.418Z","tags":[{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"brand","value":"Kyprolis","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"brand","value":"Revlimid","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"brand","value":"Velcade","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"generic","value":"carfilzomib","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"modality","value":"Anti-CD38 Antibody","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"modality","value":"Autologous Stem Cell Transplantation","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"sample_size","value":"n=60","value_numeric":60},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"warning","value":"Follow-up of 28.5 months is relatively short for myeloma outcomes; PFS and OS estimates may change with longer observation.","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"warning","value":"MRD was assessed by multiparameter flow cytometry rather than next-generation sequencing; sensitivity threshold and comparability to other studies may differ.","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"warning","value":"Retrospective single-institution design with a small cohort (n=60) limits the strength of conclusions; results should be interpreted with caution pending prospective validation.","value_numeric":null},{"paper_doi":"10.1080/10428194.2026.2723847","tag_type":"warning","value":"The study does not clearly report patient age range or sex distribution, so age_group and sex tags are inferred from transplant-eligible NDMM context.","value_numeric":null}],"summaries":{"what_studied":"This single-institution retrospective study assessed an MRD-guided induction intensification strategy in 60 transplant-eligible newly diagnosed multiple myeloma (NDMM) patients treated between 2020–2025, where MRD-positive patients received daratumumab, carfilzomib, and dexamethasone intensification before ASCT.","key_result":"Among 52 evaluable patients, 67.3% (35/52) achieved MRD negativity pre-ASCT and 93.8% (30/32) post-ASCT; at median 28.5 months follow-up, 2-year PFS was 87.3% and OS was 98.0%. R-ISS stage III, extramedullary disease, and high-risk cytogenetics were associated with worse PFS.","limitations":"Single-institution retrospective design with only 60 patients limits generalizability; short median follow-up of 28.5 months may not capture late relapses; MRD assessment used multiparameter flow cytometry rather than next-generation sequencing, which may affect sensitivity.","practice_takeaway":"An MRD-guided intensification approach with daratumumab-carfilzomib before ASCT is feasible and achieves deep responses without compromising stem cell mobilization, but clinicians should consider additional post-transplant strategies for patients with high-risk cytogenetics, R-ISS III, or extramedullary disease."}},{"doi":"10.1016/s2352-3026(26)00198-5","pmid":"42660129","title":"Epcoritamab with rituximab and lenalidomide as first-line treatment for follicular lymphoma (EPCORE NHL-2): an open-label, multicentre, phase 1/2 b trial","journal_title":"The Lancet Haematology","journal_issn":"2352-3026","published_at":"2026-08-28T00:00:00.000Z","url":"https://doi.org/10.1016/s2352-3026(26)00198-5","source_score":13,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-02T06:22:24.541Z","updated_at":"2026-09-02T06:22:24.541Z","tags":[{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"brand","value":"Epkinly","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"brand","value":"Revlimid","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"brand","value":"Rituxan","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"condition","value":"Follicular Lymphoma","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"generic","value":"epcoritamab","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"modality","value":"Bispecific Antibody","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"sample_size","value":"n=41","value_numeric":41},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"study_design","value":"Phase 1b/2 Open-Label Single-Arm Trial","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"warning","value":"Brand name 'Epkinly' is the US/EU approved brand for epcoritamab; verify local availability and approval status in first-line follicular lymphoma, as this indication may not yet be approved.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"warning","value":"Complete response rate and progression-free survival data are not reported in the abstract; only overall response rate is available.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"warning","value":"The trial is phase 1b/2, single-arm, so efficacy comparisons to standard of care cannot be made directly from this study.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00198-5","tag_type":"warning","value":"Treatment-related mortality of 7% (3/41) is notable; the small sample size means this estimate carries wide uncertainty.","value_numeric":null}],"summaries":{"what_studied":"This phase 1b/2 trial (EPCORE NHL-2, Arm 6) evaluated epcoritamab (subcutaneous CD3×CD20 bispecific antibody) combined with rituximab and lenalidomide as first-line chemotherapy-free treatment in 41 adults with grade 1–3A CD20+ follicular lymphoma, with a median follow-up of 35.9 months.","key_result":"The investigator-assessed overall response rate was 95% (39/41 patients; 95% CI 84–99%) at ~3 years of follow-up. Grade 3–4 adverse events included neutropenia (49%), infections (29%), and COVID-19 (15%). Treatment-related deaths occurred in 3 patients (7%): septic shock, progressive multifocal leukoencephalopathy, and COVID-19.","limitations":"Single-arm design with no comparator limits causal inference; small sample size (n=41) reduces precision of estimates; race data were missing in 29% of patients, limiting generalizability.","practice_takeaway":"Epcoritamab plus rituximab-lenalidomide achieved a 95% response rate as first-line therapy for follicular lymphoma, but the 7% rate of treatment-related deaths—including PML—signals meaningful toxicity that warrants careful patient selection and monitoring before broader adoption."}},{"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":"10.1056/nejmoa2600157","pmid":"42456135","title":"Continuous or Fixed-Duration Maintenance Therapy in Multiple Myeloma","journal_title":"New England Journal of Medicine","journal_issn":"0028-4793","published_at":"2026-07-15T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13374710/","source_score":175,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-21T13:34:40.272Z","updated_at":"2026-07-21T13:34:40.272Z","tags":[{"paper_doi":"10.1056/nejmoa2600157","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"brand","value":"Revlimid","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"sample_size","value":"n=516","value_numeric":516},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"warning","value":"The brand tag 'Revlimid' is inferred from the generic 'lenalidomide'; the paper does not explicitly name the brand.","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"warning","value":"The full-text page content was not rendered (pages appear blank in the source), so analysis relies entirely on the abstract and results sections.","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"warning","value":"The trial enrolled only standard-risk, non-transplant patients — findings should not be extrapolated to transplant-eligible or high-risk cytogenetic populations.","value_numeric":null},{"paper_doi":"10.1056/nejmoa2600157","tag_type":"warning","value":"The trial was powered for a 50% increase in median OS; it may be underpowered to detect modest but clinically relevant survival differences.","value_numeric":null}],"summaries":{"what_studied":"This phase 3 RCT (ENDURANCE) compared indefinite (continuous) vs. fixed 2-year lenalidomide maintenance in 516 patients with standard-risk newly diagnosed multiple myeloma who did not undergo up-front autologous stem-cell transplantation, after induction with a proteasome inhibitor–lenalidomide combination; median follow-up was 86 months.","key_result":"Overall survival at 7 years was nearly identical: 68.6% (continuous) vs. 69.0% (fixed-duration; difference −0.4 pp; 95% CI −9.0 to 8.3; P=0.93), with 80 deaths in each group. Progression-free survival at 7 years favored continuous therapy but was not significant (36.1% vs. 29.7%; difference 6.4 pp; 95% CI −2.6 to 15.4). Grade ≥3 nonhematologic adverse events were substantially higher with continuous lenalidomide (48.2% vs. 31.5%), and 5-year second primary cancer incidence was higher (11.2% vs. 8.3%).","limitations":"- Trial enrolled only standard-risk, non-transplant patients, limiting generalizability to high-risk or transplant-eligible populations.\n- The study was powered to detect a large survival difference (50% increase in median OS); smaller but clinically meaningful differences may have been missed.\n- Full-text page content was not available for detailed subgroup analysis review.","practice_takeaway":"For standard-risk, non-transplant myeloma patients, 2 years of lenalidomide maintenance appears to provide equivalent overall survival to indefinite therapy, with meaningfully fewer serious adverse events and a lower second-cancer burden. Clinicians may reasonably offer fixed-duration maintenance as a standard option, sparing patients prolonged toxicity without sacrificing survival."}},{"doi":"10.1182/bloodadvances.2025018896","pmid":"42418393","title":"Maintenance therapy and improved relapse-free survival in patients with monoclonal gammopathy of renal significance","journal_title":"Blood Advances","journal_issn":"2473-9529","published_at":"2026-07-08T00:00:00.000Z","url":"https://doi.org/10.1182/bloodadvances.2025018896","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-06T06:23:11.810Z","updated_at":"2026-09-06T06:23:11.810Z","tags":[{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"brand","value":"Darzalex","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"condition","value":"Monoclonal Gammopathy of Renal Significance","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"condition","value":"Proliferative Glomerulonephritis With Monoclonal Immunoglobulin Deposits","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"generic","value":"cyclophosphamide","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"modality","value":"Anti-CD38 Antibody","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"modality","value":"Autologous Stem Cell Transplantation","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"sample_size","value":"n=50","value_numeric":50},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"warning","value":"Maintenance therapy details (agent type, duration) are not fully specified in the available text, limiting direct clinical translation.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"warning","value":"Sex breakdown of the cohort is not explicitly reported in the abstract or full text provided.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — findings are hypothesis-generating given the small, retrospective sample and lack of a randomized control group.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025018896","tag_type":"warning","value":"The wide confidence intervals in the multivariate OS analysis (e.g., HR 21.39; 95% CI 1.94–2915.45) reflect very small event counts and should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"Retrospective analysis of 50 biopsy-proven MGRS patients across 3 institutions, evaluating plasma cell (PC)-directed vs. B-cell-directed therapy, induction regimen, ASCT use, maintenance therapy, and induction duration on relapse-free survival (RFS) and overall survival (OS) over a median follow-up of 6.15 years.","key_result":"Among PC-treated patients (n=37), maintenance therapy was associated with an 87% reduction in relapse risk (HR 0.13; 95% CI 0.03–0.53; p=0.004) on multivariate analysis; induction duration ≥6 months also independently improved RFS (HR 0.21; 95% CI 0.06–0.68; p=0.009). Median RFS was 3.74 years in the PC group vs. 19 years in the B-cell group. No significant RFS or OS differences were found by induction regimen type or ASCT use.","limitations":"- Small retrospective cohort (n=50) from 3 institutions limits generalizability and statistical power.\n- Maintenance therapy group (n=13/37) is particularly small, increasing risk of confounding despite multivariate adjustment.\n- Heterogeneous MGRS histopathologies (72% PGNMID) and varied treatment regimens preclude definitive regimen-specific conclusions.","practice_takeaway":"Consider maintenance therapy and prolonged induction (≥6 months) in PC-driven MGRS to reduce relapse risk—these factors independently improved RFS even after adjustment for age and induction duration. Choice of induction regimen (including daratumumab-based) or ASCT did not significantly affect outcomes in this cohort."}},{"doi":"10.1002/ajh.70405","pmid":"42400116","title":"Myelodysplastic Syndromes: 2026 Update on Diagnosis, Risk‐Stratification and Management","journal_title":"American Journal of Hematology","journal_issn":"0361-8609","published_at":"2026-07-03T00:00:00.000Z","url":"https://doi.org/10.1002/ajh.70405","source_score":27,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-10T13:25:25.883Z","updated_at":"2026-07-10T13:25:25.883Z","tags":[{"paper_doi":"10.1002/ajh.70405","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"brand","value":"Inqovi","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"brand","value":"Reblozyl","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"brand","value":"Rytelo","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"condition","value":"Acute Myelogenous Leukemia","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"condition","value":"Myelodysplastic Syndromes","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"generic","value":"azacitidine","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"generic","value":"decitabine/cedazuridine","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"generic","value":"imetelstat","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"generic","value":"luspatercept","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"modality","value":"Allogeneic Stem Cell Transplantation","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"modality","value":"Erythroid Maturation Agent","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"modality","value":"Hypomethylating Agent","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"modality","value":"Intensive Chemotherapy","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"modality","value":"Telomerase Inhibitor","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"study_design","value":"Narrative Review / Clinical Update","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"warning","value":"Brand name assignments (Reblozyl, Inqovi, Rytelo) are based on standard drug knowledge and not explicitly stated in the source text.","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"warning","value":"The abstract does not specify exact patient population sizes or trial-level effect estimates; numeric tags could not be assigned for sample size.","value_numeric":null},{"paper_doi":"10.1002/ajh.70405","tag_type":"warning","value":"This is a review/update article, not a primary study — no new trial data or patient-level outcomes are reported in the abstract. Level of evidence reflects the review design.","value_numeric":null}],"summaries":{"what_studied":"This is a 2026 update review covering diagnosis, risk-stratification, and management of myelodysplastic syndromes (MDS/myelodysplastic neoplasms), including the 2022 WHO classification, prognostic scoring systems (IPSS-R, IPSS-M), and available therapies across risk groups.","key_result":"AlloSCT remains the only curative option. Approved US therapies now include luspatercept (2020), oral decitabine/cedazuridine (2020), and imetelstat (2024) for transfusion-dependent lower-risk MDS. No combination regimen has proven superior to single-agent azacitidine, and no approved options exist for HMA-refractory disease.","limitations":"As a narrative review/update, it does not present new primary trial data or meta-analytic pooling. Evidence quality for individual recommendations varies and is not formally graded within the abstract.","practice_takeaway":"Risk-stratify all MDS patients using IPSS-R and IPSS-M to guide therapy selection, including transplant eligibility. For transfusion-dependent lower-risk MDS, imetelstat (approved 2024) is now an option alongside luspatercept; no approved therapy exists for HMA-refractory disease, so clinical trial enrollment should be prioritized."}},{"doi":"10.1038/s41408-026-01537-4","pmid":"42337234","title":"Characteristics and outcomes of secondary hematological malignancies following autologous stem cell transplantation for multiple myeloma","journal_title":"Blood Cancer Journal","journal_issn":"2044-5385","published_at":"2026-06-23T00:00:00.000Z","url":"https://doi.org/10.1038/s41408-026-01537-4","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-28T13:27:08.422Z","updated_at":"2026-06-28T13:27:08.422Z","tags":[{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"condition","value":"Second Primary Malignancy","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"condition","value":"Therapy-Related B-Cell Acute Lymphoblastic Leukemia","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"condition","value":"Therapy-Related Myeloid Neoplasm","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"generic","value":"cyclophosphamide","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"modality","value":"Alkylating Agent","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"modality","value":"Autologous Stem Cell Transplantation","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"sample_size","value":"n=3401","value_numeric":3401},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"warning","value":"Brand names for lenalidomide (Revlimid) and cyclophosphamide (Cytoxan) were not mentioned in the abstract; only generic names are tagged.","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"warning","value":"The 32-year study span (1990–2022) encompasses major shifts in MM treatment; era-related confounding may affect risk factor estimates. Readers should interpret multivariate predictors with caution.","value_numeric":null},{"paper_doi":"10.1038/s41408-026-01537-4","tag_type":"warning","value":"The paper's DOI year (2026) is consistent with today's date, but the journal volume/issue details were not provided for independent verification.","value_numeric":null}],"summaries":{"what_studied":"This retrospective study examined the incidence, characteristics, and outcomes of second hematological malignancies (SHM) in 3,401 multiple myeloma (MM) patients who underwent autologous stem cell transplantation (auto-SCT) at a single institution between 1990 and 2022.","key_result":"110 patients (3.2%) developed SHM — 98 therapy-related myeloid neoplasms (t-MN), 11 therapy-related B-ALL, and 1 mixed phenotype acute leukemia. Cumulative SHM incidence rose significantly from the pre-novel agent era to the novel agent era (1.1% vs. 2.0% at 60 months; P=0.03). Independent predictors included alkylator-based induction, radiation therapy, complete response after auto-SCT, cyclophosphamide mobilization, and lenalidomide maintenance. TP53 mutations were found in 40% of t-MN cases. SHM was associated with inferior overall survival.","limitations":"Single-institution retrospective design limits generalizability. Evolving treatment protocols over a 32-year span introduce significant era-related confounding. Causal inference is constrained by the observational nature of the data.","practice_takeaway":"Clinicians should counsel MM patients — especially those receiving lenalidomide maintenance, alkylator-based induction, or cyclophosphamide mobilization — about the rising risk of SHM after auto-SCT. As MM survival improves, routine long-term monitoring for secondary hematological malignancies should be part of survivorship care."}},{"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":"10.1016/s2352-3026(26)00112-2","pmid":"42285113","title":"Epcoritamab monotherapy or epcoritamab with lenalidomide as first-line therapy for patients with diffuse large B-cell lymphoma (EPCORE DLBCL-3): primary analysis of an open-label, multicentre, randomised, phase 2 trial","journal_title":"The Lancet Haematology","journal_issn":"2352-3026","published_at":"2026-06-12T00:00:00.000Z","url":"https://doi.org/10.1016/s2352-3026(26)00112-2","source_score":99,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-15T13:21:57.365Z","updated_at":"2026-06-15T13:21:57.365Z","tags":[{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"brand","value":"Epkinly","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"condition","value":"Diffuse Large B-Cell Lymphoma","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"generic","value":"epcoritamab","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"modality","value":"Bispecific Antibody","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"sample_size","value":"n=108","value_numeric":108},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"warning","value":"Epcoritamab is marketed under the brand name 'Epkinly' in some regions; brand availability may vary by country.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"warning","value":"No standard-of-care comparator arm was included, so relative efficacy vs. R-miniCHOP or best supportive care cannot be determined from this study alone.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"warning","value":"Phase 2 designation noted; results should be considered hypothesis-generating pending phase 3 confirmation.","value_numeric":null},{"paper_doi":"10.1016/s2352-3026(26)00112-2","tag_type":"warning","value":"The trial used a two-stage adaptive design; CR rates differ notably between stage 1 (63.6%) and stage 2 (45.5%) for monotherapy, which the authors acknowledge but do not fully explain — clinicians should interpret the pooled 57.6% figure with caution.","value_numeric":null}],"summaries":{"what_studied":"This open-label, randomised phase 2 trial (EPCORE DLBCL-3) evaluated fixed-duration epcoritamab monotherapy vs. epcoritamab + lenalidomide as first-line anthracycline-free therapy in patients aged ≥80 (or ≥75 with comorbidities) with newly diagnosed CD20+ DLBCL ineligible for standard chemoimmunotherapy, across 44 centres in 11 countries.","key_result":"In stage 1 (n=44 per arm), epcoritamab monotherapy achieved a complete response (CR) rate of 63.6% (95% CI 47.8–77.6) vs. 45.5% (95% CI 30.4–61.2) with epcoritamab + lenalidomide; across both stages, monotherapy CR rate was 57.6% (95% CI 44.8–69.7; 38/66 patients). Grade ≥3 infections occurred in 24% and serious adverse events in 70% of all monotherapy-treated patients.","limitations":"- Phase 2 design without a comparator arm (e.g., R-miniCHOP), limiting causal inference on superiority.\n- Small sample sizes per stage reduce precision of CR estimates, as reflected by wide confidence intervals in stage 2 (45.5%, 95% CI 24.4–67.8).\n- Population was predominantly White (81%), limiting generalisability to other ethnic groups.","practice_takeaway":"For older adults (≥80 years, or ≥75 with comorbidities) with newly diagnosed DLBCL who cannot tolerate anthracyclines, subcutaneous epcoritamab monotherapy yielded CR rates above 57% with a manageable but notable safety burden (70% serious adverse events). Clinicians should counsel patients on infection risk and monitor closely, particularly for CMV reactivation and COVID-19."}},{"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":"10.1182/bloodadvances.2025019036","pmid":"41925575","title":"BCMA/CD19 dual-targeting CAR T-cell therapy in older patients with newly diagnosed multiple myeloma: a phase 1 study","journal_title":"Blood Advances","journal_issn":"2473-9529","published_at":"2026-04-02T00:00:00.000Z","url":"https://doi.org/10.1182/bloodadvances.2025019036","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-16T13:54:37.301Z","updated_at":"2026-06-16T13:54:37.301Z","tags":[{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"brand","value":"AZD0120","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"generic","value":"bortezomib","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"generic","value":"dexamethasone","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"modality","value":"CAR T-Cell Therapy","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"sample_size","value":"n=8","value_numeric":8},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"study_design","value":"Phase 1 Single-Arm Trial","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"warning","value":"AZD0120 was formerly known as GC012F; clinicians searching the literature may need to use both names.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"warning","value":"Extremely small sample (n=8) — efficacy and safety estimates are highly uncertain and should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"warning","value":"Median follow-up of 9.8 months is insufficient to assess progression-free or overall survival; MRD negativity at month 12 is based on only 2 evaluable patients.","value_numeric":null},{"paper_doi":"10.1182/bloodadvances.2025019036","tag_type":"warning","value":"No formal dose-response analysis was possible given the small N across two dose levels.","value_numeric":null}],"summaries":{"what_studied":"Phase 1 single-arm study evaluating AZD0120 (formerly GC012F), a BCMA/CD19 dual-targeting autologous CAR T-cell therapy, as frontline treatment in 8 patients with newly diagnosed multiple myeloma (NDMM) aged ≥70 years, following 2 cycles of VRD induction, at doses of 1.5×10⁵ or 3×10⁵ cells/kg, with a median follow-up of 9.8 months post-infusion.","key_result":"All 8 patients (100%) achieved stringent complete response (sCR) and MRD negativity at 10⁻⁶ by Euroflow at 1 month; MRD negativity was maintained in 100% of evaluable patients at month 6 (n=7) and month 12 (n=2). Grade ≥3 toxicities included neutropenia (75%), leukopenia (50%), and lymphopenia (25%); CRS occurred in 4 patients (50%), all grade 1; no ICANS was observed.","limitations":"Very small sample size (n=8) limits generalizability; short median follow-up (9.8 months) precludes durability conclusions; single-arm design with no comparator group.","practice_takeaway":"AZD0120 CAR T-cell therapy after VRD induction produced universal sCR and MRD negativity in older and frail NDMM patients with a manageable toxicity profile, suggesting this approach may be feasible even in patients ≥70 years. Larger studies with longer follow-up are needed before routine clinical adoption."}},{"doi":"10.1182/blood.2026033126","pmid":"41915772","title":"Lenalidomide plus rituximab for previously untreated advanced follicular lymphoma: the 10-year RELEVANCE trial analysis","journal_title":"Blood","journal_issn":"0006-4971","published_at":"2026-03-31T00:00:00.000Z","url":"http://hdl.handle.net/2078.1/313224","source_score":13,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-20T13:25:07.681Z","updated_at":"2026-06-20T13:25:07.681Z","tags":[{"paper_doi":"10.1182/blood.2026033126","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"brand","value":"Revlimid","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"brand","value":"Rituxan","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"condition","value":"Follicular Lymphoma","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"modality","value":"Anti-CD20 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"modality","value":"Immunochemotherapy","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"sample_size","value":"n=1030","value_numeric":1030},{"paper_doi":"10.1182/blood.2026033126","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"warning","value":"Older adult subgroup outcomes are not separately reported; age was a stratification factor (≤60 vs >60 years) but age-specific long-term data are not detailed in the abstract or text excerpt.","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"warning","value":"R-Chemo included three different chemotherapy regimens without stratification, limiting intra-chemo comparisons.","value_numeric":null},{"paper_doi":"10.1182/blood.2026033126","tag_type":"warning","value":"The trial enrolled patients between 2011–2014; some newer frontline agents (e.g., obinutuzumab-based regimens, PI3K inhibitors, bispecific antibodies) were not available as comparators.","value_numeric":null}],"summaries":{"what_studied":"The RELEVANCE phase 3 RCT compared rituximab + lenalidomide (R2; n=513) vs. rituximab-based immunochemotherapy (R-Chemo; n=517) in 1,030 previously untreated advanced follicular lymphoma (FL) patients, with a preplanned final analysis at 120 months (median follow-up 118.2 months).","key_result":"10-year PFS was equivalent: 46.4% (R2) vs. 46.6% (R-Chemo); median PFS 110.6 vs. 102.8 months. 10-year OS was 82.4% vs. 81.1%; median OS not reached in either arm. POD24 carried a markedly worse prognosis (HR 6.215; P<0.0001) but did not differ between arms. SPM incidence was 2.11 per 100 patient-years (95% CI 1.80–2.46), comparable between groups.","limitations":"- Randomization was 1:1 between R2 and R-Chemo only, without stratification by specific chemotherapy regimen, preventing direct comparisons across chemo backbones.\n- Open-label design may introduce assessment bias despite independent review committee adjudication of PFS.\n- ~7% of patients were lost to follow-up, though similar between arms.","practice_takeaway":"R2 delivers 10-year PFS and OS on par with immunochemotherapy and can be offered as a chemotherapy-free frontline option for advanced FL. SPM rates were not higher with lenalidomide-containing therapy vs. chemo in this setting, which should reassure clinicians counseling patients on long-term risks."}},{"doi":"10.1182/blood.2025030207","pmid":"41770790","title":"CSF-1R inhibition and lenalidomide synergize to promote myeloma control after autologous stem cell transplantation","journal_title":"Blood","journal_issn":"0006-4971","published_at":"2026-03-02T00:00:00.000Z","url":"https://doi.org/10.1182/blood.2025030207","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:24:30.252Z","updated_at":"2026-06-10T14:24:30.252Z","tags":[{"paper_doi":"10.1182/blood.2025030207","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"brand","value":"Axatilimab","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"category","value":"Hematology","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"generic","value":"axatilimab","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"modality","value":"Autologous Stem Cell Transplantation","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"modality","value":"CSF-1R Inhibitor","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"modality","value":"Immunomodulatory Agent","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"study_design","value":"Preclinical Study with Translational Correlative Analysis","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"warning","value":"Sample size not reported in the abstract; no 'n=' tag applied.","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"warning","value":"Study design label reflects a combined preclinical mouse model plus human correlative bone marrow data; no randomized clinical trial component.","value_numeric":null},{"paper_doi":"10.1182/blood.2025030207","tag_type":"warning","value":"The 'practice_changing' impact flag is aspirational here — findings are preclinical; no clinical trial results are presented. Flagged because the combination has a clear regulatory pathway via axatilimab's existing FDA approval.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated whether immunosuppressive myeloid populations in bone marrow affect outcomes after autologous stem cell transplantation (ASCT) with lenalidomide maintenance in multiple myeloma, and tested whether combining CSF-1R inhibition with lenalidomide could improve disease control in a preclinical ASCT model.","key_result":"CSF-1R inhibition combined with lenalidomide synergistically reduced disease progression and prolonged survival in a preclinical ASCT model, where neither agent alone showed significant benefit; CD64+CD169+CD163+ macrophages expressing CSF-1R, PD-L1, and CD155 were expanded in patients who relapsed post-ASCT.","limitations":"Findings are primarily preclinical (mouse ASCT model); the model was deliberately suboptimal in endogenous antimyeloma activity, which may not fully represent human disease biology. No clinical trial data yet confirming the combination's efficacy or safety in myeloma patients.","practice_takeaway":"Consider the potential of adding a CSF-1R inhibitor (e.g., axatilimab, already FDA-approved for chronic GvHD) to lenalidomide maintenance after ASCT as a strategy worth testing in clinical trials, particularly in patients at high risk for relapse."}},{"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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