The Fellow on Call: The Heme/Onc Podcast

In this week’s episode, we continue our journey through the relapsed/refractory myeloma space, with a focus on the role of bispecific T-cell engagers. Another incredibly important conversation that is so important in the current treatment landscape and one that you don’t want to miss.If you haven’t done so already, be sure to check out our CAR T episode.Content:- What are bispecific T-cell engagers? - How are they different than CAR T? - A discussion of the pivotal MajesTEC-3 trial (NEJM 2025) - What are key side effects?- How to sequence CAR T vs. bispecific T-cell engagers? ** This episode is sponsored by The Lymphoma, Leukemia and Myeloma Congress! To learn more and register for the meeting, visit llmcongress.com/podcast! Be sure to use our special TFOC code TFOC40 to save 40% off registration. ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Youtube

In this week’s episode, we take a practical dive into the relapsed/refractory myeloma space, with a focus on the role of CAR T therapy for relapsed/refractory. In our next episode, we will continue on with a discussion on bispecific agents! This is a conversation that is so important in the current treatment landscape and one that you don’t want to miss. Content:- What are treatment options for patients with relapsed/refractory multiple myeloma (R/R MM)? - What is CAR T therapy? And what role does it play in R/R MM?- What are the available options for CAR T for R/R MM?- What are the toxicity profiles of available agents? - How to choose between the options?** This episode is sponsored by The Lymphoma, Leukemia and Myeloma Congress! To learn more and register for the meeting, visit llmcongress.com/podcast! Be sure to use our special TFOC code TFOC40 to save 40% off registration. ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Youtube

Discussion of maintenance strategies after transplant for multiple myeloma, focusing on lenalidomide as standard care. Debate over adding anti‑CD38 antibodies like daratumumab and trial evidence for combined approaches. Use of MRD to guide treatment duration and stopping rules. Special considerations and intensified plans for high‑risk patients.

Dr. Amar Kelkar, Dana-Farber transplant physician focused on allogeneic transplant and ethics, and Dr. Shonali Midha, Dana-Farber myeloma specialist and autologous transplant expert, discuss transplant candidacy and pre-transplant testing. They walk through stem cell collection and mobilization, melphalan dosing, MRD-adapted strategies, second transplants, allogeneic roles, and financial/cost-effectiveness considerations.

A deep dive into transplant consolidation for multiple myeloma, highlighting three pivotal trials and how timing of autologous transplant affects outcomes. Discussion covers continuous maintenance strategies, MRD-directed approaches, and emerging therapies like bispecifics and CAR-T. Practical takeaways on current practice and ongoing trials are reviewed.

Hetty Carraway, leukemia program director and academic leader, and Alfred Lee, chief of classical hematology and seasoned mentor, discuss mentorship choices. They cover defining mentorship, learning from failure and resilience, picking mentors for different roles, when to renegotiate relationships, and practical scripts for awkward conversations. Short, actionable career-development talk for trainees.

A deep dive into first-line therapy for newly diagnosed multiple myeloma. They compare triplet versus quadruplet regimens and when to consider transplant. Discussion covers risk stratification, melphalan dosing, and infection and safety trade-offs with modern combinations. Trial data like Perseus, MASTER, Cepheus, and others shape practical treatment planning.

Dive into the complexities of myeloma risk stratification and response criteria! Explore how newly diagnosed patients are assessed and why those criteria are crucial for treatment decisions. Learn about the significance of minimal residual disease (MRD) testing and its evolving role in clinical practice. The hosts break down different response definitions, such as partial and complete responses, alongside genomic factors that contribute to high-risk situations. Tune in for in-depth insights and the latest research trends!

Kathryn Maples, a clinical pharmacy specialist at Winship Cancer Institute, dives deep into myeloma pharmacology. She discusses the importance of triplet and quadruplet regimens and explains the intricacies of prescribing medications for myeloma treatment. Kathryn highlights side effects of key drugs like bortezomib and lenalidomide, and shares insights on managing toxicity and infection risks. Listeners will find her practical advice on supportive care and dosing strategies particularly eye-opening and valuable.

Explore the evolving management strategies for smoldering multiple myeloma (SMM) and its higher-risk features. Delve into landmark studies revealing the nuances of this disease's natural history. Learn about the hot debate on whether early treatment or observation is more beneficial. Discover insights from trials like QUIREDEX and AQUILA, highlighting the effectiveness of lenalidomide and daratumumab. Plus, hear about personalized surveillance strategies to empower patient decision-making.