⬇️ The most comprehensive 🧵 looking into the weeds with powerful Tec-3 data. Surprisingly low rates of prior Dara exposure (5%), much lower than seen in CART-4.

#ASH25 delivered 1,000+ myeloma abstracts—and we had the impossible task of picking the very best. Innovation came in every flavor: LIMITEC (@AlGarfall @BeaRazzo) testing “less is more,” AI to detect amyloid a decade early, in-vivo & dual-target CARs, and early bispecific

#ASH25 US Multiple Myeloma Immunotherapy consortium We presented 14 orals, 8 posters at ASH! Now with 25+ sites Could never have imagined this success when Dr Hansen, Patel and I co-founded this 4+ years ago. Incredible collaborative effort!! A lot of work goes into this.

Med Student edition: Why longitudinal strain? Why not just EF? AL amyloid hearts often have preserved LVEF until very late. But: 🔑 Longitudinal subendocardial fibers are hit early ⭐️ GLS falls well before EF drops So GLS is like a magnified lens for subtle systolic

GLS thresholds in AL (lots of variable thresholds here): •Normal: ≲ –18% •Mildly reduced: –16 to –18% •Moderately reduced: –10 to –16% •Severely reduced: > –10% (i.e., closer to 0) AL ISS, a new validated, includes GLS of -9 or lower as an independent prognostic marker 🌟

How is GLS measured? (Echo version) Using speckle-tracking echocardiography: •High-quality apical views (2-, 3-, 4-chamber) •Software tracks natural acoustic “speckles” frame-to-frame •Generates segmental strain curves and a bull’s-eye (polar) map •Averaged across all LV

Biologic basis of GLS in Amyloid cardiomyopathy 🌟 AL is a toxic infiltrative cardiomyopathy (unlike TTR which is mostly a real estate problem in the heart) Misfolded light chains deposit in the interstitium, especially subendocardium •Direct light-chain toxicity (oxidative

What is GLS? GLS is a measure of myocardial deformation i.e. how much the LV muscle fibers shorten in the longitudinal direction during systole. Reported as a negative % 🔑 The more negative the better •Normal ≈ –18 to –22% •Less negative (e.g., –10%) = impaired

With Global longitudinal strain (GLS) becoming an increasingly important prognosticator in AL amyloidosis, it’s worth revisiting what GLS actually is and why does it matter in AL amyloid (Wish I knew this in med school edition) @Taxkourel @RahulBanerjeeMD @bdermanmd

The #ASH25 Ernest Beutler Prize and Lecture was delivered by two doyens of MPNs: Dr. Ruben Mesa @mpdrc and Dr. Radek Skoda. Their journeys have been equally mesmerising as their scientific contribution, and their parallel paths formed a perfect partnership of scientific

@SurbhiSidanaMD (#boss) up on stage right now describing risk factors for delayed neurotoxicity among pt tx with ciltacel #ASH2025

It’s been a lot of fun acting as @JoselleCookMD's deputy in bringing #ASH25 ASHNewsDaily to life! Great to finally meet the team IRL today 😍 @ZanwarSaurabh @EmperorBlackMD @majorajay @ChrisGrahamMD @supriyaguptaMD @ASH_hematology

My annual #ASH25 algorithms Relapsed Algorithms tomorrow Meanwhile, here is the 2nd one How I treat Newly Diagnosed Myeloma. It’s getting simpler.

Everyone deserves to have a @ZhuoerXie as a friendtor during fellowship! I was one of the lucky ones!! Zoey was hands down one of the best seniors I had! Volunteered to cover my leukemia service during parental leave! Since it’s been so rainy, sharing some sunny San Diego

Bispecifics have been such a game changer! Amazing data. Congratulations @rajshekharucms @SLentzsch and the study team! The myeloma gifts that keep on giving!

#ASH25 High ORR 100% VGPR to Etentamig (BCMA bisp mAb) in RRAL #amyloidosis presented by @rajshekharucms

With high ORRs and substantial improvement in PFS with Tec+Tal in EMD, PET responses for EMD must evolve. Deauville is imperfect and remains to be validated in true EMD-specific situations. RedirecTT-1 showed that volume of EMD matters. Total lesion glycolysis (TLG) captures

For context: Median PFS with cilta- cel for EMD was around 7-8 months https://t.co/L22P3ZQEy4 Median PFS with ide- cel in EMD was 5 months: https://t.co/XvXO23dRDG

Tec+Tal demonstrate some of the most sustained responses yet in true extramedullary disease, a highly aggrsssve and near universally fatal disease state in myeloma! 12 month PFS rates of 61%! 👏👏@myelomaMD @szusmani https://t.co/scyJQxY0qQ

3/ 4069: on behalf of the US MM immunotherapy consortium, likely the largest yet collated series of patients with RRMM (n =943) treated with bispecific antibodies. Some very interesting data on early treatment failures and exposure to prior BCMA agents .