Georgia McCaughan
@gjmccaughan
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Haematologist interested in plasma cell disorders at St Vincent’s Hospital Sydney and Garvan Institute of Medical Research
Joined July 2013
Is your center allowing for BCMA CAR T-cell therapy in patients with myeloma on dialysis for renal failure? We describe our early experience with ide-cel/cilta-cel in patients on dialysis. Bottom line: - Don't let ESKD be a barrier! - Reducing fludarabine + dialyzing each day
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Excited to share new study out today on @JCO_ASCO where we leveraged #WGS to reclassify MGUS and SMM and define the concept of "malignant transformation" @MSKCancerCenter @LaStatale @MDAndersonNews @MoffittNews @SylvesterCancer @nyulangone @sangerinstitute @MayoClinic #mmsm 1/14
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Biggest & best #downwithdex study yet - IFM 2017-03 by Manier et al in @TheLancetOncol 👏 Dara-R (dex 20mg weekly for 2 cycles, then stop, not needed as pre-med) drastically outperformed Rd. Stopping dex after 2 cycles: better tolerability & better efficacy. This is the way!
#Myeloma Paper of the Day: IFM2017-03 trial of Revlimid/Darzalex w/ 2 cycles of dex versus triplet w/ continuous dex finds DRAMATICALLY reduced progression risk (53.4 mos (95% CI 35.3-not reached) vs. 22.5 mos (HR 0.51, 95% CI 0.37-0.70, p<0.0001)): https://t.co/2xJYCJGIFo.
#mmsm
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Advances in Myeloma. 2025 Edition Key takeaways from #IMS25 1) Early intervention is here: Given recent EU approval of daratumumab for high risk smoldering myeloma in Europe, and NCCN category 1 recommendation in the US, ~55% of the attendees would offer early intervention
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At #IMS25 @RahulBanerjeeMD - CIBMTR analysis: MM pts with PD </= 12 m after ASCT have poor outcomes and outcome is not affected by the induction strategy received Need novel approaches in this group - @MyelomaAmarc ZEPFHR study currently recruiting to the Tec/tal domain in 🇦🇺🦘
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beaming with pride seeing Dr Masa Lasica on the podium presenting our Australian Academic BelaCarD study at #IMS2025 @MyelomaAmarc @MyelomaAust_MFA
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#IMS25 Not bela-maf, but bela-naked… just BCMA mAb, not the ADC! @HangQuach1 presents DREAMM-20 - with bela alone, not even dex, 28% ORR and no real Gr2+ 👁️ AEs (blame the “maf” for that)! Clearly can be combined with other drugs to ⬆️ ORR, just need to figure out what…
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Dr Doris Hansen presents an analysis of the FLATIRON registry demonstrating poor outcomes for patients who have received 3+ prior lines, quad class exposed and receive a further line of therapy #IMS25 EFS (death, progression or initiation of new line of therapy) 4.5m OS 13.4m
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#IMS25 excellent 🇦🇺 study: BELACARD supporting Bela-Kd in RRMM. Quite effective. Excellent work! Here, they started with Q8W bela-maf from the beginning rather than waiting for visual AEs… and this dose schedule was quite tolerable a priori & was maintained. #lessismore !
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Dr Masa Lasica 🇦🇺 presents results of @MyelomaAmarc BelaCarD with q8w belantamab mafodotin Median prior lines 2 38% grade 3/4 BCVA decline. At median FU 27.4m, median PFS 22.6 and estimate median OS 36.3m Moving forward with study using reduced frequency of belantamab mafodotin
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FIH Phase 1 study of Cemsidomide presented at #IMS25 IKZF1/3 MonoDAC cereblon-based degrader Heavily pre-treated cohort - 75% prior CAR-T ORR 34% at all dose levels, 50% at highest dose 57% grade 3/4 neutropenia 25% grade 3+ infection
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🇦🇺 Using #MRDR #Myeloma1000 Biobank Dr Daniel Wong demonstrates circulating extracellular BCL-2 RNA associated with higher risk of progression in SMM #IMS25
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In those with neoplastic transformation - 4 genomic features associated with shorter time to progression - RAS mutations, MYC translocations, APOBEC mutagenesis, and copy number complexity #IMS25
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1/ #IMS25 @SagarLonialMD impressive Iber-Dd results across the board in ASCT-ineligible NDMM. 1️⃣ Legit MAIA-esque pts (58% aged ≥75) 2️⃣ AE profile mainly heme... rash, fatigue much better with iber than with len. 3️⃣ 64% MRD neg 10^-5 👏 Also, with regard to neutropenia...
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#IMS25 @ldandersonjr updated AURIGA data. Fascinating points: 1️⃣ By new HR criteria, not a single HR pt on len alone converted to MRD-. 2️⃣ PFS continues to look great (I'd wager that CD38 in induction wouldn't dramatically change this) 3️⃣ 👀 OS curves starting to separate!!
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And important addition - this was a prospective trial and not retrospective data, and very few trials of PCL have ever been done - kudos to #IMS25 investigators for presenting this! Because ASCT (even tandem) often does not yield durable responses here, maybe CAR-T will help.
#IMS25 CAR-T can be given to patients with PCL even in the absence of antecedent transplant. Many of these patients would have gone onto frontline ASCT in 🇺🇸 since all aged ≤ 75, but - to be fair - ASCT doesn’t work well for these pts so this may be a new paradigm! By
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And 5-color flow if we add @gjmccaughan whom I’d seen just earlier - grateful to have collaborated on so many projects before and at #IMS25!
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