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  • ||||||||||  Keytruda (pembrolizumab) / Merck (MSD), Adcetris (brentuximab vedotin) / Takeda, Pfizer, Opdivo (nivolumab) / BMS
    Hodgkin Lymphoma: Next Questions () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1056;    
    P2, P3
    Recently, the S1826 study established nivo-AVD (nivolumab plus adriamycin, vinblastine, and dacarbazine) as a standard for frontline treatment of advanced-stage HL, but novel agents are not yet standard for initial treatment of Early-Stage disease.1 It is likely that incorporation of brentuximab vedotin (BV) and/or checkpoint inhibition (CPI) would improve efficacy and reduce toxicity for Early-Stage disease; however, the optimal way to incorporate these agents into frontline treatment is not yet known...RADAR is a phase III study comparing PET-adapted therapy with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) to PET-adapted therapy with BV-AVD for non-bulky Early-Stage HL...Chemotherapy agents may have varying effects on anti-tumor immunity, suggesting that certain chemotherapy agents may enhance the efficacy of CPI better than others.14 Based on this, it may still be reasonable to rechallenge patients relapsing after CPI-based frontline therapy, such as nivolumab plus AVD, with a different CPI-based salvage therapy, such as pembrolizumab plus gemcitabine, vinorelbine, and liposomal doxorubicin...A possible mechanism by which CPI-based salvage therapy may improve transplant efficacy is by restoring chemosensitivity.16,17 An ongoing Canadian Clinical Trials Group study comparing salvage therapy with pembrolizumab plus BV to GDP (gemcitabine, dexamethasone, and cisplatin) (NCT05180097) will aid in answering the question of whether a CPI-based salvage therapy truly improves outcomes for patients with R/R HL...Finally, as frontline treatments are now curing over 90% of patients, it will be important to identify which patients are likely to fail frontline therapies and which patients can be cured with less intense therapies. Studies evaluating ctDNA and TMTV-directed treatment approaches may help answer these questions.
  • ||||||||||  Mantle Cell Lymphoma: Next Steps () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1055;    
    Studies evaluating ctDNA and TMTV-directed treatment approaches may help answer these questions. The most commonly used agents are the Bruton tyrosine kinase (BTK) inhibitors, with ibrutinib becoming Food and Drug Administration (FDA)-approved in 2013, acalabrutinib in 2017, and zanubrutinib in 2019...Excitingly, pirtobrutinib, a BTK inhibitor that binds noncovalently and reversibly to BTK, is also now FDA-approved and is providing acceptable results even in many patients with prior relapse to covalent BTK inhibitors...Brexucabtagene autoleucel (brexu-cel) is an anti-CD19 chimeric antigen receptor (CAR) T-cell therapy that was approved by the FDA in 2020...Most excitingly, a second anti-CD19 CAR T-cell therapy, lisocabtagene maraleucel (lisocel), was approved a week ago...The most advanced ones include glofitamab (CD20/CD3) and epcoritamab (CD20/CD3), both of which are approved for diffuse large B-cell lymphoma and are currently being tested for mantle cell lymphoma as well...In this phase 3 trial, ibrutinib plus venetoclax produced a high complete response (CR) rate, longer progression-free survival (PFS), and a trend of improved overall survival (OS)...In the near future, I
  • ||||||||||  Next Questions in Aggressive B-cell Lymphomas () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1054;    
    P3
    The most commonly used agents are the Bruton tyrosine kinase (BTK) inhibitors, with ibrutinib becoming Food and Drug Administration (FDA)-approved in 2013, acalabrutinib in 2017, and zanubrutinib in 2019...Excitingly, pirtobrutinib, a BTK inhibitor that binds noncovalently and reversibly to BTK, is also now FDA-approved and is providing acceptable results even in many patients with prior relapse to covalent BTK inhibitors...Brexucabtagene autoleucel (brexu-cel) is an anti-CD19 chimeric antigen receptor (CAR) T-cell therapy that was approved by the FDA in 2020...Most excitingly, a second anti-CD19 CAR T-cell therapy, lisocabtagene maraleucel (lisocel), was approved a week ago...The most advanced ones include glofitamab (CD20/CD3) and epcoritamab (CD20/CD3), both of which are approved for diffuse large B-cell lymphoma and are currently being tested for mantle cell lymphoma as well...In this phase 3 trial, ibrutinib plus venetoclax produced a high complete response (CR) rate, longer progression-free survival (PFS), and a trend of improved overall survival (OS)...In the near future, I CAR-T therapy targeting CD19 has improved our ability to cure patients with chemotherapy-refractory LBCL-Axicabtagene ciloleucel, lisocabtagene maraleucel, and tisagenlecleucel have been approved as salvage therapy and cure 30
  • ||||||||||  Venclexta (venetoclax) / Roche, AbbVie, Rituxan (rituximab) / Roche
    CD19 CAR T Therapy Should be the Preferred Therapy for Richter's Transformation () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1052;    
    CAR-T therapy targeting CD19 has improved our ability to cure patients with chemotherapy-refractory LBCL-Axicabtagene ciloleucel, lisocabtagene maraleucel, and tisagenlecleucel have been approved as salvage therapy and cure 30 The standard approach has been a combination of cytotoxic chemoimmunotherapy with R-CHOP-like regimens.3 Although most patients have an initial response to treatment, the median progression-free survival (PFS) with these regimens ranges from 6
  • ||||||||||  Accessing BTK Inhibitors and Other Novel Therapies for Mantle Cell Lymphoma: Are We All Invited to the Party? () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1051;    
    Finally, chimeric antigen receptor T cells (CARTs) have also shown great efficacy in heavily treated MCL patients, leading to the approval of both brexucabtagene autoleucel and lisocabtagene maraleucel for these patients...Enrollment of patients in clinical trials may not help the accessibility of study drugs in the future, but it will guarantee that some patients receive proper therapy. There is a clear need to discuss ethical aspects of these studies, including post-protocol therapy, but we strongly believe that clinical trials are an important tool for optimizing therapy for MCL patients in LICs and LMICs.
  • ||||||||||  Sequencing Therapies in Relapsed/ Refractory Large B-cell Lymphoma to Optimize the Chance of Cure () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1050;    
    Early treatment failure (within 12 months after completing first-line therapy) For patients who are refractory to the firstline therapy or relapse within 12 months after achieving a response to their first line of therapy, the randomized studies, ZUMA-7 and TRANSFORM, have demonstrated the benefit of using axi-cel and liso-cel compared to salvage immunochemotherapy and ASCT...Although treatments targeting the CD19 antigen were usually not recommended before the use of CD19-directed CAR T-cells, recent data indicate that both loncastuximab (from a retrospective clinical series) and tafasitamab (based on experimental models) might not impair the efficacy of CAR T-cell therapy...For patients considered ineligible for cellular therapies, antibody-drug conjugates either alone or in combination (approved as polatuzumab vedotin, bendamustine, and rituximab) and the tafasitamab/lenalidomide combination are preferable options rather than a chemotherapy-based option in the context of early firstline failure, an indication of chemoresistance...Recently, the STARGLO study enrolled 270 patients who were non-eligible for ASCT and showed a significant OS benefit for the glofitamab-gemcitabine/oxaliplatin (GemOx) combination versus rituximab-GemOx (Abramson et al., EHA 2024)...The bispecific antibodies, glofitamab and epcoritamab, have demonstrated more than a 50% overall response rate (ORR) and a 39% CR rate...Recently, a study has shown that the combination of brentuximab vedotin with rituximab lenalidomide was significantly superior to rituximab-lenalidomide, with a median OS of 13.8 months (Kim et al...For example, the combination of ibrutinib, lenalidomide, prednisone, venetoclax, and obinutuzumab (VIPOR) has shown promising results, particularly in non-germinal center B-cell-like (GCB) DLBCL...These therapies alongside other regimens anchored on antibodies (naked or conjugated) offer new alternatives. During this presentation, we will discuss a possible algorithm to navigate this dynamic landscape.
  • ||||||||||  BTK Inhibitor Therapy Can be Stopped in CLL () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1048;    
    P2, P3
    During this presentation, we will discuss a possible algorithm to navigate this dynamic landscape. Results and Discussion Because deep responses are rare with BTKi monotherapy and BTKis have relatively short half-lives (ibrutinib: 4
  • ||||||||||  MM Therapy in Resource-Constrained Including Maintenance () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1047;    
    In the public sector, for first-line patients eligible for ASCT in the induction phase, the option is VTd or VCd, followed by ASCT and then followed by consolidation or not and thalidomide maintenance, due to lenalidomide not being incorporated in the public sector...Unfortunately, the difference in treatments between public and private institutions leads to a lower OS in the public ones. To improve the management of MM patients in LMICs, additional novel agents and their facilitated access are imperative and further discussion on policy and pricing for these is most warranted.
  • ||||||||||  Bispecific T-Cell Engagers: Sequencing, BCMA, GPRC5D, and Resistance () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1046;    
    Currently, both FDA-approved CAR T-cell therapies, idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel), target the B-cell maturation antigen (BCMA) receptor on the surface of MM cells, and two of the FDA-approved bispecific antibodies, teclistamab and elranatamab, also target BCMA...Early clinical results indicate relatively encouraging response rates from teclistamab and elranatamb post-CAR T-cell therapy,6,7 and one retrospective study suggests a relatively prolonged benefit from bispecific antibodies in general.8 However, another retrospective study indicates that PFS may be limited.9 Although antigen escape may not be central when other targets are chosen, as with talquetamab, other mechanisms, including immune exhaustion that may also occur with bispecific antibodies, anti-CAR antibodies, and alterations in the tumor microenvironment, can have a detrimental impact on later lines of therapy...Ultimately, to comprehensively answer the sequencing question, the field requires prospective studies with adequate follow-up as well as banking and analysis of tumor and non-tumor specimens. As BCMA-directed CAR T-cell therapies are now approved in the earlier stages of disease, including at first relapse, this question is even more urgent.
  • ||||||||||  Treatment of Early Relapse: Non-CAR T Cells () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1045;    
    Patient and treatment characteristics of the firstline therapy should guide the optimal therapeutic choice at first relapse and thereafter. The sequencing of novel immunotherapies at relapse remains to be determined in upcoming clinical trials and real-world studies.
  • ||||||||||  Progress in Lower-Risk MDS () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1041;    
    Roxadustat, an oral HIF1- alpha hydroxylase inhibitor, was approved for treating anemia in Europe and China for chronic renal insufficiency...Both romiplostim and eltrombopag are approved for treating immune thrombocytopenic purpura, but their use in LR- MDS is still off label...Conclusions Significant progress has been obtained in treating anemia in LR- MDS, but there is still room for improvement by building a strategy to optimize the sequence of therapies with agents with different mechanisms of action and by evaluating combinations of them to achieve long-lasting TI. Target therapies like ivosidenib, a mutant IDH1 inhibitor, could be a candidate for LR-MDS cases with this mutation, as suggested by pivotal studies.
  • ||||||||||  Blincyto (blinatumomab) / Astellas, Amgen
    Enhancing Precision Treatment for Childhood Acute Lymphoblastic Leukemia () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1040;    
    This strategy allows the agents to act synergistically to kill leukemia cells while sparing normal tissues from excessive toxicity. Acknowledgement Supported in part by US National Cancer Institute Grant CA021765 and by American Lebanese Syrian Associated Charities (ALSAC).
  • ||||||||||  Scemblix (asciminib) / Novartis, Iclusig (ponatinib) / Takeda, Otsuka, Blincyto (blinatumomab) / Astellas, Amgen
    Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia can be Treated with Chemotherapy-Free Regimens without Transplant () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1039;    
    Acknowledgement Supported in part by US National Cancer Institute Grant CA021765 and by American Lebanese Syrian Associated Charities (ALSAC). Significant progress has been made in recent years in the treatment of adults with Philadelphia chromosome-positive (Ph-positive) acute lymphoblastic leukemia (ALL).1 Combining BCR::ABL1 tyrosine kinase inhibitors (TKIs) with intensive chemotherapy regimens like hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high-dose methotrexate and cytarabine (hyper-CVAD) and others has greatly improved patient outcomes.2 As a result, allogeneic hematopoietic stem cell transplantation (HSCT) has become an additional valuable option...Specifically, the 5-year PFS rates were 81% with hyper-CVAD plus ponatinib, 54% with hyper-CVAD plus dasatinib, and 64% with hyper-CVAD plus imatinib...In contrast to the D-ALBA trial, only two patients underwent HSCT.26 Whether the combination of blinatumomab and ponatinib can overcome the poor prognosis of IKZF1plus and the negative impact of an elevated white blood cell count (higher than 70
  • ||||||||||  Blincyto (blinatumomab) / Astellas, Amgen
    Transplant in Adult ALL: Who and When () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1038;    
    Similarly, a multicenter analysis of 83 patients with Ph-like ALL undergoing transplant in CR1 demonstrated that patients with Ph-like ALL had higher rates of induction failure but responded to blinatumomab becoming MRD negative prior to transplant. Notably, after transplant, outcomes for Ph-like patients were comparable to other Ph-negative subtypes.4 Studies investigating the differential risk of Ph-like subsets are ongoing, but the sum observations of currently published studies suggest benefit for transplant in CR1.
  • ||||||||||  SENL101 / SenlangBio
    CD7 CAR-T Therapy for Treating CD7-Positive Hematological Malignancies () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1037;    
    P=N/A, P1
    Our study highlights the NS7CAR-T therapy as a promising approach for achieving a favorable initial CR in CD7-positive AML patients, even in those who have undergone extensive prior treatments and experienced relapse post-transplant. The safety profile of NS7CAR-T therapy was manageable.
  • ||||||||||  Venclexta (venetoclax) / Roche, AbbVie, Rituxan (rituximab) / Roche, Imbruvica (ibrutinib) / AbbVie, J&J
    Should We Note Subset #2-Positive Patients as a Specific Group Within Mutated or Unmutated CLL? () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1031;    
    In contrast, eight patients with unmutated IGHV genes (i.e., U-CLL) belonging to subset #2 and treated with fludarabine, cyclophosphamide, and rituximab (FCR) in the HOVON-68 trial experienced an excellent progression-free survival (PFS) (median PFS: 61.3 months and 49.6 months for subset #2 U-CLL and M-CLL, respectively).10 However, we should interpret this finding with caution, given the small number of patients included in this analysis...Similarly, in the comparison of FCR to ibrutinib plus venetoclax Subset #2: biological features Subset #2 is defined by the expression of stereotyped BcR IGs encoded by the IGHV3-21/ IGLV3-21 genes with a highly distinctive variable heavy complementarity-determining region 3 (VH CDR3).5 Patients belonging to subset #2 share a quasi-identical BcR IG that remains constant throughout their disease...Conclusions The current evidence suggests that patients belonging to subset #2 often experience a short TTFT and have suboptimal outcomes when treated with CIT. Thus, subset #2 membership can provide valuable information, especially for M-CLL, if CIT is among the treatment options.14 On the other hand, shedding light on the predictive value of subset #2 in the era of novel agents will require large-scale collaborative studies combining data from many RCTs.
  • ||||||||||  The Role of Maintenance Therapy in the Treatment of Newly Diagnosed Multiple Myeloma () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1030;    
    P1, P1/2,
    Additionally, studies assessing the efficacy and safety of iberdomide (NCT06179888) and mezigdomide (NCT06048250) as maintenance agents post idecabtagene vicleucel are underway...Furthermore, a distinct benefit to patients currently receiving CAR-T is the possibility of experiencing a prolonged treatment-free interval afterwards,25 and the routine prescription of maintenance will change this radically. Moreover, maintenance therapy after CAR-T may also lead to increased patient financial toxicity and increase financial burdens on health care systems,26 noting the already high cost of CAR-T therapies.
  • ||||||||||  Rituxan (rituximab) / Roche
    Does Limited-Stage Diffuse Large B-Cell Lymphoma (LS-DLBCL) Matter? () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1027;    
    Ongoing international collaborative efforts to refine treatment paradigms according to risk are required to improve outcomes in these patients. Novel therapy studies should also be part of the immediate research agenda.
  • ||||||||||  Polivy (polatuzumab vedotin-piiq) / Roche, Rituxan (rituximab) / Roche
    Management of High-Grade B-Cell Lymphoma () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1026;    
    An important consideration is the potential use of Pola-RCHP (polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone) among patients with HGBL...Ongoing trials evaluating firstline CAR T-cell therapy for aggressive B-cell lymphomas, or combinations of bispecific antibodies with chemotherapy, might provide insight into the responsiveness of HGBL to adoptive immunotherapy. Additional research should focus on biologically rational treatments for HGBL that account for their highly proliferative nature, frequent MYC rearrangements, TP53 mutations, and immune-deserted microenvironment.
  • ||||||||||  Blincyto (blinatumomab) / Astellas, Amgen, Besponsa (inotuzumab ozogamicin) / Pfizer, UCB
    Development of Inotuzumab Ozogamicin and Blinatumomab for Frontline Treatment of Older Patients with Ph-Negative B-Cell Acute Lymphoblastic Leukemia () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1025;    
    In the single-arm, phase II INITIAL-1 trial (median age 64 years), the GMALL group administered 3 cycles of InO with dexamethasone as remission induction therapy, followed by reduced-intensity chemotherapy, and then maintenance therapy with mercaptopurine and methotrexate...With 15 months of follow-up, the estimated 1-year OS and leukemia-free survival rates were 73% and 65%, respectively.7 Similarly, MD Anderson studied a reduced-dose InO in combination with mini-hyperCVD (dose-reduced cyclophosphamide, vincristine, and dexamethasone, alternating with methotrexate and cytarabine) regimen in older patients (median age 68 years)...Elimination of conventional chemotherapy by using highly active targeted agents is highly effective in Ph-positive ALL, and the preliminary results for InO and blinatumomab with either dose-reduced or no conventional chemotherapy support some of these approaches as valid options for the treatment of older patients in clinical practice. Given this success, the integration of additional targeted agents holds promise to further improve outcomes for older and, by extension, younger patients with B-cell ALL, thereby representing a new paradigm of older-adult-inspired therapy for ALL.
  • ||||||||||  Is There a Role for Combination Therapy, And If So, What Combinations? () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1023;    
    Other trials are still ongoing which combine atezolizumab plus bosutinib and avelumab plus TKIs...Asciminib, considering its mechanism of action, can be used in combination with other TKIs: in the phase 1 trial, was tested at different dosages with nilotinib, imatinib, and dasatinib in 26, 25, and 32 patients, respectively...In this setting, combination strategies could be an option. Several strategies have been explored to increase the rate of DMR and the eligibility to TFR, but further studies are needed to understand the perfect in vivo possible combination.
  • ||||||||||  Rituxan (rituximab) / Roche
    Management Algorithm for Nodular Lymphocyte-Predominant Hodgkin Lymphoma () -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1022;    
    If chemotherapy is preferred or required in limited-stage disease, one should include rituximab and avoid the use of anthracyclines unless histologic transformation is highly suspected.16,17 Combined-modality therapy does not appear to offer additional benefit over radiation alone...Additional palliative radiation can be considered in limited recurrences without prior radiation or in sites that have not been previously radiated. Those with symptomatic advanced disease can consider additional chemotherapy The most common cause of death in NLPHL is not due to the underlying lymphoma.9 For this reason, it is important to avoid treatments with excessive toxicity and to be mindful of the risk of transformation, even if it requires additional procedures and/or biopsies in order to verify the diagnosis.
  • ||||||||||  Kineret (anakinra) / SOBI, Rituxan (rituximab) / Roche
    DAIR to Be Different: Successful Use of DAIR Regimen, a Novel Treatment Combination for EBV-induced HLH (LEVEL 3, HALL B3) -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1011;    
    This case demonstrates the efficacy of the DAIR regimen in treating EBV-induced HLH, highlighting its potential as a viable treatment option. The combination of dexamethasone, anakinra, IVIG, and rituximab offers a multifaceted approach to managing the complex pathogenesis of HLH, leading to favorable outcomes and sustained remission.
  • ||||||||||  Promacta (eltrombopag) / Novartis
    Intermittent Dosing of Eltrombopag in Steroid-Refractory Chronic ITP: A Case Report (LEVEL 3, HALL B3) -  Aug 30, 2024 - Abstract #SOHO2024SOHO_1002;    
    Intermittent dosing of eltrombopag in steroid-refractory chronic ITP may provide an effective alternative to daily dosing, improving patient adherence and reducing treatment costs. Further studies are warranted to compare this alternative dosing protocol's long-term efficacy and cost-effectiveness with standard daily regimens.
  • ||||||||||  Kymriah (tisagenlecleucel-T) / Novartis, Yescarta (axicabtagene ciloleucel) / Gilead
    Unveiling the Future: Insights From the Current Landscape in Solid Tumor CAR T Clinical Trials (LEVEL 3, HALL B3) -  Aug 30, 2024 - Abstract #SOHO2024SOHO_979;    
    A substantial effort is being made worldwide to improve these technologies, resulting in unique strategies for treating solid tumors. The United States lags in clinical trial efforts compared to other nations.
  • ||||||||||  Darzalex (daratumumab) / J&J, Rituxan (rituximab) / Roche
    Incidence of Oral Fungal Infections (OFIs) in Post (LEVEL 3, HALL B3) -  Aug 30, 2024 - Abstract #SOHO2024SOHO_978;    
    P=N/A
    The United States lags in clinical trial efforts compared to other nations. Multiple myeloma patients (n=8, 32%) were treated with VCD, VRd
  • ||||||||||  Nplate (romiplostim) / Amgen, Kyowa Kirin
    Place of Romiplostim in the Treatment of Bone Marrow Aplasia (LEVEL 3, HALL B3) -  Aug 30, 2024 - Abstract #SOHO2024SOHO_954;    
    Romiplostim constitutes a therapeutic alternative in patients suffering from AA, whether or not they are eligible for bone marrow transplantation. In our series, it was possible to maintain an average platelet level around 45,000/ mm3, thus lowering the risk of hemorrhage.
  • ||||||||||  Elrexfio (elranatamab-bcmm) / Pfizer
    MagnetisMM-32: Evaluation of Elranatamab vs EPd, PVd, or Kd in Patients With Relapsed or Refractory Multiple Myeloma and Prior Anti-CD38 (LEVEL 3, HALL B3) -  Aug 30, 2024 - Abstract #SOHO2024SOHO_921;    
    P3
    These results, demonstrating efficacy benefit in key subgroups with a high-unmet need, support BVd as a potential new SOC in this setting. Objective: To evaluate elranatamab monotherapy vs elotuzumab-pomalidomide-dexamethasone (EPd), pomalidomide-bortezomib-dexamethasone (PVd), or carfilzomibdexamethasone (Kd) in patients with RRMM to determine whether elranatamab has superior clinical benefit...Patients: Key inclusion criteria include age ?18 years, prior multiple myeloma diagnosis with measurable disease (per IMWG criteria), evidence of progressive disease or failure to achieve a response to last line of multiple myeloma therapy, 1-4 prior LOTs including an anti-CD38 antibody