Episode 68. ASH 2025 Myeloma Special: MajesTEC-3 and the Bispecific Revolution with Dr. Luciano Costa

 Join hosts Raj, Ashwin, and Eddie in this episode of Blood Cancer Talks as they welcome Dr. Luciano Costa, the first author of the NEJM manuscript on the MajesTEC-3 RCT, which was presented at ASH 2025. This episode dives deep into the trial's topline findings, capturing the nuances of the patient population, efficacy and safety data, and the future implications for treatment. The episode also examines the comparative efficacy of bispecific T-cell engagers versus CAR-T therapies, along with spirited discussion on the potential for fixed-duration treatment in myeloma care. 

Episode Highlights 

Main Topics Covered 

1. MajesTEC-3 Trial: Teclistamab-Daratumumab vs. Standard of Care 
   • Trial design and patient population
   • Primary endpoint: Progression-free survival (PFS)
   • MRD negativity rates and depth of response
   • Overall survival and safety profile
   • Clinical implications for treatment selection
2. Treatment Selection in Early Relapse 
   • Comparing MajesTEC-3 and CARTITUDE-4 patient populations
   • Framework for choosing between bispecific antibodies vs. CAR T-cell therapy
   • Managing anti-CD38 exposed patients

Link to the NEJM paper: https://www.nejm.org/doi/abs/10.1056/NEJMoa2514663