Episode 74. Myeloma Updates from ASCO/EHA 2026 with Dr. Prashant Kapoor

Blood Cancer Talks — Show Notes

Episode: Best of ASCO/EHA 2026 — Multiple Myeloma & AL Amyloidosis

Guest: Dr. Prashant Kapoor, MD Professor of Medicine, Mayo Clinic, Rochester, MN Chair, Myeloma, Amyloidosis and Dysproteinemia Group, Mayo Clinic

Episode Overview

In this episode, the hosts sit down with Dr. Prashant Kapoor to review the highest-impact multiple myeloma and AL amyloidosis data from the 2026 ASCO and EHA annual meetings. The discussion centers on the rapidly shifting relapsed/refractory myeloma landscape, where a wave of phase 3 trials of T-cell engaging immunotherapies (bispecific antibodies and CAR T) have now each demonstrated superiority over traditional triplet regimens.

Topics Covered

1. MajesTEC-3

Phase 3, open-label trial of teclistamab + daratumumab SC (n=291) vs. investigator's choice of DPd or DVd (n=296) in 587 patients with relapsed/refractory myeloma and 1–3 prior lines; prior BCMA-directed therapy and anti-CD38-refractory disease were exclusions (only 5% CD38-exposed, none were refractory). Initially presented at ASH 2025, with cytogenetic subgroup data updated at EHA 2026.

Key results (34.5-month median follow-up):

Median PFS not reached with Tec-Dara vs. 18.1 months with DPd/DVd; 36-month PFS 83.4% vs. 29.7% (HR 0.17)36-month OS 83.3% vs. 65.0% (HR 0.46)Severe infection rate front-loaded: ~35% → ~17% between the first and second 6-month windows, plateauing at ~10–11%/window beyond 12 months; overall grade 3–4 infection 54%, 4.6% fatal infections (mostly without IVIG prophylaxis)EHA 2026 cytogenetic subgroup: 2-year PFS 90% (0 HRCA), 82% (1 HRCA), 76% (≥2 HRCA) — vs. only 14% with DPd/DVd in patients with ≥2 HRCADiscussion points: Applicability to patients at 1st/2nd relapse seen in clinic today; whether infection risk limits use of Tec-Dara at first relapse; implications of the high-risk cytogenetic subgroup data.

2. MajesTEC-9

Phase 3 trial of teclistamab monotherapy vs. investigator's choice of PVd or Kd in relapsed/refractory myeloma enrolling a heavily anti-CD38-refractory population (100% CD38-exposed, 85% refractory) — the population MajesTEC-3 excluded. Natural comparator: CARTITUDE-4 (phase 3, cilta-cel vs. DPd/PVd in Len-refractory myeloma, 1–3 prior lines, ~25% CD38-refractory/exposed).