“With t(4;14), there’s FGFR3, MMSET, IgH, and NSD2. Everything just seems like random letters and numbers strung together.” 🤣 Very much agree - thank goodness #MMsm docs like @andrew02114 are trying to figure out how to target t(4;14) beyond just bortezomib! (@DAVAOnc Bermuda) (@RahulBanerjeeMD)

How do you prefer your Velcade for pts with myeloma #MMsm? 🍺🤯 - RVd classic - RVd lite - RVd premium lite - RVd ultra lite Tell us using this 2-3 min survey about bortezomib prescribing! https://t.co/AQyeo4YsAl cc @GKaurMD @ldandersonjr @BoWangMD1 @gjmccaughan @VincentRK https://t.co/DGyBG78v5B (@RahulBanerjeeMD)

Thank you to ~100 #MMsm physicians from 🇨🇦🇨🇱🇫🇷🇩🇪🇮🇳🇲🇽🇲🇦🇳🇴🇹🇷🇬🇧🇺🇸🇻🇪 who've already responded to our 2-3 minute survey about bortezomib (Velcade) 💉. If you haven't, here's the link: thank you in advance! https://t.co/AQyeo4XUKN CC @VincentRK @ldandersonjr @GKaurMD @BoWangMD1 (@RahulBanerjeeMD)

Us as well - I don’t think there will be one practice type / setting / country that disproportionately uses twice-weekly Velcade in #MMsm, but we will find out… 🙏 again! (@RahulBanerjeeMD)

Help @RahulBanerjeeMD in filling this survey about velcade dosing #mmsm 👇 (@HadidiSamer)

Please help us filling out this survey about Bortezomib (Velcade) weekly vs bi-weekly prescribing patterns in MM practice #mmsm Excited to see the results! @GKaurMD @RahulBanerjeeMD Survey link: https://t.co/G5M5RYa9iI (@FiekeHoff)

Velcade Prescription Patterns: - Part 1 of Red Cap Survey, a project with @RahulBanerjeeMD, is in the works. - @FiekeHoff (UTSW IM PGY2) spearheads Part 2, unveiling the RW contrast between "what providers say" vs "what they do!" STAY TUNED FOR THE FULL ANALYSIS! #mmsm (@GKaurMD)

Despite bortezomib being >20 yrs old, we (including @GKaurMD @BoWangMD1 @ldandersonjr @VincentRK) suspect there will be significant heterogeneity in #MMsm practice patterns & rationales. Help prove us right or wrong - thanks in advance! 🙏 Survey link: https://t.co/AQyeo4XUKN (@RahulBanerjeeMD)

Very helpful 🙏 Because we use D-CyBorD so ubiquitously for AL amyloidosis, I sometimes think about R-bortezomib when the clone is unexpectedly shown to be MZL and not a plasma cell clone... but I will stick to R-Benda based on this! (@RahulBanerjeeMD)

Congrats @NEpperla @PallawiTorkaMD on great @BloodAdvances paper about +SPEP in MZL! Also relevant to us on other side of the aisle as #MMsm docs: rarely the culpable AL amyloid clone is paraprotein-producing MZL, and R-Benda >> R. (Authors: curious, did anyone get Velcade?) (@RahulBanerjeeMD)

Amazing times @mayoclinic #myeloma team circa 2010 global team, fellows from argentina, netherlands, montreal, edmonton, mexico, wurzburg did 1st whole genomes, 1st myeloma gene panel, 1st in man carfilzomib, isatuximab, new mouse models, cereblon etc. Many babies arrived! (@akeithstewart)

4/ @AjayNookaMD et al, KPd maintenance for high-risk #MMsm Ideally Kyprolis will be q2wk and #downwithdex in RRMM (cc @jmikhaelmd), but pom less temperamental than len in CKD plus (?) ⬇️ risk of SPMs... so I'm all in! Why else I love this abstract 👇 https://t.co/6psf0E1f6G (@RahulBanerjeeMD)

High risk newly dx #myeloma patients? Consider carfilzomib vs. bortezomib with CD38 monoclonal antibody in the quad combo. @AjayNookaMD #peerview #healthtreemm (@HealthtreeMM)

Dr. @majorajay's @UChicagoHemOnc fellowship study of changes in cardiovascular & endothelial function during treatment with carfilzomib is also presented as an abstract: https://t.co/IiEyueUaLy #mmsm (@CULymphoma)

One of the commandments of myeloma trials: “Thou should not combine carfilzomib/dex with any other active drug in a control arm lest your Phase 3 trial be a failure”. On a serious note though, when will these 3 versus 2 trials end? https://t.co/IeSMSh8VJa #mmsm #ASCO23 (@ManniMD1)

Fascinating!! A sequelae of mismatch between vial sizes and typical mg/m2 dosing in #MMsm - and tribute to Velcade’s staying power after 25 yrs. Although thanks to 🇲🇽 LMIC firepower by @GomezDLeonMD @dgomezalmaguer et al, I’ve learned that fixed half-vial Velcade an option! (@RahulBanerjeeMD)

For more carfilzomib (pr-171) trivia - two phase 1 trials - one used 5 daily doses every 2 weeks @Rfonsi1 #myeloma patient first known response to drug with reduction in plasmacytomas during “on” week but regrowth on “off week” (@akeithstewart)

This is why it is important to follow patients on trials and amend protocols when needed to help in making interventions more appropriate/tolerable , check this thread on carfilzomib by @szusmani #mmsm 👇 (@HadidiSamer)

CONGRESS | #COMy23 | @YimerHabte shared updated subgroup analyses by age and frailty from the full US MM-6 study on transitioning from bortezomib-based induction to IRd in patients with NDMM; demonstrating an improved depth of response and tolerable safety profile overall #mmsm (@MM_Hub)

I wanted to share an interesting story with trainees and junior faculty in #mmsm from my early years as an MM investigator @HemOncFellows. While serving as the PI for the carfilzomib compassionate use IIT at @UAMSMyeloma , we observed cardiopulmonary signal when giving (1/5) (@szusmani)

Gene-expression profiling in DLBCL ! DOI: 10.1200/JCO.23.00033 R-CHOP vs BR-CHOP (Bortezomib) ABC type- 5 yr PFS 54%-->69% GCB type- No benefit Severe neuropathy with BR-CHOP <5% Should GEP now be routinely adopted in clinic? @lingarajnayak @DrGPrakash @drvineetgovinda (@shikharkumar89)

If you want to know the story of development of bortezomib, and the sequence of events, please see article below. @BloodJournal @Myeloma_Doc was a key player. https://t.co/XSjBPsouta (@VincentRK)

20 years ago today: FDA accelerated approval of bortezomib (Velcade) in myeloma. A revolutionary new treatment. A special vial of the drug from that time that we received as investigators. #MedTwitter @Mohty_EBMT (@VincentRK)

There is no head to head comparison as that would be too useful of a trial for myeloma to run. I use DRd over RVd in elderly based on toxicity profile. Velcade is tough in older patients. Rev is also and usually stop and continue dara. (@AaronGoodman33)

Dr Moreau discussing the use of RWE to confirm pivotal phase 3 myeloma trials. Thank you for highlighting our UK data of DVd with weekly bortezomib. @COMyCongress @COMy23 @Anniemcmillan10 (@DrRakeshPopat)

Orbital Rosai Dorfman Disease on 6 MP maintenance therapy with Multiple Myeloma -ISS II (IgG Kappa and IgG Lambda) (Biclonal) Post Bortezomib -Thal /Dexa - now on Thal !! a 4 year old follow up @EshaKaul1 @DrNeha90356702 (@Prasshmehta)

You would think they would mention that overall survival was worse for the ixazomib arm in this new subset analysis just published. https://t.co/Wdj33ZcbD9 An omission that shouldn't have passed peer review. P.S: Please don't use ixazomib. Not equivalent to other PIs. #mmsm (@ManniMD1)

Decades ago, I heard the critics say that outstanding results in Little Rock were due to enrollment bias. Passage of time shows the real story is that Bart brought together a team that brought us bortezomib and convinced the world that multiple myeloma is curable. Bravo, man (@MTomasson)

t(4;14) = FGFR3-IgH = Myeloma (intermediate risk with bortezomib) 1q gain (4 or more) = Myeloma (high risk) t(14;16) = IgH-cMAF = Myeloma (high risk) t(14;20) = IgH-MAFB = Myeloma (high risk) del(17p) = TP53 = Myeloma (high risk) t(9;22) = BCR-ABL1 = CML/B-ALL/AML (rare) (@AaronGoodman33)

HIV Lymphoma DLBCL Usually EBV+ R-EPOCH? Plasmablastic CD20- EBV+ Jaw mass EPOCH+/-Velcade? Primary effusion CD20-/CD30+ HHV8+ EPOCH Primary CNS EBV+ HDMTX Burkitt EBV+ CODOX-M/IVAC or R-EPOCH Hodgkin (🚫AIDS defining) EBV+ ABVD or A+AVD Start ART (🚫protease inhibitor) (@AaronGoodman33)

High serum bone-specific ALP level after Velcadd combined therapy in refractory MM. Velcade directly inhibit secretion of DKK1 from osteoblasts, activation of Wnt signal pathway and osteoblast differentiation #mmsm #myeloma #medEd #MedTwitter (@Abdallah81MD)

Impact of Velcade (PI) in #myeloma with bone lesions: Velcade reduces levels of RNAKL and inhibits Dkk1 expression which leads to inhibition of osteoclasts activity and increases osteoblasts activity #mmsm #myeloma #MedEd #MedTwitter #USMRC (@Abdallah81MD)

Now that is interesting !! Pretreatment serum level of interleukin-6 predicts carfilzomib-induced hypertension in relapsed/refractory multiple myeloma https://t.co/KFa6UgET4g #mmsm #myeloma #USMRC #medEd #MedTwitter (@Abdallah81MD)

#Myeloma Paper of the Day: Pre-clinical studies show that deubiquitylase USP12 induces pro-survival autophagy and #Velcade resistance in #myeloma models by stabilizing HMGB1: https://t.co/8RrCh4AqDL. (@Myeloma_Doc)

@myelomaMD presents final PH3 BELLINI data of venetoclax-Velcade/dex vs placebo-Vd in relapsed refractory #myeloma . Data supports further development with a biomarker-driven approach in t(11;14) and high BCL2 expressors. #ASH21 (@theMMRF)

#ASH21 #lymphoma BR+Bortizomib in R/R Waldenstrom’s. ORR in the 80s%. Plasma MYD88 detection in plasma and BM was comparable. @DrConnieBatlevi @jonathonbcohen (@AlhajMoustafa)

Thanks for the kind words. We haven’t had a chance to explore the method in MM, or to study our findings of interactions between proteasome inhibitors and CXCR5+/CD8+ T cells in influencing outcomes. Could similar effects be in play there? #mmsm (@AshAlizadeh)

Proteasome inhibition may overcome ALK-TKI resistance in ALK-Rearranged/TP53-Mutant #NSCLC @CCR_AACR #LCSM @ALKLungCancer @alk_fusion https://t.co/5sd0lD4f4Q (@CharuAggarwalMD)

Concomitant TP53 mutns reduce the efficacy of alectinib for ALK+ NSCLC. Combined use of a proteasome inhibitor(Ixazomib) with alectinib is a promising therapy for ALK+ /TP53 + NSCLC. 10.1158/1078-0432.CCR-20-2853 (@oncologician)

Dear #ASH20 community, how would you treat de novo/primary plasma cell leukemia in 2020? D-PACE vs Dara-VRD/Dara-KRD? Other suggestions? Role of venetoclax if t(11;14)+? Is bortezomib detrimental if t(11;14)+ and CD20-? @SurbhiSidanaMD @DrAlexisTalbot @VincentRK @ninashah33 (@fernandbteich)

Bellini trial, a RCT of venetoclax/plcbo plus bortezomib for myeloma led by @myelomaMD. One of the most interesting sub-group results for t(11;14) and BCL2 high but some others fared much worse. https://t.co/60npCF7sDq (@DrRakeshPopat)

VIDEO: @mvmateos on the ARROW trial: once vs. twice weekly #carfilzomib for #MultipleMyeloma: https://t.co/WzZJ384L15 #ASCO18 @ASCO #MMSM #Myeloma #hcsm #ClinicalTrials #CTSM #HemOnc #HemeOnc #ProteasomeInhibitor #CaxTx (@VJHemOnc)