In February, clinical research teams activated the phase 2 FASTER trial led locally by Ravi Kishore Narra, MD, MS, Assistant Professor of Hematology and Oncology. The study tests whether a novel immunotherapy approach could replace or delay the need for a stem cell transplant in patients with newly diagnosed multiple myeloma.

The trial uses a response-adaptive design that personalizes treatment based on how quickly the cancer disappears during the first year, explained Dr. Narra. Patients who respond quickly may be able to pause therapy for a period of time—an approach that could shift a standard of care that has remained largely unchanged for more than 30 years.

“This study aims to show that we can achieve deeper, longer-lasting remissions with fewer toxic side effects,” Dr. Narra said, “and potentially avoid the trauma of a stem cell transplant.”

Participants in one arm of this study will receive elranatamab (Elrexfio), a highly effective and less toxic immunotherapy that activates T cells to kill myeloma cells, and the monoclonal antibody daratumumab (Darzalex). Participants in the other arm undergo an autologous stem cell transplant followed by maintenance therapy.

If cancer is still detectable after one year, participants switch to the alternate treatment. Those with two consecutive tests showing no measurable residual disease (MRD) in the bone marrow may stop treatment entirely. A stem cell transplant remains available as a “Plan B” if needed.

“The goal is to make myeloma a highly manageable condition where treatment is tailored to each patient rather than following a rigid schedule,” Dr. Narra said. Using cutting-edge “off-the-shelf” therapies and MRD-guided treatment decisions reflects MCW and Froedtert’s commitment to testing innovative strategies in cancer care.

The team plans to enroll 15 local patients as part of a nationwide study of 100 participants.