This article is part of the special JITC series: COVID-19 and Cancer Immunotherapy

This article is part of the special JITC series: COVID-19 and Cancer Immunotherapy

This article is part of the special JITC series: COVID-19 and Cancer Immunotherapy

This article is part of the special JITC series: COVID-19 and Cancer Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

This article is part of the special JITC series: Imaging and Immunotherapy

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This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This review has a companion letter: Brave new world of cfDNA-omics for early cancer detection

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This viewpoint letter refers to a companion review: [Cell-free DNA approaches for cancer early detection and interception] (https://jitc.bmj.com/content/11/9/e006013)

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

Update 8-1-2023

The mUC treatment algorithm has been updated based on the label change for pembrolizumab, the voluntary withdrawal of the atezolizumab indication, and the approval of pembrolizumab plus enfortumab vedotin for the treatment of patients with advanced mUC.

Updated mUC treatment algorithm

This is a companion letter corresponding with the review: Genomic approaches to cancer and minimal residual disease detection using circulating tumor DNA

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This review has a companion letter: Challenges in the implementation of ultrasensitive liquid biopsy approaches in precision oncology

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This is a companion letter corresponding with the review: Regulatory implications of ctDNA in immuno-oncology for solid tumors

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This review has a companion letter: Liquid biopsies, are we ready for prime time?

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This review has a companion letter: Next-generation ctDNA-driven clinical trials in precision immuno-oncology

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This is a companion letter corresponding with the review: Liquid biopsy approaches to capture tumor evolution and clinical outcomes during cancer immunotherapy

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This is a companion letter corresponding with the review: Crucial roles of circulating tumor cells in the metastatic cascade and tumor immune escape: biology and clinical translation

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

This review has a companion letter: Comments on roles of circulating tumor cells in the metastatic cascade and tumor immune escape: biology and clinical translation

This article is part of the special JITC series: Liquid Biopsies Coming of Age: Biology, Emerging Technologies, and Clinical Translation

SITC continuously evaluates the field for emerging data and new FDA approvals. Updates to the recommendations, tables, treatment algorithms, and/or guideline text in this publication are made with the approval of the SITC Urothelial Cancer Immunotherapy Guideline Expert Panel. More information on the SITC Guidelines can be found at sitcancer.org/guidelines.

Update 8-17-22

Based on advances in the field, including the following three FDA approvals and ongoing trials, the RCC CPG has been updated throughout the entire manuscript:

(1) Pembrolizumab for the adjuvant treatment of RCC: In November of 2021, the FDA approved pembrolizumab (anti-PD-1) for the adjuvant treatment of resected RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions.

Reference: FDA approves pembrolizumab for adjuvant treatment of renal cell carcinoma FDA press release

(2) Pembrolizumab plus lenvatinib for the treatment of advanced RCC: In August of 2021, the FDA approved pembrolizumab in combination with lenvatinib (a VEGF receptor tyrosine kinase inhibitor; TKI) for the first-line treatment of patients with advanced RCC (aRCC).

Reference: FDA approves lenvatinib plus pembrolizumab for advanced renal cell carcinoma FDA press release

(3) Nivolumab plus cabozantinib for the treatment of advanced RCC: In January of 2021, the FDA approved nivolumab (anti-PD-1) in combination with cabozantinib (a VEGF receptor TKI) for the first-line treatment of patients with aRCC.

Reference: FDA approves nivolumab plus cabozantinib for advanced renal cell carcinoma FDA press release

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, the following text was added:

For first-line treatment of patients with unresectable, metastatic clear cell RCC and a remote history of a non-life threatening autoimmune condition, irrespective of IMDC risk status, the Expert Panel recommends the following: pembrolizumab plus lenvatinib (23%), nivolumab plus ipilimumuab (23%), nivolumab plus cabozantinib (15%), appropriate anti-VEGF TKI monotherapy (15%), pembrolizumab plus axitinib (15%), or anti-PD-1 monotherapy (8%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for the use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, this text was modified as follows:

For first-line treatment for patients with chromophobe RCC, the Expert Panel recommends the following: VEGF TKI plus ICI (40%: lenvatinib plus pembrolizumab [3 Expert Panel members], cabozantinib plus nivolumab [2 Expert Panel members], axitinib plus pembrolizumab [1 Expert Panel member]), lenvatinib plus everoliums (40%), everolimus (7%), or everolimus plus bevacizumab (7%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, this text was modified as follows:

For first-line treatment for patients with papillary RCC, the Expert Panel recommends the following: nivolumab plus cabozantinib (87%), mivolumab plus ipilimumab (7%), or anti-PD1 monotherapy (7%).

For first-line treatment for patients with undifferentiated RCC, the Expert Panel recommends the following: VEGF TKI plus ICI (53%: nivolumab plus cabozantinib [4 Expert Panel members], pembrolizumab plus lenvatinib [4 Expert Panel members]), or nivolumab plus ipilimumab (47%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approval for use of adjuvant pembrolizumab for RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions, the following text was added:

For patients with nccRCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of isolated soft tissue metastases, 80% of the Expert Panel disagreed that adjuvant pembrolizumab is recommended (presuming that the patient has an acceptable performance status and no contraindications to checkpoint inhibitor therapy).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, the following text was modified as follows:

For first-line treatment for patients with sarcomatoid RCC irrespective of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk factors, the Expert Panel recommends: nivolumab plus ipilimumab (80%), pembrolizumab plus axitinib (13%), or nivolumab plus cabozantinib (7%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approval for use of adjuvant pembrolizumab for RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions, this text was modified as follows:

For patients who develop unresectable metastatic RCC at or beyond 6 months following adjuvant pembrolizumab (presuming that the patient has an acceptable performance status and no contraindications to checkpoint inhibitor therapy or any TKI), the Expert panel recommends the following: ICI plus TKI (47%), cabozantinib plus nivolumab (2 Expert Panel members), lenvatinib plus pembrolizumab (3 Expert Panel members), nivolumab plus ipilimumab (53%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approval for use of adjuvant pembrolizumab for RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions, this text was modified as follows:

For patients who develop unresectable metastatic RCC during or within 6 months of receiving adjuvant pembrolizumab (presuming that the patient has an acceptable performance status and no contraindications to checkpoint inhibitor therapy or any TKI), the Expert panel recommends the following: nivolumab plus ipilimumab (33%), single agent TKI (27%), ICI plus TKI (20%), pembrolizumab plus lenvatinib (2 Expert Panel members), nivolumab plus cabozantinib (1 Expert Panel member), lenvatinib plus everolimus (7%), or other/ unsure of what would be best in this setting (7%).

Update 8-17-22

Subheader changed to the following: SOC in adjuvant setting (including ongoing trials)

Update 8-17-22

Upon survey of the Expert Panel following the FDA approval for use of adjuvant pembrolizumab for RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions, the following text was added:

For patients with resected ccRCC and no contraindications to immunotherapy, this expert panel recommends adjuvant pembrolizumab for: all patients meeting inclusion criteria for KEYNOTE-564 (60%), only higher risk patients eg, T4 or N+ (27%), or no patients until there is a statistically significant OS advantage (13%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, the following text was added:

For a patient who has progressed after lenvatinib plus pembrolizumab combination therapy, the Expert Panel recommends the following: <br /> cabozantinib (73%), ipilimumab plus nivolumab (13%), lenvatinib plus everolimus (7%), cabozantinib plus nivolumab (7%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, the following text was added:

For a patient who has progressed after cabozantinib plus nivolumab combination therapy, the Expert Panel recommends the following: lenvatinib plus everolimus (67%), nivolumab plus ipilimumab (13%), tivozanib (7%), everolimus (7%), or lenvatinib + pembrolizumab (7%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, this text was modified as follows:

For a patient who has progressed after axitinib plus pembrolizumab combination therapy, the Expert Panel recommends the following: cabozantinib (67%), ipilimumab plus nivolumab (13%), lenvatinib plus everolimus (7%), cabozantinib plus nivolumab (7%), or lenvatinib plus pembrolizumab (7%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, the following text was added:

For first-line treatment of patients with unresectable, metastatic VHL-associated ccRCC, the Expert Panel recommends the following: belzutifan (53%), nivolumab plus ipilimumab (27%), or cabozantinib plus nivolumab (20%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, the following text was added:

For first-line treatment of patients with unresectable, metastatic clear cell RCC and a remote history of a non-life threatening autoimmune condition, irrespective of IMDC risk status, the Expert Panel recommends the following: pembrolizumab plus lenvatinib (23%), nivolumab plus ipilimumuab (23%), nivolumab plus cabozantinib (15%), appropriate anti-VEGF TKI monotherapy (15%), pembrolizumab plus axitinib (15%), or anti-PD-1 monotherapy (8%).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, the following text was added:

For a treatment naïve, ECOG ≥ 1 ccRCC patient with “poor” risk per IMDC, who is determined to need systemic therapy and has no contraindication to receiving either an IO or an anti-VEGF therapy, the Expert Panel recommends the following: nivolumab plus ipilimumab (47%), VEGF TKI plus checkpoint inhibitor combination (23%: pembrolizumab plus lenvatinib [17%], pembrolizumab plus axitinib [11%], nivolumab plus cabozantinib [11%], pembrolizumab or nivolumab monotherapy [6%]).

Update 8-17-22

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, this text was modified as follows:

For a treatment naïve, ECOG 0 ccRCC patient with “favorable” risk per IMDC, who is determined to need systemic therapy and has no contraindication to receiving either an IO or anti-VEGF therapy, the Expert Panel recommends the following: TKI plus anti-PD1 (60%), nivolumab plus ipilimumab (33%), or anti-PD1 monotherapy (7%).

Algorithm updated 8-17-22

(1) Pembrolizumab for the adjuvant treatment of RCC: In November of 2021, the FDA approved pembrolizumab (anti-PD-1) for the adjuvant treatment of resected RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions. - This approval was based on a statistically significant improvement in DFS demonstrated at a prespecified interim analysis of the KEYNOTE-564 study, with 109 (22%) events in the pembrolizumab arm and 151 (30%) events in the placebo (HR 0.68; 95% CI: 0.53, 0.87; p=0.0010). The November of 2021 FDA approval of pembrolizumab for the adjuvant treatment of resected RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions, was based on data from the KEYNOTE-564 study. This study demonstrated a statistically significant improvement in DFS at a pre-specified interim analysis, with 109 (22%) events in the pembrolizumab arm and 151 (30%) events in the placebo (HR 0.68; 95% CI: 0.53, 0.87; p=0.0010).

Upon survey of the Expert Panel following the FDA approvals for use of first-line pembrolizumab plus lenvatinib or nivolumab plus cabozantinib for aRCC, this text was modified as follows:

For a treatment naïve, ECOG 0 ccRCC patient with “intermediate/poor” risk per IMDC, who is determined to need systemic therapy and has no contraindication to receiving either an IO or an anti-VEGF therapy, the Expert Panel recommends the following: nivolumab plus ipilimumab (80%), anti-PD1 plus TKI (20%, with 53% preferring nivolumab plus cabozantinib and 40% preferring pembrolizumab plus lenvatinib), or other (7% preferring lenvatinib + everolimus).

The August 2021 FDA approval of pembrolizumab in combination with lenvatinib for the first-line treatment of patients with aRCC was based on a statistically significant improvement in PFS and OS in CLEAR (Study 307/ KEYNOTE-581). Patients receiving pembrolizumab plus lenvatinib had a median PFS of 23.9 months versus 9.2 months for those receiving sunitinib (HR 0.39; 95% CI: 0.32 to 0.49; p<0.0001). Median OS was not reached in either arm (HR 0.66; 95% CI: 0.49 to 0.88; p=0.0049).

The January 2021 FDA approval of nivolumab in combination with cabozantinib for the first-line treatment of patients with aRCC was based on a statistically significant improvement in PFS, OS, and ORR in the CHECKMATE-9ER study. Patients receiving nivolumab plus cabozantinib had a median PFS of 16.6 months versus 8.3 months for those receiving sunitinib (HR 0.51; 95% CI: 0.41, 0.64). Median OS was not reached in either arm (HR 0.60; 95% CI: 0.40 to 0.89). ORR was 55.7% versus 27.1% in the nivolumab plus cabozantinib and sunitinib arms, respectively.

Update 8-27-2021

To add additional guidance on the management of patients with ICI-related hypophysitis and severe compressive symptoms, this recommendation was updated, as noted below:

• Patients with hypophysitis should receive replacement hydrocortisone at 10–12 mg/m2/day; a short-course of prednisone 1mg/kg (or equivalent) may be given for patients with severe compressive symptoms (e.g. headache, double vision).

Update October 2022

The recommendation on baseline troponin testing has been updated, as noted below:

• Consider performing a baseline electrocardiogram (EKG) and baseline troponin testing on patients deemed at a higher risk for myocarditis (eg, cardiac comorbidities, diabetes mellitus, ICI combination regimens including dual ICIs or VEGF TKIs, etc). Patients receiving ICI plus VEGF TKIs who have elevated baseline troponin T should be closely monitored for major cardiac adverse events.

SITC continuously evaluates the field for emerging data and new FDA approvals. Updates to the recommendations, tables, treatment algorithms, and/or guideline text in this publication are made with the approval of the SITC Cancer Immunotherapy Guideline Expert Panel. More information on the SITC Guidelines can be found at sitcancer.org/guidelines

Update October 2022

In response to recent data regarding increased risk for MACE in patients with RCC receiving ICI + VEGF TKI therapy, the ICI-related Adverse Events Guideline was updated in the following location: * General Expert Panel Recommendations

Reference: Prospective Cardiovascular Surveillance of Immune Checkpoint Inhibitor-Based Combination Therapy in Patients With Advanced Renal Cell Cancer: Data From the Phase III JAVELIN Renal 101 Trial

Update 8-7-2021

To add additional guidance on the management of patients with ICI-related hypophysitis and severe compressive symptoms, the ICI-related Adverse Events CPG was updated in the following location: * Endocrine Toxicity Expert Panel Recommendations

Update 4-9-2021

Information on idecabtagene vicleucel approval data and indication has been added, as noted below:

• Idecabtagene vicleucel is a BCMA-directed CAR T cell therapy, indicated for the treatment of adult patients with relapsed or refractory multiple myeloma after four or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody. Approval was based on safety and efficacy in a multicenter study of 127 patients with relapsed and refractory multiple myeloma who had received at least three prior lines of antimyeloma therapies with 88% having received four or more prior lines of therapies. Efficacy was evaluated in 100 patients who received idecabtagene vicleucel at a dose range of 300 to 460 x 106 CAR-positive T cells. The ORR (by IMWG criteria) was 72% (95% CI, 62% to 81%) and CR rate was 28% (95% CI, 19% to 38%). An estimated 65% of patients who achieved CR remained in CR for at least 12 months. The expert panel recommendations on CAR T cell therapy for multiple myeloma were developed, in part, based on experience from trials of idecabtagene vicleucel.

Update 8-5-2020

A recommendation has been added, as noted below:

• Avoid use of contact lenses unless directed by an opthamologist during treatment with belantamab mafadotin.

Update 8-5-2020

The following recommendation has been removed:

• During belantamab mafodotin treatment specifically, therapy can be restarted once keratopathy or other AEs (such as cytopenias) have resolved to grade 1 or less. Dose reduction from 3.4 to 2.5 mg/kg may be considered. Further dose reductions to 1.9 mg/kg may be done if significant toxicity recurs.

Update - 8-5-2020

A recommendation was updated, as noted below:

• Belantamab mafadotin should be withheld in the event of moderate to severe corneal toxicity, then restarted with a reduced dose once symptoms resolve

Update 8-5-2020

A recommendation was updated, as noted below:

• Patients being treated with belentamab mafadotin should be advised to use preservative-free eye drops at least 4 times per day starting with the first infusion and continuing until end of treatment.

Update 8-5-2020

A recommendation was updated, as noted below:

• Patients should be routinely monitored with complete blood counts and complete metabolic panels.

Update 8-5-2020

An additional recommendation was added, as noted below:

• Belantamab mafadotin is approved for adult patients with relapsed or refractory multiple myeloma who have received at least 4 prior therapies including an anti-CD38 mAb, a proteasome inhibitor and an immunomodulatory agent

Update 8-5-2020

The approval status and information regarding Belantamab mafadotin has been updated, as noted below:

• Belantamab mafadotin, an anti-BCMA antibody conjugated to the cytotoxic monomethyl auristatin F via a non-cleavable linker, received accelerated approval for relapsed or refractory multiple myeloma in August, 2020. Approval was based on the open-label, multicenter trial DREAMM-2 (NCT 03525678). Because of the risks of ocular toxicity, belantamab mafodotin is only available through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS), called the BLENREP REMS.

Update August 2022

Text has been added to the introduction to include updated information on pembrolizumab and dostarlimab tissue-agnostic approvals, as noted below:

• Since the guideline’s original publication, pembrolizumab was subsequently approved by FDA for the treatment of tumors with high tumor mutation burden (TMB-H) as well as mismatch repair deficient (dMMR)/microsatellite instability high (MSI-H) cancers, which includes a small number of advanced prostate tumors. Dostarlimab (anti-PD-1) has also been approved by the FDA for the treatment of dMMR tumors.

SITC continuously evaluates the field for emerging data and new FDA approvals. Updates to the recommendations, tables, treatment algorithms, and/or guideline text in this publication are made with the approval of the SITC Prostate Cancer Immunotherapy Guideline Expert Panel. More information on the SITC Guidelines can be found at sitcancer.org/guidelines.

Update August 2022

Based on the tissue agnostic approvals for pembrolizumab for the treatment of TMB-H and MSI-H/dMMR solid tumors and dostarlimab for the treatment of dMMR solid tumors, and their approved companion diagnostics, the Prostate Cancer CPG has been updated in the following location: - Introduction

References: Pembrolizumab (KEYTRUDA) TMB-H tissue-agnostic approval

Pembrolizumab (KEYTRUDA) MSI-H/dMMR tissue-agnostic approval

Dostarlimab (JEMPERLI) dMMR tissue-agnostic approval

Update 8-24-22

Based on new approvals of immunotherapy agents for the treatment of prostate cancer and new data that has been published since its original publication, the Prostate CPG was updated in the following locations: - Figure 1 - Prostate Cancer Treatment Algorithm

SITC continuously evaluates the field for emerging data and new FDA approvals. Updates to the recommendations, tables, treatment algorithms, and/or guideline text in this publication are made with the approval of the SITC Multiple Myeloma Cancer Immunotherapy Guideline Expert Panel. More information on the SITC Guidelines can be found at sitcancer.org/guidelines.

Update 2-1-2022

Based on the FDA approval of daratumumab in combination with carfilzomib and dexamethasone for adult patients with relapsed or refractory multiple myeloma who have received 1 to 3 prior lines of therapy on November 30, 2021, the Multiple Myeloma CPG has been updated in the following locations: * Monoclonal Antibodies Expert Panel Recommendations * Multiple Myeloma Key Monoclonal Antibody Therapies Trials

Reference: Daratumumab + hyaluronidase-fihj (Darzalex Faspro, Janssen Biotech, Inc.) and carfilzomib (Kyprolis, Amgen, Inc.) plus dexamethasone press release

Update 4-9-2021

Based on the approval of idecabtagene vicleucel for the treatment of adult patients with relapsed or refractory multiple myeloma after four or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody, the Multiple Myeloma CPG has been updated in the following locations: * Background * CAR T cell Therapies

Reference: Idecabtagene vicleucel (ABECMA) FDA press release

Based on the approval of isatuximab-irfc in combination with carfilzomib and dexamethasone, for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three prior lines of therapy, the Multiple Myeloma CPG has been updated in the following locations: * Monoclonal Antibody Therapies * Multiple Myeloma Key Monoclonal Antibody Therapies Trials

Reference: Isatuximab-irfc (SARCLISA) FDA press release

Update 8-5-2020

Based on the accelerated approval of belantamab mafodotin-blmf for adult patients with relapsed or refractory multiple myeloma who have received at least 4 prior therapies, including an anti-CD38 monoclonal antibody, a proteasome inhibitor, and an immunomodulatory agent, the Multiple Myeloma CPG was updated in the following locations: * Antibody-Drug Conjugates * Background

Reference: Belantamab mafodotin-blmf (BLENREP) FDA press release