24-month overall survival rate of 67 percent achieved with
TALVEY® 0.8 mg/kg biweekly dosing in the Phase 1/2
MonumenTAL-1 study
MADRID, June 14,
2024 /PRNewswire/ -- Johnson & Johnson (NYSE:
JNJ) announced today that long-term data from the Phase 1/2
MonumenTAL-1 study showed that with 20 to 30 months of median
follow-up, triple-class-exposed patients with relapsed or
refractory multiple myeloma (RRMM) who were treated with
TALVEY® (talquetamab-tgvs) maintained high overall
response rates (ORR) and durable responses, irrespective of whether
they had received prior T-cell redirection
therapy.1 These data, featured in a
poster presentation at the 2024 European Hematology Association
(EHA) Congress (Abstract #P915) demonstrate the efficacy and
durability of TALVEY® when used before or after chimeric
antigen receptor T-cell (CAR-T) therapy or bispecific antibody
therapies in triple-class-exposed patients with
RRMM.1
"Results from the MonumenTAL-1 study continue to show deeper
response levels and a longer duration of response in patients
treated with either of the approved dose options of talquetamab,
while the median overall survival has yet to be reached at two
years," said Dr. Leo Rasche,
attending physician on the myeloma service, University Hospital of
Würzburg.* "It is encouraging to see no notable increases in
treatment-related discontinuations with this longer follow-up
across cohorts."
In MonumenTAL-1, 297 patients with no prior exposure to T-cell
redirection therapy received TALVEY® at the recommended
Phase 2 dose (RP2D) of 0.8 mg/kg biweekly (Q2W) (n=154) or 0.4
mg/kg weekly (QW) (n=143).1 At a median follow-up
of 23.4 months, patients in the Q2W cohort demonstrated a median
duration of response (DOR) of 17.5 months, with median DOR not
reached in patients with complete response (CR) or better. For
patients in the QW arm, a median follow-up of 29.8 months showed a
median DOR of 9.5 months with a median DOR of 28.6 months in
patients with a CR or better. At 24 months, 67.1 percent and 60.6
percent of patients were alive from the two dosing cohorts,
respectively.1
At a median follow-up of 20.5 months, TALVEY®
continued to show strong efficacy in patients with prior T-cell
redirection therapy exposure (n=78), with 55.1 percent of patients
achieving very good partial response (VGPR) or better and 57.3
percent alive at 24.2 months.1
Infection rates remained lower than in studies of B-cell
maturation antigen–targeted bispecific antibodies (BsAbs),
consistent with previous reports. No increase in grade 3/4
infections was observed, with longer follow-up GPRC5D-associated
adverse events (AEs) led to few dose reductions and
discontinuations. One additional patient discontinued treatment due
to AEs since the previous report. Weight loss, as assessed by vital
signs, was evident early but stabilized and improved over time,
including in patients with oral toxicities. 1
Data from MonumenTAL-2 support continued durable responses at
one year with investigational combination of TALVEY® and
pomalidomide in patients with RRMM who had ≥ two prior lines of
therapy
Longer follow-up from the Phase 1b
MonumenTAL-2 study of the investigational use of TALVEY®
and pomalidomide show deep responses and a manageable safety
profile in patients with RRMM and support the potential to combine
TALVEY® with an immunomodulatory agent (IMiD). These
updated data, from the first-ever study of a regimen combining a
GPRC5D-targeted therapy and an immunomodulatory agent, were
featured as a poster presentation at the 2024 EHA Congress
(Abstract #P911).2
Patients in the Phase 1b
MonumenTAL-2 study (n=35) were treated with subcutaneous (SC)
TALVEY® at the RP2D of 0.8 mg/kg (Q2W) (n=19) or 0.4
mg/kg (QW) (n=16) with step-up doses, plus 2.0 mg of
oral pomalidomide daily. At a median follow-up of 16.8
months (range, 1.2-25.1), response-evaluable patients demonstrated
an ORR of 88.6 percent (≥ VGPR, 80 percent).2
"With multiple dosing options and the ability to be used both
before or after CAR-T therapy and BCMA bispecifics, TALVEY is an
important and versatile treatment option for the treatment of
relapsed or refractory multiple myeloma," said Jordan Schecter, M.D., Vice President, Disease
Area Leader, Multiple Myeloma, at Johnson & Johnson Innovative
Medicine. "The low rate of grade 3/4 infections seen in
MonumenTAL-2 suggests the flexibility of TALVEY as a combination
partner with an immunomodulatory agent for patients who continue to
face limited treatment options with this complex hematologic
disease."
At 12 months, 80.4 percent of patients who achieved a CR or
better maintained their response.2 The
progression-free survival (PFS) rate at 12 months was 72.6
percent.2
The most common grade 3/4 hematologic AEs were neutropenia (57.1
percent), anemia (25.7 percent), and thrombocytopenia (20
percent).2 Taste, nail, skin, and rash toxicities
occurred in 85.7 percent, 68.6 percent, 74.3 percent, and 28.6
percent of patients, respectively; the majority were grade 1/2 with
few discontinuations.2 Cytokine release
syndrome (CRS) occurred in 74.3 percent and infections occurred in
80 percent (22.9 percent, grade 3/4) of
patients.2
*Dr. Leo Rasche has provided
consulting, advisory, and speaking services to Johnson &
Johnson; he has not been paid for any media work.
About
TALVEY®
TALVEY® (talquetamab-tgvs)
received approval from the U.S. FDA in August 2023 as a first-in-class GPRC5D-targeting
bispecific antibody for the treatment of adult patients with
relapsed or refractory multiple myeloma who have received at least
four prior lines of therapy, including a proteasome inhibitor, an
immunomodulatory agent, and an anti-CD38
antibody.3 Since FDA approval, 1,500 patients were
treated with TALVEY®. The European Commission (EC)
granted conditional marketing authorization (CMA) of
TALVEY® ▼ (talquetamab-tgvs) in August 2023 as monotherapy for the treatment of
adult patients with relapsed and refractory multiple myeloma (RRMM)
who have received at least three prior therapies, including an
immunomodulatory agent, a proteasome inhibitor, and an anti-CD38
antibody and have demonstrated disease progression on the last
therapy.4
TALVEY® is a bispecific T-cell engaging
antibody that binds to the CD3 receptor expressed on the surface of
T-cells and G protein-coupled receptor class C group 5 member D
(GPRC5D), a novel multiple myeloma target which is highly expressed
on the surface of multiple myeloma cells and non-malignant plasma
cells, as well as some healthy tissues such as epithelial cells of
the skin and tongue.
For more information, visit www.TALVEY.com.
About MonumenTAL-1
MonumenTAL-1 (Phase 1: NCT03399799, Phase 2: NCT04634552) is a
Phase 1/2 single-arm, open-label, multicohort, multicenter
dose-escalation study involving more than 300
patients.5,6 Phase
1 evaluated the safety and efficacy of TALVEY® in adults
with relapsed or refractory multiple myeloma who received three or
more prior lines of therapy, including a proteasome inhibitor, an
immunomodulatory agent, and an anti-CD38 monoclonal
antibody. The study excluded patients who experienced T-cell
redirection therapy within 3 months, prior Grade 3 or higher CRS
related to any T-cell redirection therapy, an autologous stem cell
transplant within 12 weeks, an allogenic stem cell transplant
within 6 months, Eastern Cooperative Oncology Group (ECOG)
performance score of 3 or higher, stroke or seizure within 6
months, CNS involvement or clinical signs of meningeal involvement
of multiple myeloma, plasma cell leukemia, or active or documented
history of autoimmune disease (exception of vitiligo, resolved
childhood atopic dermatitis or resolved Graves' Disease that is
euthyroid based on clinical and laboratory testing).
Phase 2 of the study evaluated the efficacy of
TALVEY® in participants with relapsed or refractory
multiple myeloma at the recommended Phase 2 dose(s) (RP2D),
established as SC 0.4 mg/kg weekly and 0.8 mg/kg every two weeks,
respectively. Efficacy was based on overall response rate (ORR) and
duration of response (DOR) as assessed by an Independent Review
Committee using the International Myeloma Working Group (IMWG)
criteria.1
About MonumenTAL-2
The MonumenTAL-2 (NCT05050097) study is an ongoing Phase 1 study
of subcutaneous talquetamab in combination with carfilzomib,
daratumumab SC, lenalidomide or pomalidomide for the treatment of
patients with multiple myeloma. The primary objective of the
MonumenTAL-2 study is to identify and characterize the safety of
the treatment combinations. Secondary objectives of the
MonumenTAL-2 study include overall response rates, duration of
response and time to response.7
About Multiple Myeloma
Multiple myeloma is an incurable blood cancer that affects a
type of white blood cell called plasma cells, which are found in
the bone marrow.8 In multiple myeloma,
these plasma cells change, spread rapidly and replace normal cells
in the bone marrow with
tumors.9 Multiple myeloma is the third
most common blood cancer and remains an incurable
disease.10 In 2023, it is estimated that
more than 35,000 people will be diagnosed with multiple myeloma in
the U.S. and more than 12,000 people will die from the
disease.11 People living with multiple
myeloma have a five-year relative survival rate of 59.8
percent.12 While some people diagnosed
with multiple myeloma initially have no symptoms, most patients are
diagnosed due to symptoms that can include bone fracture or pain,
low red blood cell counts, tiredness, high calcium levels and
kidney problems or
infections.13,14
TALVEY® IMPORTANT SAFETY
INFORMATION
INDICATION AND USAGE
TALVEY® (talquetamab-tgvs) is indicated for
the treatment of adult patients with relapsed or refractory
multiple myeloma who have received at least four prior lines of
therapy, including a proteasome inhibitor, an immunomodulatory
agent, and an anti-CD38 monoclonal antibody.
This indication is approved under accelerated approval based on
response rate and durability of response. Continued approval for
this indication may be contingent upon verification and description
of clinical benefit in a confirmatory trial(s).
IMPORTANT SAFETY INFORMATION
WARNING: CYTOKINE
RELEASE SYNDROME and NEUROLOGIC TOXICITY, including IMMUNE EFFECTOR
CELL-ASSOCIATED NEUROTOXICITY SYNDROME
Cytokine release
syndrome (CRS), including life-threatening or fatal reactions, can
occur in patients receiving TALVEY®. Initiate TALVEY®
treatment with step-up dosing to reduce the risk of CRS. Withhold
TALVEY® until CRS resolves or
permanently discontinue based on severity.
Neurologic toxicity,
including immune effector cell-associated neurotoxicity syndrome
(ICANS), and serious and life-threatening or fatal reactions, can
occur with TALVEY®. Monitor patients for signs and symptoms of
neurologic toxicity including ICANS during treatment and treat
promptly. Withhold or permanently
discontinue TALVEY® based on
severity.
Because of the risk
of CRS and neurologic toxicity, including ICANS,
TALVEY® is available only
through a restricted program called the TECVAYLI® and TALVEY® Risk Evaluation and
Mitigation Strategy (REMS).
|
CONTRAINDICATIONS: None.
WARNINGS AND PRECAUTIONS
Cytokine Release Syndrome (CRS): TALVEY® can cause
cytokine release syndrome, including life-threatening or fatal
reactions. In the clinical trial, CRS occurred in 76% of patients
who received TALVEY® at the recommended dosages, with Grade 1 CRS
occurring in 57% of patients, Grade 2 in 17%, and Grade 3 in 1.5%.
Most events occurred following step-up dose 1 (29%) or step-up dose
2 (44%) at the recommended dosages. Recurrent CRS occurred in
30% of patients. CRS occurred in 33% of patients with step-up
dose 3 in the biweekly dosing schedule (N=153). CRS occurred in 30%
of patients with the first 0.4 mg/kg treatment dose and in 12% of
patients treated with the first 0.8 mg/kg treatment dose. The CRS
rate for both dosing schedules combined was less than 3% for each
of the remaining doses in Cycle 1 and less than 3% cumulatively
from Cycle 2 onward. The median time to onset of CRS was 27 (range:
0.1 to 167) hours from the last dose, and the median duration was
17 (range: 0 to 622) hours. Clinical signs and symptoms of CRS
include but are not limited to pyrexia, hypotension, chills,
hypoxia, headache, and tachycardia. Potentially life-threatening
complications of CRS may include cardiac dysfunction, acute
respiratory distress syndrome, neurologic toxicity, renal and/or
hepatic failure, and disseminated intravascular coagulation
(DIC).
Initiate therapy with step-up dosing and administer
pre-treatment medications (corticosteroids, antihistamine, and
antipyretics) prior to each dose of TALVEY® in the
step-up dosing schedule to reduce the risk of CRS. Monitor patients
following administration accordingly. In patients who experience
CRS, pre-treatment medications should be administered prior to the
next TALVEY® dose.
Counsel patients to seek medical attention should signs or
symptoms of CRS occur. At the first sign of CRS, immediately
evaluate patient for hospitalization and institute treatment with
supportive care based on severity, and consider further management
per current practice guidelines. Withhold TALVEY® until
CRS resolves or permanently discontinue based on severity.
Neurologic Toxicity including ICANS: TALVEY® can cause
serious or life-threatening neurologic toxicity, including immune
effector cell-associated neurotoxicity syndrome (ICANS), including
fatal reactions. In the clinical trial, neurologic toxicity
occurred in 55% of patients who received the recommended dosages,
with Grade 3 or 4 neurologic toxicity occurring in 6% of patients.
The most frequent neurologic toxicities were headache (20%),
encephalopathy (15%), sensory neuropathy (14%), and motor
dysfunction (10%).
ICANS was reported in 9% of 265 patients where ICANS was
collected and who received the recommended dosages. Recurrent ICANS
occurred in 3% of patients. Most patients experienced ICANS
following step-up dose 1 (3%), step-up dose 2 (3%), step-up dose 3
of the biweekly dosing schedule (1.8%), or the initial treatment
dose of the weekly dosing schedule (2.6%) (N=156) or the biweekly
dosing schedule (3.7%) (N=109). The median time to onset of ICANS
was 2.5 (range: 1 to 16) days after the most recent dose with a
median duration of 2 (range: 1 to 22) days. The onset of ICANS can
be concurrent with CRS, following resolution of CRS, or in the
absence of CRS. Clinical signs and symptoms of ICANS may include
but are not limited to confusional state, depressed level of
consciousness, disorientation, somnolence, lethargy, and
bradyphrenia.
Monitor patients for signs and symptoms of neurologic toxicity
during treatment and treat promptly. At the first sign of
neurologic toxicity, including ICANS, immediately evaluate the
patient and provide supportive care based on severity. Withhold or
permanently discontinue TALVEY® based on severity and consider
further management per current practice guidelines. [see Dosage and
Administration (2.5)].
Due to the potential for neurologic toxicity, patients receiving
TALVEY® are at risk of depressed level of consciousness.
Advise patients to refrain from driving or operating heavy or
potentially dangerous machinery during the step-up dosing schedule
and for 48 hours after completion of the step-up dosing schedule,
and in the event of new onset of any neurological symptoms, until
symptoms resolve.
TECVAYLI® and
TALVEY® REMS: TALVEY® is
available only through a restricted program under a REMS, called
the TECVAYLI® and TALVEY® REMS because of the
risks of CRS and neurologic toxicity, including ICANS.
Further information about the TECVAYLI® and
TALVEY® REMS program is available at www.TEC-TALREMS.com
or by telephone at 1-855-810-8064.
Oral Toxicity and Weight Loss: TALVEY® can
cause oral toxicities, including dysgeusia, dry mouth, dysphagia,
and stomatitis. In the clinical trial, 80% of patients had oral
toxicity, with Grade 3 occurring in 2.1% of patients who received
the recommended dosages. The most frequent oral toxicities were
dysgeusia (49%), dry mouth (34%), dysphagia (23%), and ageusia
(18%). The median time to onset of oral toxicity was 15 (range: 1
to 634) days, and the median time to resolution to baseline was 43
(1 to 530) days. Oral toxicity did not resolve to baseline in 65%
of patients.
TALVEY® can cause weight loss. In the clinical trial,
62% of patients experienced weight loss of 5% or greater,
regardless of having an oral toxicity, including 28% of patients
with Grade 2 (10% or greater) weight loss and 2.7% of patients with
Grade 3 (20% or greater) weight loss. The median time to onset of
Grade 2 or higher weight loss was 67 (range: 6 to 407) days, and
the median time to resolution was 50 (range: 1 to 403) days. Weight
loss did not resolve in 57% of patients who reported weight
loss.
Monitor patients for signs and symptoms of oral toxicity.
Counsel patients to seek medical attention should signs or symptoms
of oral toxicity occur and provide supportive care as per current
clinical practice, including consultation with a nutritionist.
Monitor weight regularly during therapy. Evaluate clinically
significant weight loss further. Withhold TALVEY® or
permanently discontinue based on severity.
Infections: TALVEY® can cause infections,
including life-threatening or fatal infections. Serious
infections occurred in 16% of patients, with fatal infections in
1.5% of patients. Grade 3 or 4 infections occurred in 17% of
patients. The most common serious infections reported were
bacterial infection (8%), which included sepsis and COVID-19
(2.7%).
Monitor patients for signs and symptoms of infection prior to
and during treatment with TALVEY® and treat
appropriately. Administer prophylactic antimicrobials according to
local guidelines. Withhold or consider permanently discontinuing
TALVEY® as recommended, based on severity.
Cytopenias: TALVEY® can cause cytopenias,
including neutropenia and thrombocytopenia. In the clinical trial,
Grade 3 or 4 decreased neutrophils occurred in 35% of patients, and
Grade 3 or 4 decreased platelets occurred in 22% of patients who
received TALVEY®. The median time to onset for Grade 3
or 4 neutropenia was 22 (range: 1 to 312) days, and the median time
to resolution to Grade 2 or lower was 8 (range: 1 to 79) days. The
median time to onset for Grade 3 or 4 thrombocytopenia was 12
(range: 2 to 183) days, and the median time to resolution to Grade
2 or lower was 10 (range: 1 to 64) days. Monitor complete blood
counts during treatment and withhold TALVEY® as
recommended, based on severity.
Skin Toxicity: TALVEY® can cause serious
skin reactions, including rash, maculo-papular rash, erythema, and
erythematous rash. In the clinical trial, skin reactions occurred
in 62% of patients, with grade 3 skin reactions in 0.3%. The median
time to onset was 25 (range: 1 to 630) days. The median time to
improvement to grade 1 or less was 33 days.
Monitor for skin toxicity, including rash progression. Consider
early intervention and treatment to manage skin toxicity.
Withhold TALVEY® as recommended based on severity.
Hepatotoxicity: TALVEY® can cause
hepatotoxicity. Elevated ALT occurred in 33% of patients, with
grade 3 or 4 ALT elevation occurring in 2.7%; elevated AST occurred
in 31% of patients, with grade 3 or 4 AST elevation occurring in
3.3%. Grade 3 or 4 elevations of total bilirubin occurred in 0.3%
of patients. Liver enzyme elevation can occur with or without
concurrent CRS.
Monitor liver enzymes and bilirubin at baseline and during
treatment as clinically indicated. Withhold TALVEY® or
consider permanent discontinuation of TALVEY®, based on
severity [see Dosage and Administration (2.5)].
Embryo-Fetal Toxicity: Based on its mechanism of action,
TALVEY® may cause fetal harm when administered to a
pregnant woman. Advise pregnant women of the potential risk to the
fetus. Advise females of reproductive potential to use effective
contraception during treatment with TALVEY® and for 3
months after the last dose.
Adverse Reactions: The most common adverse reactions
(≥20%) are pyrexia, CRS, dysgeusia, nail disorder, musculoskeletal
pain, skin disorder, rash, fatigue, weight decreased, dry mouth,
xerosis, dysphagia, upper respiratory tract infection, diarrhea,
hypotension, and headache.
The most common Grade 3 or 4 laboratory
abnormalities (≥30%) are lymphocyte count decreased, neutrophil
count decreased, white blood cell decreased, and hemoglobin
decreased.
Please read full Prescribing Information, including
Boxed WARNING, for TALVEY®.
About Johnson & Johnson
At Johnson & Johnson, we believe health is everything. Our
strength in healthcare innovation empowers us to build a world
where complex diseases are prevented, treated, and cured, where
treatments are smarter and less invasive, and solutions are
personal. Through our expertise in Innovative Medicine and MedTech,
we are uniquely positioned to innovate across the full spectrum of
healthcare solutions today to deliver the breakthroughs of
tomorrow, and profoundly impact health for humanity. Learn more at
https://www.jnj.com/ or at
www.janssen.com/johnson-johnson-innovative-medicine. Follow us
at @JanssenUS and @JNJInnovMed. Janssen Research &
Development, LLC and Janssen Biotech, Inc. are both Johnson &
Johnson companies. Source: Johnson & Johnson
Cautions Concerning Forward-Looking Statements
This press release contains "forward-looking statements" as
defined in the Private Securities Litigation Reform Act of 1995
regarding product development and the potential benefits and
treatment impact of TALVEY®
(talquetamab-tgvs). The reader is cautioned not to
rely on these forward-looking statements. These statements are
based on current expectations of future events. If underlying
assumptions prove inaccurate or known or unknown risks or
uncertainties materialize, actual results could vary materially
from the expectations and projections of Janssen Research &
Development, LLC, Janssen Biotech, Inc., and/or Johnson &
Johnson. Risks and uncertainties include, but are not limited to:
challenges and uncertainties inherent in product research and
development, including the uncertainty of clinical success and of
obtaining regulatory approvals; uncertainty of commercial success;
manufacturing difficulties and delays; competition, including
technological advances, new products and patents attained by
competitors; challenges to patents; product efficacy or safety
concerns resulting in product recalls or regulatory action; changes
in behavior and spending patterns of purchasers of health care
products and services; changes to applicable laws and regulations,
including global health care reforms; and trends toward health care
cost containment. A further list and descriptions of these risks,
uncertainties and other factors can be found in Johnson &
Johnson's Annual Report on Form 10-K for the fiscal year ended
December 31, 2023, including in the
sections captioned "Cautionary Note Regarding Forward-Looking
Statements" and "Item 1A. Risk Factors," and in Johnson &
Johnson's subsequent Quarterly Reports on Form 10-Q and other
filings with the Securities and Exchange Commission. Copies of
these filings are available online at www.sec.gov, www.jnj.com or
on request from Johnson & Johnson. None of Janssen Research
& Development, LLC, Janssen Biotech, Inc. nor Johnson &
Johnson undertakes to update any forward-looking statement as a
result of new information or future events or developments.
1 Rasche, L et al., Long-term efficacy and safety
results from the Phase 1/2 MonumenTAL-1 study of talquetamab, a
GPRC5DxCD3 bispecific antibody, in patients with
relapsed/refractory multiple myeloma. 2024 European Hematology
Association Hybrid Congress. Accessed June 2024.
2 Searle, E et al., Talquetamab, a GPRC5dxCD3 bispecific
antibody, in combination with pomalidomide in patients with
relapsed/refractory multiple myeloma: safety and efficacy results
from the Phase 1b MonumenTAL-2 study.
2024 European Hematology Association Hybrid Congress. Accessed
June 2024.
3 TALVEY® U.S. Prescribing Information,
August 2023.
4 European Medicines Agency. TALVEY Summary of Product
Characteristics. August 2023.
5 ClinicalTrials.gov Identifier NCT03399799.
https://clinicaltrials.gov/ct2/show/NCT03399799. Accessed:
June 2024.
6 ClinicalTrials.gov Identifier NCT04634552.
https://clinicaltrials.gov/ct2/show/NCT04634552 Accessed:
June 2024.
7 ClinicalTrials.gov Identifier NCT05050097.
https://clinicaltrials.gov/study/NCT05050097. Accessed:
June 2024.
8 Rajkumar SV. Multiple myeloma: 2020 update on
diagnosis, risk-stratification and management. Am J Hematol.
2020;95(5):548-5672020;95(5):548-567.
http://www.ncbi.nlm.nih.gov/pubmed/32212178. Accessed: June 2024.
9 National Cancer Institute. Plasma Cell Neoplasms.
Available at:
https://www.cancer.gov/types/myeloma/patient/myeloma-treatment-pdq.
Accessed: June 2024.
10 Multiple myeloma. City of Hope, 2022. Multiple
Myeloma: Causes, Symptoms & Treatments. Available at:.
https://www.cancercenter.com/cancer-types/multiple-myeloma.
Accessed: June 2024.
11 American Cancer Society. Key Statistics About
Multiple Myeloma. Available at:
https://www.cancer.org/cancer/multiple-myeloma/about/key-statistics.html#:~:text=Multiple%20myeloma%20is%20a%20relatively,men%20and%2015%2C370%20in%20women.
Accessed: June 2024.
12 SEER*Explorer: An interactive website for SEER cancer
statistics [Internet]. Surveillance Research Program, National
Cancer Institute. Available at: https://seer.cancer.gov/explorer/.
Accessed: June 2024
13 American Cancer Society. What is Multiple Myeloma?
Available at:
https://www.cancer.org/cancer/multiple-myeloma/about/what-is-multiple-myeloma.html.
Accessed: June 2024
14 American Cancer Society. Multiple Myeloma Early
Detection, Diagnosis, and Staging. Available at:
https://www.cancer.org/cancer/types/multiple-myeloma/detection-diagnosis-staging/detection.html.
Accessed: June 2024
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SOURCE Johnson & Johnson