2025 Tandem Meetings Transplantation and Cellular Therapy Meetings of ASTCT and CIBMTR

Olivia White, PharmD, BCOP, Clinical Pharmacy Specialist - Hematology/Oncology, UT Southwestern Medical Center

Introduction:

The Tandem Meetings is an in-person annual conference hosted by the American Society of Transplantation and Cellular Therapy (ASTCT) and Center for International Blood and Marrow Transplant Research (CIBMTR). Individuals from around the world come to share and learn about the latest updates in transplantation and cellular therapy. This year’s meeting was held from February 12-15, 2025, in Honolulu, Hawaii.

At the Tandem Meetings, there are a wide variety of presentations, all spaced through different "tracks" – some of those being focused more on groundbreaking research versus hot pharmacy topics versus advanced practitioner considerations, etc. Below are listed some of the highlights from both the pharmacy track, APP track, and scientific track.

Highlight 1 (Pharmacy Track): ChatBMT: Harnessing AI to Elevate Your Clinical Practice

In this presentation, Dr. Alexandra Wolff discussed the use of artificial intelligence and how this can be implemented into daily practices as pharmacists. The use of AI in healthcare is continuing to grow and these tools can be further capitalized upon by a pharmacy team. Dr. Wolff described the different types of AI that currently exist and are available through different modalities – even beyond healthcare (e.g. Netflix, vehicles, etc.). Specifically for healthcare, she discussed the applications that can be used with AI and literature that exists for different health systems. She focused on how we can use these models in our day-to-day practice and how to prompt a language learning model (LLM) to get the results you need. Some of these key techniques included being clear and specific to the model, defining your audience and tone, setting constraints, and iterating/refining your prompt based on initial responses. Furthermore, image generation was discussed along with how AI can be a tool in this setting.

Before finishing, the limitations of LLMs were also discussed, primarily through clinical knowledge. There are instances where AI can create misinformation, so checking sources and asking the LLM for citations upon implementation into day-to-day use is pertinent. This was an excellent discussion and has inspired me to incorporate this in my daily use.

Highlight 2 (Pharmacy Track): Sequencing of Therapy and Role of HCT in Multiple Myeloma

This session was organized into a "debate"-style session with Drs. Christopher Ferreri, Doris Hansen, and Rebecca Gonzalez. These three practitioners did an excellent job debating the role of HCT in the frontline space with the current CAR T-cell regimens available for relapsed patients. Specifically, they discussed the PFS benefits that were seen in the IFM2009 and DETERMINATION trials – both of which favored the use of HCT as standard of care (SoC) for newly diagnosed multiple myeloma (NDMM). They also discussed the evolving role of minimal residual disease (MRD) adapted approaches to myeloma patients. They highlighted ongoing studies with the MIDAS and ADVANCE trials both using MRD positivity to guide the decision making for HCT and potentially help merge currently available literature with MRD-guided practices.

Furthermore, this group discussed the role of early versus deferred CAR T-cell therapy by discussing the KarMMa-3 trial and CARTITUDE-4 trials, both of which assessed the earlier roles of anti-BCMA CAR T-cell therapy and prompted what is currently the FDA-approved uses of these agents. They also highlighted the ongoing trials of moving CAR-T into even earlier spaces. Lastly, sequencing of the anti-BCMA CAR-T agents with bispecific antibodies (both BCMA-targeting agents and non-targeting agents) was discussed. The presenters highlighted that while targeting differing antigens with talquetamab may be preferred, this can be limited due to toxicity profiles of the agents and anticipated tolerability. The presenters summarized the meeting by demonstrating that many of these decisions are still patient-specific and an evolving landscape. Ongoing trials may help to delineate these roles in the future.

Highlight 3 (APP Track): Navigating Medical Marijuana in BMT Patients

During this time, Dr. Erin Goodell discussed the potential role of medical marijuana in patients who are undergoing transplantation and considerations for use. She highlighted that this is a common topic among practitioners with their patients. Notably, it is strongly encouraged, due to infection risk, for patients to avoid inhaled marijuana options. She discussed the synthetic THC agents available on the market at present, their indications, and then other cannabinoid components that are commonly dispensed but not FDA approved. When considering the clinical impact of these agents, she discussed the literature for CINV, anti-neoplastic effects, pain, insomnia, anxiety, and appetite stimulation – of which, the most robust literature stands for CINV. Furthermore, she discussed the potential clinical impact marijuana can have pertaining to drug-drug interactions and T-cell function when treating patients with anti-cancer therapies.

Lastly, Dr. Goodell described the role she had with other colleagues at her institution on a marijuana consult service. After a pharmacist and social worker are consulted for patients with specific questions regarding marijuana use, they then work up the patient for social barriers and/or drug interactions/treatment concerns. Lastly, they coordinate with the patient and primary team to optimize the patient’s monitoring/regimen.

Highlight 4 (Scientific Track): No Impact of Prophylactic Corticosteroid Use in Patients Receiving Axicabtagene Ciloleucel for Large B-Cell Lymphoma

During this presentation Dr. Megan Melody presented a multi-center retrospective study focused on the impact of prophylactic dexamethasone on mitigating cytokine release syndrome when administering axi-cel at their respective institutions. This analysis included 233 patients, 50 of whom received prophylactic dexamethasone consistent with the ZUMA-1, safety cohort 6 subgroup analysis that demonstrated favorable lower-grade CRS with this intervention. Dr. Melody and her team found no difference in the incidence, median time of onset, and duration of CRS with prophylactic dexamethasone use. Notably, when looking at the CRS grading, there were numerically lower grade incidences with the dexamethasone cohort; however, this was not significant (p=0.87). Of the patients receiving dexamethasone, 51% had CRS occur while receiving prophylaxis. There were no differences in incidence, onset, and duration of ICANS between the two groups; however, higher grades of ICANS were noted in the prophylactic cohort (p=0.028). The use of dexamethasone prophylaxis did not minimize the use of other interventions for CAR T-cell toxicity. The median PFS and OS outcomes were similar between both groups. This team concluded that dexamethasone prophylaxis did not have a significant impact on incidence or duration of axi-cel-related toxicities.

Highlight 5 (Scientific Track): Durable Clinical Benefits in Severe Sickle Cell Disease with Exagamglogene Autotemcel

Dr. Stephen Grupp presented extended outcomes on one of the CRISPR-Cas9 therapies FDA approved for sickle cell disease (SCD): exagamglogene autotemcel (exa-cel).

In his presented analysis, the median follow up duration was 33 months, with the longest patient being monitored for 5 years. This cohort consisted of 42 patients ages12-35 who previously had a minimum of 2 or more vaso-occlusive crises (VOC) per year prior to exa-cel intervention. The baseline mean VOC/year prior to intervention was 4.2. The primary endpoint of this analysis was the proportion of patients free from severe VOC for >12 consecutive months. Of the involved patients, 93% met the primary endpoint, with the median duration of VOC-free intervals being 30.9 months (95% CI 12.9-59.6). Some of the key secondary endpoints included time to engraftment, percentage of fetal hemoglobin (HbF) percentage and maintenance of that percentage, and duration of hospitalization-free time. During his presentation, Dr. Grupp reported a median time to platelet engraftment of 34.5 days and a durable HbF percentage throughout the follow up period. As for duration following infusion the patient remained hospitalization-free, 98% of the patients in the study were able to be hospitalization-free at 12 months following exa-cel, with the mean duration of a hospitalization-free period being 31.5 months (95% CI 12.9-59.6). These data helped to demonstrate the clinical impact gene therapy can have on SCD with longer follow up and the potential for true "cure" of SCD.

Conclusion

In addition to the above-mentioned sessions, there were excellent discussions on improving access to transplantation/cellular therapy worldwide, bridging therapy, pharmacokinetic/dynamic models, administrative considerations for TIL implications, and much more. This was a wonderful 2025 meeting – the next Tandem meeting will be February 4-8, 2026, in Salt Lake City, Utah.

Recommended Readings

1.Richardson PG, Jacobus SJ, Weller EA, et al. Triplet Therapy, Transplantation, and Maintenance until Progression in Myeloma. N Engl J Med. 2022;387(2):132-147. doi: 10.1056/NEJMoa2204925.

2.Attal M, Lauwers-Cances V, Hulin Cet al. Lenalidomide, Bortezomib, and Dexamethasone with Transplantation for Myeloma. N Engl J Med. 2017;376(14):1311-1320. doi: 10.1056/NEJMoa1611750.

3.Rafae A, van Rhee F, Al Hadidi S. Perspectives on the Treatment of Multiple Myeloma. Oncologist. 2024;29(3):200-212. doi: 10.1093/oncolo/oyad306.

4.Munshi NC, Anderson LD Jr, Shah N, et al. Idecabtagene Vicleucel in Relapsed and Refratory Multiple Myeloma. N Engl J Med. 2021;384(8):705-716. doi: 10.1056/NEJMoa2024850.

5.San-Miguel J, Dhakal B, Yong K, et al. Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma. N Engl J Med. 2023;389(4):335-347. doi: 10.1056/NEJMoa2303379.

6.Hansen DK, Peres LC, Dima D, et al. Comparison of Standard-of-Care Idecabtagene Vicleucel and Ciltacabtagene Autoleucel in Relapsed/Refractory Multiple Myeloma. J Clin Oncol. 2025:JCO2401730. doi: 10.1200/JCO-24-01730.

7.Costa LJ, Banerjee R, Mian H, et al. International myeloma working group immunotherapy committee recommendation on sequencing immunotherapy for treatment of multiple myeloma. Leukemia. 2025;39(3):543-554. doi: 10.1038/s41375-024-02482-6.

8.Braun IM, Bohlke K, Abrams DI, et al. Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline. J Clin Oncol. 2024;42(13):1575-1593. doi: 10.1200/JCO.23.02596.

9.Locke FL, Ghobadi A, Jacobson CA, et al. Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1-2 trial. Lancet Oncol. 2019;20(1):31-42. doi: 10.1016/S1470-2045(18)30864-7.

10.Oluwole OO, Bouabdallah K, Muñoz J, et al. Prophylactic corticosteroid use in patients receiving axicabtagene ciloleucel for large B-cell lymphoma. Br J Haematol. 2021;194(4):690-700. doi: 10.1111/bjh.17527.

11.Frangoul H, Locatelli F, Sharma A, et al. Exagamglogene Autotemcel for Severe Sickle Cell Disease. N Engl J Med. 2024;390(18):1649-1662. doi: 10.1056/NEJMoa2309676.