September 2026 in Hematology: 5 Updates That Pharmacists Should Know

September’s Pharmacy Times hematology coverage focused heavily on multiple myeloma, with findings from the International Myeloma Society (IMS) Annual Meeting examining treatment goals and the practical delivery of care. A formal definition of cure brought new precision to discussions of treatment-free remission, while clinical research explored options for patients with persistent disease.^1-3

Other coverage examined the patient experience of subcutaneous therapy and the potential for earlier intervention. Here are 5 developments from September’s coverage with implications for hematology pharmacy practice.^4,5

1. A New Definition of Myeloma Cure Sets a Treatment-Free Benchmark

The International Myeloma Society and International Myeloma Working Group established a consensus definition of myeloma cure, allowing patients to be considered cured after at least 5 years of complete remission without myeloma treatment. The observation period begins when treatment ends.¹

The criteria require at least 4 negative measurable residual disease (MRD) assessments, including one at year 5, using testing sensitive to 1 myeloma cell per million cells. Advanced imaging must also show no disease at the beginning and end of the observation period, without intervening positive results.¹

The framework changes counseling about maintenance and the meaning of a negative MRD test. It gives pharmacists specific criteria for discussing treatment-free remission while preserving the distinction between meeting a research benchmark and deciding whether an individual patient should stop therapy.¹

2. Isatuximab Injector Data Highlight Comfort and At-Home Delivery

New patient-experience findings from the phase 3 IRAKLIA trial favored subcutaneous isatuximab administered through an on-body injector over intravenous delivery. Among patients satisfied with their administration method, more injector recipients disagreed that treatment was painful: 89.1% compared with 72.0% in the intravenous group.²

At the end of treatment, willingness to continue therapy was also higher with the injector, at 50.7% versus 31.4%. A separate substudy evaluated administration at home by a health care provider beginning at cycle 6. All 148 analyzed home injections were completed, with one grade 1 injection-site reaction.²

The findings have implications for infusion capacity and patient convenience. For pharmacists, they highlight the importance of delivery preferences alongside the clinical performance of a chronic regimen, particularly when evaluating opportunities to reduce the time patients spend receiving treatment.²

3. Isatuximab–Iberdomide Maintenance Deepens Responses in MIDAS

First-year results from the phase 3 MIDAS trial examined isatuximab–iberdomide maintenance in patients who remained MRD positive after induction. Patients underwent either single autologous stem cell transplantation with consolidation or tandem transplantation before receiving the maintenance doublet.³

Among 219 patients who began maintenance, 55 converted to MRD negativity at the 10⁻⁶ threshold during the first year. MRD-negative rates increased from 40% to 58% in the single-transplant arm and from 32% to 48% in the tandem-transplant arm.³

The results also underscore the monitoring burden: grade 3 or higher neutropenia occurred in 42% of patients and infections in 18%. These findings place blood count surveillance and infection prevention alongside response assessment. Because both transplant groups received the same maintenance regimen, the analysis does not establish superiority over an alternative maintenance treatment.³

4. Linvoseltamab Findings Renew the Debate About Earlier Treatment

The phase 2 LINKER-SMM1 study evaluated linvoseltamab in high-risk smoldering multiple myeloma. The update summarized in September’s coverage reported responses in all 32 evaluable patients, with 97% achieving a very good partial response or better and 69% achieving complete response. No progression to active myeloma was observed at a median follow-up of 8.6 months.⁴

Safety remains central to interpreting earlier intervention. Infections occurred in 92% of patients, including grade 3 infections in 19%, despite supportive care that included immunoglobulin replacement and infection prophylaxis.⁴

Confirmatory evidence could affect treatment eligibility and payer policies. For pharmacists, the results raise questions about balancing deep responses with the burden of treating patients before active disease develops. The findings do not establish linvoseltamab as routine therapy in this setting, and longer-term evidence remains important to assessing its clinical value.⁴

5. Ramantamig Interview Examines Response Durability and Outpatient Care

In a Pharmacy Times interview about ramantamig, Jeffrey V. Matous, MD, discussed phase 1 results for the trispecific antibody, which engages BCMA, GPRC5D, and CD3. Among 47 patients naïve to T-cell–redirecting therapy, the overall response rate was 93.6%, with 76.6% achieving complete response or better. The reported 18-month progression-free survival rate was 84.6%.⁵

Matous also reviewed an expanded 30-patient outpatient cohort using prophylactic tocilizumab before step-up dosing. His discussion addresses cytokine release syndrome management and the practical requirements for moving treatment into community settings.⁵

The interview connects efficacy findings with operational decisions, including infection prophylaxis and treatment-day scheduling. It offers pharmacists a closer look at the supportive-care planning required as investigational T-cell–engaging therapies are evaluated for broader delivery.⁵

REFERENCES

1. Gerlach A. After 180 years, multiple myeloma gets a definition of cure. Pharmacy Times. Published September 23, 2026. Accessed September 30, 2026. https://www.pharmacytimes.com/view/after-180-years-multiple-myeloma-gets-a-definition-of-cure

2. Gerlach A. Patients prefer at-home isatuximab injector over IV, IRAKLIA data show. Pharmacy Times. Published September 25, 2026. Accessed September 30, 2026. https://www.pharmacytimes.com/view/patients-prefer-at-home-isatuximab-injector-over-iv-iraklia-data-show

3. Gerlach A. Iberdomide pairs with isatuximab to rescue MRD-positive patients after transplant. Pharmacy Times. Published September 24, 2026. Accessed September 30, 2026. https://www.pharmacytimes.com/view/iberdomide-pairs-with-isatuximab-to-rescue-mrd-positive-patients-after-transplant

4. Gerlach A. Linvoseltamab shows 100% response rate in smoldering myeloma, raising early-intervention question. Pharmacy Times. Published September 23, 2026. Accessed September 30, 2026. https://www.pharmacytimes.com/view/linvoseltamab-shows-100-response-rate-in-smoldering-myeloma-raising-early-intervention-question

5. Matous JV, Gerlach A. Ramantamig’s 93.6% ORR and outpatient CRS control. Pharmacy Times. Published September 27, 2026. Accessed September 30, 2026. https://www.pharmacytimes.com/view/ramantamig-s-93-6-orr-and-outpatient-crs-control