Please describe your specialty and details about your clinical practice.

How many patients with R/R Multiple Myeloma do you treat?  At what line of treatment do patients show up to your practice? 

-Have you used Blenrep in clinical practice based on its current approval as a monotherapy so far? And if so, in what line of treatment?

When you think about safety and efficacy of blenrep, how does it compare across the landscape of treatments now available and in late stage development, and where does it currently fit into the picture?  

Other Blenrep real-world use questions:

Are there difficulties providing it? Logistical or otherwise.     
How did your patients (if any) do on the drug? Did they benefit?
How do you characterize the duration of response?  Does it match the clinical trial numbers which were used for the FDA approval?   

-Could you talk about the gamma secretase inhibitor, Nirogacestat, and its role in terms of processing BCMA and whether this might bring something to the table in treatment of MM in combination with something like Blenrep.

Could cleaved soluble BCMA released exported out of the cell and into the circulation be limiting efficacy of BCMA agents like Blenrep?
Or do you think the lack of sufficient levels of cell surface (membrane-bound) BCMA is the underlying factor limiting the therapeutic window of Blenrep as a BCMA ADC?

Are there unintended consequences you might anticipate from increasing the surface expression of BCMA or otherwise by inhibiting gamma secretase, which also cleaves other proteins besides BCMA? Or do you think this MOA has a compelling rationale?

In terms of the trial data, in later relapse patients like they are testing here (in DREAMM-5), how much duration of response is sufficient to demonstrate that the combo is active?

More generally about DREAMM5 - What are you hoping to see in this trial?

When you will see the results of this combo at ASCO, what is the bar for comparison? Which treatment option sets the standard here and what is that bar in this particular setting for efficacy and safety?

Are you looking at whether they can improve the profile of Blenrep with a lower dose, for better safety, with efficacy that matches Blenrep alone?
Or does Blenrep have such a small role currently that the real bar is for real efficacy as compared to other agents, approved or near approval?

What AEs caused by Blenrep are most pressing, and what would position this combination favorably or unfavorably depending on what is shown?

What kind of result could they show here that would make you rethink the role of Blenrep and assign it higher priority as a combo with GSI once it is approved?  What improvements specifically to safety, percentage wise or by grade that will make the agent more compelling with its current level of efficacy?
Or would efficacy also need to improve and if so, to what level?  (ORR, DOR, etc)

Did agents in late stage development such as BCMA-CD3 bispecifics already set a new bar and therefore does this combo need to match data from existing agents that are not yet approved but expected to be over the next few years?   What numbers would the combo need to match in your view?  

Please contextualize the expectations of this data in light of BCMA CAR-T products.

On a scale of 1-10, how excited are you about the upcoming ASCO Abstract 8019 of Blenrep + Nirogacestat?