Category: 3. Business

  • Ontario’s IPC covers potential risks, guardrails as AI meets health care

    Ontario’s IPC covers potential risks, guardrails as AI meets health care

    The impacts of artificial intelligence on processes and services in the health care sector raise promise and risks. Ontario’s Office of the Information and Privacy Commissioner is trying to get ahead of the delicate landscape with an eye toward balancing safety and innovation.

    In recent weeks, the IPC offered new guidance materials to help thread the needle.

    First came the new Principles for the Responsible Use of AI, developed in coordination Ontario’s Human Rights Commission. The IPC described the principles as tools to “develop, deploy, and use AI in ways that maintain public trust by respecting privacy and human rights.”

    Additional guidance from the IPC covered AI notetakers, or scribes, in health care settings and features a checklist for procurement professionals, developers and users in the health sector, which contains key considerations throughout the AI life cycle that should be weighed when evaluating potential AI solutions.

    The new resources helped set the stage for a broader discussion on AI health care during a 28 Jan. workshop commemorating Data Privacy Day.

    Delivering opening remarks at the workshop, IPC Commissioner Patricia Kosseim referenced a recent survey from the Canadian Medical Association and Canadian Federation of Independent Businesses in which 90% of the nearly 2,000 physicians surveyed reported a significant administrative burden in filling out paperwork that amounted to an aggregate of 20 million hours annually and detracted from their ability to care for patients. 

    Kosseim pointed to other responses that showed roughly half of physicians identifying AI as a potential solution for easing administrative tasks, while half of those surveyed also acknowledged “real privacy, security and legal risks” surrounding AI use in clinical settings. The survey also found that approximately one-third of physicians wanted help identifying and vetting various AI products.

    The guidance on AI scribes “will help health professionals take a privacy-first approach focusing on core governance and accountability measures needed to protect personal health information and reduce the risk of bias and inadequacy,” Kosseim said. “Together these two companion documents set out clear expectations and best practices to ensure compliance with Ontario’s health privacy law, mitigate risks of harm and ultimately preserve trust.”

    Opportunities for integrating AI in health care

    One theme from the day-long workshop focused on the potential benefits that could be realized for integrating certain aspects of health care services with AI. 

    St. Michael’s Hospital Clinician-Scientist Dr. Amol Verma said AI uses in the health care sector primarily fall into four main categories: General AI, general clinical AI, clinical AI tools and AI that is embedded in medical devices. 

    Verma said general AI, such as generative AI models like ChatGPT, are being increasingly used by practitioners to query for basic medical information, instead of more traditional search engines like Google Search. Whereas general clinical AI may embed a specific health care system’s information and data into an AI model to create a health-specific chatbot.

    “The innovation is there, but it’s uneven (in its distribution),” Verma said. “So now, we as a health care system have to look at that technology and say, ‘We’re getting 10% of the people that use this are benefitting substantially, and that’s meaningful.’ How much are we willing to pay for that technology, and what are we substituting in our healthcare system to pay for that technology? Unless we have robust standards of rigorous evidence, we can’t make those decisions.”

    University of Ottawa School of Epidemiology and Public Health Professor and Canada Research Chair in Medical AI Khaled El Emam said in order to realize the greatest benefits from AI in medicine from both a delivery of care and innovation perspective, Ontario and Canada as a whole need to develop a “playbook” for reforming regulations around enabling greater access to medical data for both researchers and companies developing cutting edge AI solutions.  

    Part of this playbook would be reducing the timeframe for medical testing that involves an AI component to get answers sooner on a tool’s efficacy. 

    “The technology moves fast,” El Emam said. “If the gold standard is to perform controlled trials and (randomized controlled trials) to evaluate interventions, these take a long time to do. If you’re going to spend a couple years evaluating a technology in the clinic, two years from now, who cares? Everything else has changed and something better is available.”

    Establishing relevant frameworks for enabling AI integration

    To ensure AI does not impede general patient rights and the right to privacy, panelists agreed Ontario’s health care sector must explore all its framework options.

    University of Ottawa Canada Research Chair in Information Law and Policy Teresa Scassa said key considerations for crafting policies around using AI in health care are data provenance and the varying degrees of consent given for the data therein and setting standards for acquiring AI solutions to ensure they meet not only Canada’s privacy laws, but Ontario-specific rules.

    “There is a proliferation of vendors that are trying to attract new customers and holding out promises that their tools were compliant with different privacy laws, and that can get complicated because the doctors or health care custodians in Ontario are subject to very specific privacy laws and those might not be the same ones (they) are being certified as being compatible with,” Scassa said. “The provenance of data that’s used to train AI is an interesting and thorny question because it can come from a variety of sources and consent can be obtained in a variety of ways. There’s data used without consent, and there may also be data that is used with consent but the consent was obtained in ways that aren’t genuine.”

    In terms of disclosing AI uses in clinical health settings, IPC Senior Health Policy Advisor Nicole Minutti said data custodians must include the purpose for using AI, what data is shared with third parties and the reason for doing so, AI risks, such bias, and the safeguards the custodian has in place to safeguard protected health information. She referenced a survey conducted Office of the Privacy Commissioner of Canada last year that found 88% of Canadian citizens are concerned about their personal information being shared and used to train AI models, with 42% of whom were “extremely concerned.” 

    “When we see this level of concern in the general public, it’s inevitable that at some point data custodians are going to be asked about their use of AI systems,” Minutti said. “They should be prepared to answer those questions.”

    Queen’s University Dean of Law Colleen Flood argued AI used in health care can pose both clinical and privacy risks. 

    She said clinicians should not be faced with explainability requirements for patients, in terms of how a given large language used by the health care institution model functions. They should be required to explain the material risks the model may pose to patients in the form of automation biases or data leak risks. She said privacy risks stem from AI being used to re-identify deidentified data. 

    Another consideration for practitioners is ensuring their employers understand the terms of use contracts they are signing with AI vendors. Flood said some contracts are written so that all clinical and privacy liability falls on the health care provider and/or their institution. 

    “The desire for vendors will be to download all of that liability, privacy liability onto the clinician, so those contracts need to be carefully reviewed and considered,” she added. “We need Big Bang (privacy) reform here: We over-assume the law does some things, it doesn’t do other things. It’s not working for what we need right now and we need to fix this.”

    In an interview with the IAPP following the workshop, the Commissioner Kosseim said the insights gleaned from the workshop will help inform the agency’s approach to monitoring AI integration with the health sector. She said for developers, they must view the need to uphold patients’ privacy as “not in conflict with innovation.”

    “As a regulator, we need to support iterative thinking so that we can help inform the risks being taken engage all of those interested parties to participate in that process,” Kosseim said. “The theme coming out of today is the need for trust across the system: Trust in providers, patients’ trust in health care institutions, and how important it is to continue to build that trust so when tools like AI scribes are introduced they are well governed and patients don’t lost that trust that is so fundamental to our health care system.”

    Alex LaCasse is a staff writer for the IAPP.

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  • CFTC Withdraws Event Contracts Rule Proposal and Staff Sports Event Contracts Advisory

    CFTC Withdraws Event Contracts Rule Proposal and Staff Sports Event Contracts Advisory

    The Commodity Futures Trading Commission today announced it has withdrawn the notice of proposed rulemaking titled “Event Contracts” that published June 10, 2024. [See CFTC Press Release No. 8907-24] The CFTC does not intend to issue final rules with respect to the proposal. 

    Additionally, Commission staff has withdrawn CFTC Staff Letter 25-36, a Staff Advisory on Certain Contract Markets, issued Sept. 30, 2025 [See CFTC Press Release No. 9137-25].

    “Today’s actions reflect the CFTC’s commitment to lawful innovation in our markets,” said CFTC Chairman Michael S. Selig. “The 2024 event contracts proposal reflected the prior administration’s frolic into merit regulation with an outright prohibition on political contracts ahead of the 2024 presidential election. The Commission is withdrawing that proposal and will advance a new rulemaking grounded in a rational and coherent interpretation of the Commodity Exchange Act that promotes responsible innovation in our derivatives markets in line with Congressional intent.”

    Chairman Selig also commended the staff’s withdrawal of its 2025 sports event contracts advisory. 

    “While intended to highlight litigation considerations, the advisory inadvertently created confusion and uncertainty for our market participants” Chairman Selig said. “I look forward to working with staff on an event contracts rulemaking.”

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  • ASH 2025: Highlights in Relapsed/Refractory Multiple Myeloma

    ASH 2025: Highlights in Relapsed/Refractory Multiple Myeloma

    “Dripping water hollows out stone, not through force but through persistence.” – Ovid

    The 2025 American Society of Hematology (ASH) Annual Meeting & Exposition delivered multiple practice-changing datasets surrounding T-cell–redirecting therapies in relapsed or refractory multiple myeloma.

    Three abstracts were especially notable: the phase III MajesTEC-3 trial (LBA-6)1, which paired teclistamab-cqyv with daratumumab and reported striking long-term progression-free and overall survival in relapsed or refractory multiple myeloma treated with one to three prior lines of therapy; the phase II RedirecTT-1 study (Abstract 698)2, which tested dual bispecific targeting (GPRC5D and BCMA) in true extramedullary disease; and early results from inMMyCAR (LBA-1)3, which used an intravenously delivered gene therapy (KLN-1010) to generate anti-BCMA chimeric antigen receptor (CAR) T cells in vivo without leukapheresis or lymphodepleting chemotherapy.

    For full details of the study abstracts, visit www.hematology.org/meetings/annual-meeting/abstracts.

    LBA-6 (MajesTEC-3): Teclistamab Plus Subcutaneous Daratumumab vs Standard Daratumumab Triplets

    Background: Daratumumab-based triplets such as daratumumab plus pomalidomide and lenalidomide (DPd) and daratumumab plus bortezomib and lenalidomide (DVd) are commonly used in patients with relapsed or refractory multiple myeloma after one to three prior lines of therapy, but outcomes remain limited, particularly in those previously exposed to proteasome inhibitors and immunomodulatory drugs. Teclistamab, a BCMA × CD3 bispecific antibody, has shown deep and durable responses in later-line disease. In October 2022, teclistamab was granted accelerated approval by the U.S. Food and Drug Administration, based on the results of MajesTEC-1 trial; patients with relapsed or refractory multiple myeloma who received at least three prior lines of therapy and were treated with teclistamab had an overall response rate of 63.0%,4,5 and 46.1% achieved a complete response or better.4 Long-term follow-up from MajesTEC-1 (median follow-up = 30.4 months) showed a median duration of response of 24 months overall, with a 30-month duration of response rate of 60.8% in patients achieving a complete response (median = not reached).4 MajesTEC-3 (ClinicalTrials.gov Identifier: NCT05083169) is a phase III trial evaluating teclistamab plus subcutaneous daratumumab earlier in the disease course.1,6,7

    Methods: MajesTEC-3 is an ongoing randomized phase III trial in relapsed or refractory multiple myeloma after one to three prior lines of therapy (including prior lenalidomide and a proteasome inhibitor). Patients with prior BCMA-directed therapy or anti-CD38 antibody refractory disease were excluded. Participants were randomly assigned to receive teclistamab plus subcutaneous daratumumab (n = 291) or investigator’s choice of DPd or DVd (n = 296). Approximately 5% of patients had prior daratumumab exposure, balanced across arms.

    Syed A. Abutalib, MD

    After step-up dosing, teclistamab was administered at 1.5 mg/kg weekly in the first and second cycles, then 3 mg/kg every 2 weeks in the third through sixth cycles, and every 4 weeks from the seventh cycle and onward. Subcutaneous daratumumab was given weekly in the first and second cycles, every 14 days in the third through sixth cycles, and every 4 weeks from the seventh cycle and onward. The primary endpoint was progression-free survival by independent review; key secondary endpoints included overall survival, overall response rate, complete response rate, measurable residual disease (MRD) negativity, patient-reported outcomes, and safety.

    Efficacy Results: With extended follow-up (median = 34.5 months), teclistamab plus daratumumab produced a marked reduction in the risk of disease progression or death (36-month progression-free survival: 83.4% vs 29.7%; hazard ratio [HR] = 0.17, 95% confidence interval [CI] = 0.12–0.23; P < .0001). Of note, 90% of patients who were progression-free at 6 months remained progression-free at 3 years. Overall survival also favored teclistamab plus daratumumab (36-month: 83.3% vs 65.0%; HR = 0.46, 95% CI = 0.32–0.65; P < .0001). Responses were both more frequent and deeper: the overall response rate was 89.0% vs 75.3% in the control group (odds ratio [OR] = 2.65; P < .0001), and the complete response or better rates were 81.8% vs 32.1% (OR = 9.56, 95% CI = 6.46–14.14; P < .0001). Among evaluable patients, MRD-negative complete response at 10–5 sensitivity was 57.6% with teclistamab plus daratumumab vs 17.1% with DPd or DVd (OR = 6.78; P < .0001).

    Safety Results: Cytokine release syndrome was reported in 60.1% of patients treated with teclistamab plus daratumumab and was predominantly grade 1 (44.2%) or grade 2 (15.9%); no grade 2 cytokine release syndrome occurred after the first cycle, and discontinuations because of cytokine release syndrome were rare. Immune effector cell–associated neurotoxicity syndrome was uncommon (1.1%).

    As expected with BCMA-directed T-cell–engaging therapy, infections and hypogammaglobulinemia were common. Any-grade infections were observed in 96.5% of patients treated with teclistamab plus daratumumab vs 84.1% of those who received the control. Thirteen patients (4.6%) treated with teclistamab plus daratumumab died from infection; of these deaths, 12 occurred within 6 months of treatment, including 3 due to COVID-19, and 9 of the 12 had not received immunoglobulin replacement therapy. After a protocol amendment reinforcing immunoglobulin replacement therapy was made, only one infection-related death occurred. Overall, 87.3% of the patients treated with teclistamab plus daratumumab received at least one dose of intravenous immunoglobulin.

    Clinical Implications: MajesTEC-3 is the first phase III randomized study to pair a bispecific regimen with concurrent improvements in progression-free survival, overall survival, response depth, and MRD negativity in relapsed or refractory multiple myeloma treated with one to three prior lines of therapy. The unprecedented efficacy results support teclistamab plus daratumumab as a potential new standard of care for appropriately selected patients with one to three prior lines of therapy who are not refractory to anti-CD38 monoclonal antibodies. Broad adoption will hinge on standardized infection prevention pathways (eg, early intravenous immunoglobulin/immunoglobulin replacement therapy, vaccination strategy, and antimicrobial prophylaxis) and on defining sequencing vs BCMA-directed CAR T-cell therapy.

    698 (RedirecTT-1): Talquetamab-tgvs Plus Teclistamab in Relapsed or Refractory Multiple Myeloma With Centrally Confirmed True Extramedullary Disease

    Background: True extramedullary disease—defined as bone-independent soft-tissue or organ plasmacytomas—remains among the highest-risk manifestations of myeloma and is associated with heterogeneous antigen expression and immune microenvironment features, as well as inferior response rates and survival compared with patients without true extramedullary disease.8,9 Extramedullary disease lesions can be biologically heterogeneous, including variable expression of BCMA and GPRC5D, raising the possibility that dual antigen targeting could mitigate antigen escape.10,11 RedirecTT-1 (ClinicalTrials.gov Identifier: NCT04586426) tested dual antigen targeting with talquetamab (GPRC5D × CD3) plus teclistamab in this high-risk population.2,12,13

    Methods: Eligible patients had triple-class–exposed relapsed or refractory multiple myeloma with centrally confirmed true extramedullary disease (n = 90)—defined as at least one nonirradiated, bone-independent soft-tissue plasmacytoma measuring at least 2 cm in greatest dimension, confirmed by central PET/CT review. Nonsecretory and oligosecretory myeloma were allowed. Prior anti-BCMA CAR T-cell therapy and non-BCMA/non-GPRC5D bispecific therapy were permitted; the median time from CAR T-cell therapy to study treatment was 295 days (range: 98–1,030 days).

    Talquetamab and teclistamab were administered subcutaneously on the same day (30 ± 10 minutes apart) with three step-up doses given 2 to 4 days apart, followed by full doses of 0.8 mg/kg of talquetamab every 2 weeks and 3.0 mg/kg of teclistamab every 2 weeks. Patients were permitted to transition to monthly dosing after four cycles if they achieved a very good partial response or better, or after six cycles irrespective of response.

    The primary endpoint was overall response rate by an independent review committee per International Myeloma Working Group (IMWG) criteria; extramedullary disease response incorporated centralized PET/CT assessment using the Deauville 5-point scale and IMPeTUs criteria.14,15

    Efficacy Results: At a median follow-up of 16.8 months, the overall response rate was 79% (95% CI = 69%–87%), including complete responses or better in 54% of patients. The median time to first response was 2.6 months (range: 1.0–5.8 months), and the median time to best response was 5.1 months (range: 1.0–16.6 months). Responses appeared durable: 62% of patients had an ongoing response at 12 months, and the median duration of response was not reached (95% CI = 11.5 months–not estimable). With extended follow-up, the report cited a median progression-free survival of 15 months; 91% of patients maintained or deepened response in the 6 months following protocol-defined de-escalation to monthly dosing.

    Safety Results: Safety was generally consistent with the known profiles of each bispecific. Any-grade and grade 3 or 4 infections occurred in 80% and 33% of the population, respectively; pneumonia and COVID-19 were among the most frequent serious infections. Opportunistic infections were reported in 6.7% (grade 3/4: 3.3%) of patients. Hypogammaglobulinemia was frequent after treatment (71%), and 86% of patients received at least one dose of immunoglobulin replacement therapy. Cytokine release syndrome was observed in 77.8% of patients and was largely low grade. After switching from every-2-week to monthly dosing, new-onset key toxicities were less frequent. Adverse events resulted in death in 10 patients, including 5 infection-related deaths.

    Clinical Implications: Dual bispecific targeting of GPRC5D and BCMA produced unusually deep and durable responses in centrally confirmed true extramedullary disease—an outcome that could materially change expectations for this subgroup if replicated. The data also underscore that dose/interval de-escalation is not merely a convenience strategy but may be a critical safety lever to reduce cumulative toxicity while preserving response. In summary, this off-the-shelf bispecific antibody combination regimen offers clinically meaningful efficacy for one of the most challenging-to-treat subgroups of patients with multiple myeloma.

    LBA-1 (inMMyCAR): In Vivo Gene Therapy to Generate Anti-BCMA CAR T Cells Without Lymphodepletion

    Background: Despite major advances with ex vivo–manufactured BCMA-directed CAR T-cell therapies, delivery remains constrained by leukapheresis, centralized manufacturing, time to infusion, and the need for lymphodepleting chemotherapy—factors that can limit access, increase cost, and add toxicity. The inMMyCAR trial (ClinicalTrials.gov Identifier: NCT07075185) explores an investigational approach to overcome the access and logistical constraints of ex vivo CAR T-cell therapy.3,16 KLN-1010 is an intravenously administered, replication-incompetent lentiviral vector designed to transduce circulating T cells in vivo, generating a fully human anti-BCMA CAR T-cell population without leukapheresis, centralized manufacturing, or lymphodepleting chemotherapy.

    Methods: This first-in-human multicenter phase I study uses a 3 + 3 dose-escalation design with primary objectives of safety/tolerability and selection of a recommended phase II dose. Eligibility includes relapsed or refractory multiple myeloma with measurable disease after at least three prior lines of therapy, including prior exposure to a proteasome inhibitor, an immunomodulatory drug, and an anti-CD38 monoclonal antibody, with an Eastern Cooperative Oncology Group performance status of 0 to 1 and adequate organ function. The ASH presentation summarized the outcomes of the first four treated patients (three treated at dose level 1 and one treated at dose level −1), with follow-up through at least month 3 in those with the longest observation.

    Efficacy Results: KLN-1010 generated measurable CAR T cells in vivo, with peak expansion around day +15. CAR-positive cells comprised a substantial fraction of circulating CD3-positive T cells (at day +15: 22%–72% in dose level 1; 85% in dose level −1). No adverse clinical sequelae were attributed to lymphocytosis during expansion, and dexamethasone promptly resolved lymphocytosis in the patient with the highest level. Circulating CAR T cells were detectable in peripheral blood and bone marrow through month 3 and were predominantly memory phenotype, a feature historically associated with durable remissions after ex vivo CAR T-cell therapy.

    All treated patients (n = 4; 100%) achieved early MRD negativity at month 1 by next-generation flow cytometry or next-generation sequencing (10–5–10–6 sensitivity), with sustained MRD negativity through month 2 in the two patients with the longest follow-up.

    SafetyResults: Treatment-emergent adverse events clustered around infusion and the period of CAR T-cell expansion. Infusion-related reactions were early and generally self-limited; after an initial reaction, prophylactic tocilizumab was incorporated. Cytokine release syndrome occurred with a median onset of 10 days (range: 10–12 days) and was limited to grade 1 to 2, with no grade 3 or higher events reported. Management included supportive care with tocilizumab and/or dexamethasone when indicated. No immune effector cell–associated neurotoxicity syndrome or delayed neurotoxicity (eg, parkinsonism or cranial nerve palsies) was reported in this early cohort, and cytopenias appeared limited compared with typical ex vivo CAR T-cell experiences.

    Clinical Implications: These preliminary first-in-human observations provide proof of concept for an off-the-shelf in vivo CAR T-cell platform, with the potential to shorten time to treatment and reduce the intensity of supportive care required for lymphodepletion-related cytopenias. If durability and safety are confirmed with longer follow-up and across dose levels, in vivo CAR T-cell platforms such as KLN-1010 could significantly advance the field of CAR T-cell therapy. By simplifying logistics, shortening time to treatment, and potentially enabling outpatient delivery, in vivo CAR T-cell products may meaningfully expand access to cellular therapy for appropriate patients with relapsed or refractory multiple myeloma. The study remains ongoing. ν

    DISCLOSURE: Dr. Abutalib reported a relationship with AstraZeneca. Dr. Pianko has received research funding and/or consulting fees from AbbVie, AstraZeneca, Bristol Myers Squibb/Celgene, Janssen, Karyopharm, Kite/Gilead, GlaxoSmithKline, Oncopeptides, Pfizer, Regeneron, and Sanofi.

    REFERENCES

    1. Mateos M-V, Bahlis N, Perrot A, et al: Phase 3 randomized study of teclistamab plus daratumumab versus investigator’s choice of daratumumab and dexamethasone with either pomalidomide or bortezomib in patients with relapsed refractory multiple myeloma: Results of majestec-3. 2025 ASH Annual Meeting & Exposition. Abstract LBA-6. Presented December 8, 2025.

    2. Usmani S, Kumar S, Mateos MM, et al: Efficacy and safety of talquetamab + teclistamab in patients with relapsed/refractory multiple myeloma and extramedullary disease: Updated phase 2 results from the redirectt-1 study with extended follow-up. 2025 ASH Annual Meeting & Exposition. Abstract 698. Presented December 2025.

    3. Harrison S, Ho PJ, Lim S-L, et al: Minimal residual disease-negative outcomes following a novel, in vivo gene therapy generating anti–B-cell maturation antigen chimeric antigen receptor-T cells in patients with relapsed and refractory multiple myeloma: Preliminary results from inMMyCAR, the first-in-human phase 1 study of KLN-1010. 2025 ASH Annual Meeting & Exposition. Abstract LBA-1. Presented December 2025.

    4. Garfall AL, Nooka AK, van de Donk NWCJ, et al: Long-term follow-up from the phase 1/2 MajesTEC-1 trial of teclistamab in patients with relapsed/refractory multiple myeloma. J Clin Oncol 42:7540, 2024.

    5. Moreau P, Garfall AL, van de Donk NWCJ, et al: Teclistamab in relapsed or refractory multiple myeloma. N Engl J Med 387:495-505, 2022.

    6. Mateos M-V, Bahlis N, Perrot A, et al: Phase 3 randomized study of teclistamab plus daratumumab versus investigator’s choice of daratumumab and dexamethasone with either pomalidomide or bortezomib in patients with relapsed refractory multiple myeloma: Results of majestec-3. Blood 146:LBA-6, 2025.

    7. Costa LJ, Bahlis NJ, Perrot A, et al: Teclistamab plus daratumumab in relapsed or refractory multiple myeloma. N Engl J Med. December 9, 2025 (early release online).

    8. Bladé J, Beksac M, Caers J, et al: Extramedullary disease in multiple myeloma: A systematic literature review. Blood Cancer J 12:45, 2022.

    9. Rosiñol L, Beksac M, Zamagni E, et al: Expert review on soft-tissue plasmacytomas in multiple myeloma: Definition, disease assessment and treatment considerations. Br J Haematol 194:496-507, 2021.

    10. John M, Helal M, Duell J, et al: Spatial transcriptomics reveals profound subclonal heterogeneity and T-cell dysfunction in extramedullary myeloma. Blood 144:2121-2135, 2024.

    11. Zanwar S, Novak J, Gonsalves W, et al: Extramedullary myeloma is genomically complex and characterized by near-universal MAPK pathway alterations. Blood Adv 9:3979-3987, 2025.

    12. Kumar S, Mateos M-V, Ye JC, et al: Dual targeting of extramedullary myeloma with talquetamab and teclistamab. N Engl J Med 394:51-61, 2026.

    13. Usmani S, Kumar S, Mateos M-V, et al: Efficacy and safety of talquetamab + teclistamab in patients with relapsed/refractory multiple myeloma and extramedullary disease: Updated phase 2 results from the redirectt-1 study with extended follow-up. Blood 146:698, 2025.

    14. Nanni C, Zamagni E, Versari A, et al: Image interpretation criteria for FDG PET/CT in multiple myeloma: A new proposal from an Italian expert panel. IMPeTUs (Italian Myeloma criteria for PET USe). Eur J Nucl Med Mol Imaging 43:414-421, 2016.

    15. Zamagni E, Nanni C, Dozza L, et al: Standardization of 18F-FDG–PET/CT according to Deauville criteria for metabolic complete response definition in newly diagnosed multiple myeloma. J Clin Oncol 39:116-125, 2021.

    16. Harrison S, Ho PJ, Lim S-L, et al: Minimal residual disease-negative outcomes following a novel, in vivo gene therapy generating anti–B-cell maturation antigen chimeric antigen receptor-T cells in patients with relapsed and refractory multiple myeloma: Preliminary results from inMMyCAR, the first-in-human phase 1 study of KLN-1010. Blood 146:LBA-1, 2025.

    Dr. Abutalib is Director of the Malignant Hematology and Transplantation & Cellular Therapy Programs at the Advocate/Aurora St. Luke’s Medical Center, Milwaukee, and Associate Professor at Rosalind Franklin University of Medicine and Science, Chicago. Dr. Pianko is Clinical Associate Professor of Internal Medicine at the University of Michigan, Ann Arbor, and a member of the Multiple Myeloma & Amyloidosis Program at the Rogel Cancer Center of the University of Michigan.

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  • Chinese carmaker Chery to launch fourth brand in UK | Automotive industry

    Chinese carmaker Chery to launch fourth brand in UK | Automotive industry

    The Chinese carmaker Chery is launching a fourth brand in the UK, continuing a push into the British market where it has rapidly become a major player.

    The state-owned company said on Wednesday it would sell cars under the Lepas brand, which is developing battery and hybrid SUVs aimed at younger families, mainly in the European market.

    The decision to add a fourth brand in the UK underlines Chery’s efforts to win market share. The Lepas cars will be built initially in China and imported to the UK, which does not have the tariffs imposed by the US and EU, but the government is hopeful it will eventually decide to manufacture cars in Britain.

    Jaguar Land Rover, Britain’s largest automotive employer, is in early-stage discussions over a potential deal to use its factories to make Chery cars but no agreement has been announced.

    The new brand launch comes a week after Chery said it would open a research and development headquarters in Liverpool for commercial vehicles.

    Chery has been the largest exporter of cars from China for 23 years but did not make significant inroads in Europe because it focused on cheaper models for other regions such as the Middle East.

    The rise of electric cars and heavy government subsidies for Chinese manufacturers, however, have allowed companies such as Chery, BYD and the MG owner SAIC to take on European and Japanese carmakers.

    Chery launched its Omoda brand in 2024, Jaecoo in January 2025 and its eponymous brand last summer. It sold 53,600 of those cars in 2025 in the UK, or 2.7% of the market. That meant it outdid BYD, Tesla and the German-owned Mini, and easily outsold Japanese rivals such as Honda and Mazda.

    In January, Chery sold nearly 6,100 cars in the UK, most of which were hybrids combining a smaller battery with a petrol engine, according to figures from New Automotive, a thinktank.

    The sales figures also suggested that Tesla’s sales slump continued, with only 650 sales recorded, fewer than half the 1,400 recorded in January 2025. The US carmaker’s European sales have been hit by an ageing model lineup as well as consumer distaste for the chief executive Elon Musk’s support for far-right politicians. Tesla’s sales were less than half the 1,326 electric sales of BYD, which last year overtook it to become the world’s biggest seller of battery electric cars.

    Chery has not yet committed to manufacturing in the UK, but it has indicated that it is considering doing so. Its UK director, Victor Zhang, said in June it was “actively considering” building a UK plant as part of a “localisation” strategy.

    The company has said repeatedly it wants to pursue an “in UK, for UK, be UK” strategy, suggesting that setting up manufacturing would be a serious option.

    The Lepas brand – a madeup word referring vaguely to leopards – appears to be positioned as a mass-market offering, emphasising “fun”. Its Jaecoo brand, in contrast, has been described by some as a “Range Rover clone”, albeit for a much cheaper price.

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  • Stock market today: Live updates

    Stock market today: Live updates

    Traders work on the floor at the New York Stock Exchange (NYSE) in New York City, U.S., Jan. 21, 2026.

    Brendan McDermid | Reuters

    The S&P 500 was relatively unchanged on Wednesday as traders continued to move out of technology stocks and digested the latest labor market data.

    The broad market index hovered around the flatline, while Dow Jones Industrial Average added 259 points, or 0.5%. The Nasdaq Composite dropped 0.6%.

    Shares of Advanced Micro Devices pulled back 12% after its first-quarter forecast underwhelmed some analysts, adding to the recent pressure seen in tech. Other names in the space such as Broadcom and Micron Technology dipped as well. The former was down more than 1%, while the latter fell 3%.

    Software stocks also continued to face pressure, with stocks such as Oracle and CrowdStrike extending their losses from the prior trading day. The two names were both down roughly 3%, as were ServiceNow and Salesforce.

    “Bottom line, something I said back in late November, the GenAI tech trade is no longer a one way ride. We’ve transitioned it from ‘buy everything’ to ‘not everyone can win,’” said Peter Boockvar, chief investment officer at One Point BFG Wealth Partners. “I believe we are losing this trade in terms of its ability to carry the market but luckily so far investors have found other things to buy and that includes other parts of the S&P 500, small and mid cap and for sure international stocks.”

    Amgen was among the names leading the Dow’s outperformance. The biotechnology stock was up 3% after the company reported better-than-expected earnings and revenue for the fourth quarter. Also offering a boost to the index, industrial stock Caterpillar gained 2%, signaling that investors were continuing to rotate into more value-oriented names.

    Meanwhile, ADP on Wednesday released its monthly look at private payroll growth for January, which showed an increase of just 22,000 on the month. That’s below the gain of 45,000 jobs that economists polled by Dow Jones had forecast.

    The release generally precedes the Bureau of Labor Statistics report on nonfarm payrolls, but that won’t be out this week due to the partial government shutdown. The shutdown, which began Saturday, officially ended Tuesday, when President Donald Trump signed a funding bill into law.

    On Tuesday, the major averages sold off as investors gravitated out of riskier growth names and toward cyclical stocks like Walmart. Nvidia and Microsoft each lost almost 3% in the previous session. Big-name artificial intelligence infrastructure names Broadcom, Oracle and Micron also closed in the red. The tech sector was the worst performer in the S&P 500, down more than 2%.

    All eyes are now on Alphabet, as the company is slated to report earnings after the bell Wednesday. The quarterly results of fellow “Magnificent Seven” member Amazon are due Thursday.

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  • ADP National Employment Report: Private Sector Employment Increased by 22,000 Jobs in January; Annual Pay was Up 4.5% – PR Newswire

    ADP National Employment Report: Private Sector Employment Increased by 22,000 Jobs in January; Annual Pay was Up 4.5% – PR Newswire

    1. ADP National Employment Report: Private Sector Employment Increased by 22,000 Jobs in January; Annual Pay was Up 4.5%  PR Newswire
    2. ADP Report set to show moderate gains in US private-sector employment in January  FXStreet
    3. Private Payrolls Added 22,000 Jobs in January  Barron’s
    4. Private payroll growth in January misses expectations as market awaits official jobs data  Yahoo Finance
    5. Gold prices remain well supported as ADP shows U.S. labor market continuing to cool  KITCO

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  • Union Pacific and Wabtec Sign $1.2B Deal to Modernize Locomotives

    Union Pacific and Wabtec Sign $1.2B Deal to Modernize Locomotives

    • Largest locomotive modernization agreement in rail industry history
    • Upgrades to significantly improve operational efficiency and fleet productivity

    PITTSBURGH, Feb. 4, 2026 — Union Pacific (NYSE: UNP) and Wabtec (NYSE:WAB) signed a landmark agreement totaling $1.2 billion to modernize the railroad’s AC4400 locomotives. This agreement represents the largest locomotive modernization investment in rail industry history, building on Union Pacific’s previous 2022 order which is scheduled to be completed in 2026. The upgraded fleet will help enhance the railroad’s operational efficiency, service reliability and network performance.

    “We are committed to delivering the service we sold to our customers and one way we do that is having great American-made locomotives that can get the job done,” said Jim Vena, Union Pacific CEO. “These redesigned locomotives will be just like new, providing the improved fuel efficiency and enhanced reliability that we need to grow with our customers and to win new business.”

    Wabtec’s modernization program will extend each locomotive’s useful life, improve fleet standardization and equip Union Pacific to take advantage of next generation control and diagnostics technologies. The upgraded locomotives are expected to deliver over 5% reduction in fuel consumption, a 14% increase in tractive effort and an 80% improvement in reliability.

    “Our continued partnership with Union Pacific reflects a steady, forward-looking investment that positions the railroad and its customers for continued success,” said Rafael Santana, President and CEO of Wabtec. “By enhancing our proven locomotive platforms with advanced propulsion, controls and diagnostics, this program delivers substantial gains in performance, reliability and lifecycle value — allowing the railroad to unlock maximum efficiency and capability for its existing fleet.”

    The modernized locomotives will feature a suite of Wabtec hardware and digital innovations. Each unit will receive the FDL Advantage (FDLA) engine upgrade for enhanced fuel savings; LOCOTROL® Expanded Architecture to support safe, efficient operation of longer trains; and the new Modular Control Architecture, which unlocks the next generation data, diagnostics and software capabilities.

    This agreement, signed in the fourth quarter of 2025, marks Union Pacific’s fourth major modernization order from Wabtec since 2018. Once completed, the railroad will have more than 1,700 modernized locomotives in its fleet. Production will occur at Wabtec’s U.S. facilities, with deliveries beginning in 2027.

    About Wabtec
    Wabtec Corporation (NYSE: WAB) is focused on creating transportation solutions that move and improve the world. The company is a leading global provider of equipment, systems, digital solutions and value-added services for the freight and transit rail industries, as well as the mining, marine and industrial markets. Wabtec has been a leader in the rail industry for over 150 years and has a vision to achieve a more efficient rail system in the U.S. and worldwide. Visit Wabtec’s website at: www.wabteccorp.com.

    About Union Pacific
    Union Pacific (NYSE: UNP) delivers the goods families and businesses use every day with safe, reliable, and efficient service. Operating in 23 western states, the company connects its customers and communities to the global economy. Trains are the most environmentally responsible way to move freight, helping Union Pacific protect future generations. More information about Union Pacific is available at www.up.com.
     

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  • News | Vietjet selects RTX’s Pratt & Whitney to power 44 additional A320neo family aircraft

    News | Vietjet selects RTX’s Pratt & Whitney to power 44 additional A320neo family aircraft

    Order includes 12-year maintenance agreement

    SINGAPORE, Feb. 4, 2026 /PRNewswire/ — Vietjet Air and Pratt & Whitney, an RTX (NYSE: RTX) business, announce that the airline has selected an additional 44 GTF-powered Airbus A320neo family aircraft, including 24 A321neos and 20 A321XLRs, bringing its total orders to 137 GTF-powered aircraft. Deliveries will start in July 2026. Pratt & Whitney will also provide Vietjet with engine maintenance through a 12-year EngineWise® Comprehensive service agreement.

    Vietjet is a rapidly growing airline with an expansive fleet and flight network. “Vietjet values our relationship with Pratt & Whitney and its latest generation technology,” said Vietjet Managing Director Nguyen Thanh Son. “The GTF engine is powering our growth with industry-leading operating economics and fuel efficiency of up to 20%. We continue to trust in the long-term, comprehensive and responsible partnership with Pratt & Whitney.”

    Based in Ho Chi Minh, Vietnam, Vietjet received its first A321neo aircraft in 2018 and currently operates a fleet of 42 GTF-powered A321neo aircraft. Prior to this order, Vietjet committed to up to 93 aircraft of this type.

    “Ten years ago, Vietjet joined the Pratt & Whitney GTF family and this selection demonstrates the airline’s continued confidence in the GTF engine,” said Rick Deurloo, President of Commercial Engines, Pratt & Whitney. “With this latest order, Vietjet will further realize the benefits of the most efficient engine for single-aisle aircraft and our ongoing commitment to enabling their network expansion.”

    The GTF is the most efficient engine for the single aisle market, delivering up to 20% lower fuel consumption and a 75% smaller noise footprint compared to the prior generation of engines. To date, more than 2,600 GTF-powered aircraft have been delivered to more than 90 customers worldwide. With enhanced payload and range capability, GTF Advantage engine, which is expected to enter into service later this year, will offer a more durable configuration that delivers up to double the time on wing. Pratt & Whitney continues to invest in expanding GTF MRO network capacity and ramping supply chain output to support customers.

    With a modern, flexible fleet and an expanding route network, Vietjet further reaffirms its long-term vision as a multinational aviation group, driving aviation growth and regional economic development. The airline currently operates an extensive Asia-Pacific network, connecting Vietnam and Thailand with Australia, India, Kazakhstan, China, Japan and South Korea, among others, while progressively expanding to destinations in Europe. Vietjet aims to provide the best flying experience at the most competitive cost for passengers through strategic partnerships with leading aviation and technology partners in the industry worldwide.

    About Pratt & Whitney
    Pratt & Whitney, an RTX business, is a world leader in the design, manufacture and service of aircraft engines and auxiliary power units for military, commercial and civil aviation customers. Since 1925, our engineers have pioneered the development of revolutionary aircraft propulsion technologies, and today we support more than 90,000 in-service engines through our global network of maintenance, repair and overhaul facilities.

    About RTX
    With more than 180,000 global employees, we push the limits of technology and science to redefine how we connect and protect our world. With industry-leading capabilities, we advance aviation, engineer integrated defense systems for operational success, and develop next-generation technology solutions and manufacturing to help global customers address their most critical challenges. The company, with 2025 sales of more than $88 billion, is headquartered in Arlington, Virginia.

    About Vietjet
    The new-age carrier Vietjet has not only revolutionized the aviation industry in Vietnam but also been a pioneering airline across the region and around the world. The airline currently operates 135 aircraft and has nearly 600 additional aircraft on order, including both wide-body and narrow-body aircraft. With a focus on cost management ability, effective operations, and performance, applying the latest technology to all activities and leading the trend, Vietjet offers flying opportunities with cost-saving and flexible fares as well as diversified services to meet customers’ demands.

    Vietjet is a fully-fledged member of International Air Transport Association (IATA) with the IATA Operational Safety Audit (IOSA) certificate. As Vietnam’s largest private carrier, the airline has been awarded the highest ranking for safety with 7 stars by the world’s only safety and product rating website airlineratings.com and listed as one of the world’s 50 best airlines for healthy financing and operations by Airfinance Journal in many consecutive years. The airline has also been named as Best Low-Cost Carrier by renowned organizations such as Skytrax, CAPA, Airline Ratings, and many others.

    Media contacts:

    For questions or to schedule an interview, please contact [email protected]

    Vietjet
    Kieu Duong (Amy)
    [email protected]
    +84-932-775-066

    SOURCE RTX

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  • Major disruption on south-east England rail lines after ‘multiple incidents’

    Major disruption on south-east England rail lines after ‘multiple incidents’

    Disruption affecting one of UK’s busiest railway routespublished at 10:49 GMT

    Thomas Mackintosh
    Live reporter

    Built in the Victorian era, the Brighton Main Line is one of busiest railway routes in the UK.

    It connects the capital with the Sussex coast via Gatwick Airport, serving 37 stations through Sussex, Surrey and south London. It has one terminus station in Sussex – Brighton – and two terminus stations in the capital – London Victoria and London Bridge.

    Both of these London branches join up with the full Brighton Main Line just outside the Selhurst depot.

    That is why this morning’s disruption is so significant as the volume of trains normally using the Brighton Main Line have no other alternative to keep the same flow of services running.

    The trains that have come to a standstill cannot reach their destination and that means drivers and crew are displaced. This has a knock-on impact for further services, leading to the delays and cancellations we are now seeing.

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  • Global commercial insurance rates fall 4% in Q4 2025, marking the sixth consecutive quarterly decrease

    Global commercial insurance rates fall 4% in Q4 2025, marking the sixth consecutive quarterly decrease

    New York | February 04, 2026

    According to the latest Global Insurance Market Index released today by Marsh Risk, a business of Marsh (NYSE: MRSH) and the world’s leading insurance broker and risk advisor, global commercial insurance rates fell, on average, by 4% in the fourth quarter of 2025. Growing competition among insurers, coupled with a favorable loss environment and reinsurance pricing, were the primary drivers for the rate decline along with increased market capacity.

    With the exception of the US, all global regions experienced year-over-year composite rate decreases in Q4 2025. The Pacific (12%) and India, Middle East, and Africa (IMEA) (10%) regions experienced the largest composite rate decreases, while rates declined in Latin America and the Caribbean (LAC), the UK, and Canada by 7%. Rates declined in Europe and Asia by 6% and 5% respectively. The overall composite rate in the US – which declined by 1% in Q3 2025 – was flat in Q4.

    Q4 marks the sixth consecutive global quarterly decreases following seven years of quarterly increases and is a continuation of the moderating rate trend first recorded in Q1 2021.

    Other findings included:

    • Property rates declined by 9% globally, following an 8% decline in Q3. Four regions – the Pacific (14%), LAC (12%), IMEA (11%), and the UK (10%) – recorded double-digit decreases, while the US, Canada, and Europe declined by 8%, and Asia by 5%.
    • Casualty rates increased 4% globally – up from a 3% increase in Q3 – which was driven by a 9% increase in the US (8% in Q3) due largely to the continued concerns among insurers about the frequency and severity of casualty claims, many of which are characterized by large (so-called “nuclear”) jury awards.
    • Financial and professional lines rates decreased by 4% globally in the fourth quarter, compared to a 5% decrease in Q3. Rate declines were recorded across most regions – barring the US – ranging from 11% in IMEA to 5% in the UK and Canada. Financial and professional insurance rates in the US were flat as compared to a 2% decline in Q3.
    • Cyber insurance rates decreased by 7% globally, with declines seen in every region ranging from 14% in LAC  to 3% in the US.

    Commenting on the report, John Donnelly, President, Global Placement, Marsh Risk, said: “The global insurance market has been characterized by ample capacity across most lines and regions over the last six quarters. In the absence of unforeseen circumstances we expect this trend to continue throughout 2026. This year, clients have the opportunity to secure reduced premium rates and negotiate broader terms which may include improving the resilience of their programs to cater for the increasing complexity of risks.”

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