Expanding Access and Optimizing the Use of CAR T-Cell Therapy in Multiple Myeloma

Panelists discuss how pivotal trials and real-world evidence have reinforced CAR T-cell therapy’s high response rates, deep remissions, and durable outcomes in relapsed/refractory multiple myeloma.

Panelists discuss how differences in BCMA-directed CAR T constructs (including binding configuration and expansion kinetics) can influence toxicity timing, monitoring needs, and real-world product selection.

Panelists discuss how clinicians distinguish candidates for second-line versus third-line CAR T by weighing disease aggressiveness, relapse timing, cytogenetic risk, patient preferences, and toxicity tradeoffs.

Panelists discuss how prior BCMA-directed or bispecific therapy may affect T-cell fitness and CAR T planning, including the value of early referral and strategic washout/bridging approaches when feasible.

Panelists discuss how sequencing choices before third-line CAR T balance disease control and eligibility preservation, while avoiding prolonged therapies that could compromise later collection or outcomes.

Panelists discuss how real-world CAR T outcomes in older or comorbid patients can mirror trial results when organ function, monitoring, and multidisciplinary support are optimized.

Panelists discuss how early referral drop-off is driven by awareness gaps, outdated perceptions of when CAR T should be used, travel/caregiver burdens, and process complexity—and which barriers are most addressable.

Panelists discuss how clearer communication and streamlined referral workflows (including dedicated navigation/support roles) can reduce uncertainty around scheduling, manufacturing timelines, and treatment capacity.

Panelists discuss how early financial navigation and proactive payer coordination can mitigate insurance delays and out-of-pocket burdens that commonly derail CAR T access.

Panelists discuss how transparent counseling on expected benefits, early-onset toxicities, and practical logistics (travel, caregiver needs, support resources) helps patients make confident decisions about CAR T.

Panelists discuss how complete referral information and evolving outpatient pathways (including shortened post-infusion monitoring requirements) can improve coordination, reduce logistical burden, and maintain safe follow-up.

Panelists discuss how older patients with cardiac/renal comorbidities may still be appropriate CAR T candidates when conditions are well-managed, and why early evaluation protects eligibility and aligns care with patient goals.

Panelists discuss how clinicians set expectations for the acute toxicity window and monitoring while also considering how rising disease burden or prior BCMA exposure can influence efficacy and reinforce urgency of referral.

Panelists discuss how recent bispecific exposure does not necessarily preclude CAR T, but timing, disease tempo, infection/immune assessments, and realistic scheduling expectations shape readiness and planning.

Panelists discuss how high-risk disease biology and recent bispecific therapy heighten the need for timely, individualized sequencing and rigorous safety planning around infections, cytopenias, and early monitoring.

Dr. Krina Patel reviews a real-world comparative analysis showing improved progression-free and overall survival with idecabtagene vicleucel versus teclistamab in triple-class–exposed relapsed or refractory multiple myeloma, and discusses its implications for treatment sequencing and individualized care.