Gurbakhash Kaur, MD

The faculty consider what level of follow-up they consider meaningful for a one-time therapy, pointing to the International Myeloma Working Group consensus benchmark of sustained minimal residual disease (MRD) negativity with imaging negativity.

The program opens with panelist introductions and an overview of ciltacabtagene autoleucel (ciltacel), a BCMA-directed autologous CAR T-cell therapy given as a single infusion and approved for adults with relapsed or refractory multiple myeloma who have received at least 1 prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent, and are refractory to lenalidomide.

Dr. Thomas Martin presents the final and most challenging case: an older patient being evaluated for BCMA-directed therapy after progression on prior anti-CD38 therapy, with baseline neuropathy, mild gait instability, recurrent infections, and significant caregiver concern about neurologic toxicity, infection, and logistics.

Dr. Thomas Martin presents the second case: a younger, fit, lenalidomide-refractory patient with biochemical and radiologic progression after frontline therapy who is relatively asymptomatic with controlled disease burden and is an appropriate candidate for either CAR T-cell or bispecific therapy, with no urgency to treat.

Dr. Thomas Martin introduces the third section, a rapid case-based discussion applying the program's themes to real-world scenarios, and presents the first case: a fit, transplant-exposed patient progressing on lenalidomide maintenance with rapidly progressive, symptomatic, high-risk disease requiring prompt intervention.

The face-off debate continues with the second and third questions, moderated by Dr. Thomas Martin.

Dr. Thomas Martin opens the second section, the face-off debate, and introduces the first debate question on how clinicians should approach treatment selection between CAR T-cell therapy and bispecific antibody-based approaches in second-line disease.

Team Myeloma Mavericks presents the sixth abstract review, a real-world and safety-focused discussion of BCMA-directed therapies in earlier-relapse disease, closing out the data-and-landscape section.

Team Myeloma Mavericks presents the fifth abstract review, the updated long-term analysis of CARTITUDE-4 evaluating ciltacabtagene autoleucel against standard triplet therapy in earlier-relapse disease, framed by the durable remissions and cure signal seen in longer-term CARTITUDE-1 follow-up.

Dr. Thomas Martin introduces the fourth abstract review, and Team Myeloma Masters presents MajesTEC-9, the phase 3 study of teclistamab monotherapy versus investigator's choice of standard, non-CD38-containing regimens in patients who are both lenalidomide- and anti-CD38-refractory after prior lines of therapy.

Dr. Thomas Martin transitions the panel to the third abstract review, and Team Myeloma Masters presents real-world treatment patterns and outcomes in lenalidomide-refractory relapsed/refractory multiple myeloma drawn from the Flatiron registry.

Segment opens with the closing moments of the CAR T-cell therapy quality-of-life argument before Dr. Thomas Martin transitions to the second abstract review.

In the closing remarks, Dr. Shambavi Richard reflects on the key themes that emerged throughout the discussion on the evolving role of BCMA-directed therapies in relapsed/refractory multiple myeloma (R/R MM).

The faculty discuss treatment sequencing for a patient with relapsed/refractory multiple myeloma (R/R MM) who has experienced disease progression following prior BCMA-directed therapy.

The faculty discuss treatment selection for a fit patient with relapsed/refractory multiple myeloma (R/R MM) who is eligible for both CAR-T cell therapy and BCMA bispecific antibodies and has access to a certified CAR-T treatment center.

The faculty discuss the management of a patient with relapsed/refractory multiple myeloma (R/R MM) who has received four prior lines of therapy but faces significant logistical barriers to CAR-T treatment because of limited caregiver support and distance from a cellular therapy center.

The final FACE-OFF debate examines whether BCMA bispecific antibodies will retain a meaningful role in the management of relapsed/refractory multiple myeloma (R/R MM) as these therapies continue to move into earlier lines of treatment.

The second FACE-OFF debate explores whether currently available BCMA bispecific antibodies should be considered a therapeutic class or whether meaningful clinical differences exist among individual agents used to treat relapsed/refractory multiple myeloma (R/R MM).

The program transitions to the first FACE-OFF debate, where the faculty discuss whether CAR-T cell therapy or BCMA bispecific antibodies should be prioritized as BCMA-directed therapies move into earlier lines of treatment for relapsed/refractory multiple myeloma (R/R MM).

Following the MAJESTEC-3 presentation, the faculty discuss how the trial findings may influence the evolving treatment landscape for relapsed/refractory multiple myeloma (R/R MM).

Dr. Harsh Parmar presents results from the phase 3 MAJESTEC-3 trial evaluating the combination of teclistamab and daratumumab versus standard daratumumab-based regimens in patients with relapsed/refractory multiple myeloma (R/R MM) who had received one to three prior lines of therapy.

Following the presentation of the real-world sequencing analysis, the faculty discuss how these findings align with their own clinical experience treating relapsed/refractory multiple myeloma (R/R MM).

Dr. Mansi Shah presents a multinational real-world analysis evaluating how BCMA-directed CAR-T cell therapies and BCMA bispecific antibodies are being used in routine clinical practice for patients with relapsed/refractory multiple myeloma (R/R MM).

Following the presentation of the CARTITUDE-4 trial, the faculty discuss how the study findings may influence treatment strategies for relapsed/refractory multiple myeloma (R/R MM).

Dr. Cesar Rodriguez presents findings from the phase 3 CARTITUDE-4 trial, which compared ciltacabtagene autoleucel (cilta-cel) with standard-of-care regimens in patients with relapsed/refractory multiple myeloma (R/R MM) who were refractory to lenalidomide after one to three prior lines of therapy.

Dr. Prashant Kapoor reviews the pivotal phase 1/2 LINKER-MM1 study evaluating linvoseltamab, a BCMA × CD3 bispecific antibody, in heavily pretreated patients with relapsed/refractory multiple myeloma (R/R MM).

Dr. Shambavi Richard welcomes viewers to Cancer Network's FACE-OFF, introducing a debate-driven educational program focused on the evolving role of BCMA-targeted therapies in relapsed/refractory multiple myeloma (R/R MM).

Dr. Saad Usmani reviews key findings from the phase 3 CARTITUDE-4 trial and discusses the growing role of ciltacabtagene autoleucel (cilta-cel) in patients with second-line and earlier-relapse relapsed/refractory multiple myeloma. The discussion highlights the study population, including patients with lenalidomide-refractory disease and high-risk clinical features, as well as the significant progression-free survival benefit observed with BCMA-directed CAR T-cell therapy compared with standard triplet regimens. Dr. Usmani and the panel examine the depth and durability of response, including high rates of complete response and sustained MRD negativity, and discuss the concept of treatment-free remission as a unique advantage of CAR T-cell therapy. Faculty also explore practical considerations such as patient selection, manufacturing timelines, bridging therapy, disease burden control, and quality-of-life outcomes. The conversation further addresses important safety considerations, including cytokine release syndrome, neurotoxicity, Parkinsonism-like events, immune effector cell-associated enterocolitis, access challenges, and the logistical barriers associated with delivering CAR T-cell therapy in real-world multiple myeloma practice.

Dr. Thomas Martin opens this Cancer Network FACE-OFF program by introducing a debate-style discussion focused on one of the most rapidly evolving areas in relapsed/refractory multiple myeloma: treatment selection between BCMA-directed CAR T-cell therapy and bispecific antibody-based approaches in second-line and earlier-relapse disease. He outlines the unique format of the program, which combines clinical data review, expert debate, and case-based discussion to explore real-world treatment decision-making. Dr. Martin introduces Team Myeloma Mavericks, led by Dr. Saad Usmani and featuring Dr. Surbhi Sidana and Dr. Gurbakhash Kaur, and Team Myeloma Masters, led by Dr. Peter Voorhees with Dr. Amrita Krishnan and Dr. Hans Lee. The segment concludes with an overview of the pivotal studies that will frame the discussion, including CARTITUDE-4, MajesTEC-3, and MajesTEC-9, highlighting how emerging efficacy, durability, safety, and sequencing data are reshaping treatment strategies for patients with relapsed/refractory multiple myeloma.

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.