Gurbakhash Kaur, MD

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.

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