Gurbakhash Kaur, MD

The faculty define holding and bridging therapy, discuss how they coordinate it with the referring practice, and walk through the timeline.

A panelist describes how the treating center, local oncologist, patient, and caregivers share responsibility for monitoring after CAR T-cell therapy, including warning symptoms, immune monitoring, and infection prevention.

One panelist describes the consent conversation with patients and caregivers, including how the treatment works, what to expect from outcomes, the practical process, and side effects such as cytokine release syndrome, ICANS, cranial nerve palsy, colitis, and movement disorders.

The faculty discuss a recent exchange in Nature Reviews Clinical Oncology on the role of CAR T-cell therapy and where it fits in the treatment sequence, including concerns about toxicity and how recognition and management of these toxicities have evolved.

The moderator reviews a guideline recommendation on CAR T-cell therapy and T-cell engagers at first relapse, and one panelist describes how it compares with their practice, including the rationale for sequencing and the questions that remain open.

Panelists discuss which patients at first relapse make them think of CAR T-cell therapy and which make them pause, including disease burden and the role of holding and bridging therapy, age and fitness, kidney function, and caregiver availability.

The faculty consider how they would answer a patient who is 5 years out from a single infusion in sustained MRD-negative remission and asks whether they are cured.

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).