Peter Voorhees, MD

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.

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 long-term CARTITUDE-1 data may change clinical practice by validating earlier use of ciltacabtagene autoleucel (cilta-cel) and informing personalized treatment strategies based on risk and disease biology.

Panelists discuss how the durability of response and long-term minimal residual disease (MRD) negativity in a subset of patients supports redefining treatment end points and cure in multiple myeloma.

Panelists discuss how extended follow-up from CARTITUDE-1 shows continued overall survival benefit with minimal new safety concerns, reinforcing the durability and safety of cell therapy.

Panelists discuss how some patients in CARTITUDE-1 maintained stringent complete remission for more than 5 years without further treatment, potentially redefining the concept of cure in myeloma.

Panelists discuss how the 5-year data from CARTITUDE-1 demonstrate that a substantial subset of patients achieved long-term remission, suggesting a potential shift toward curative therapy.

Panelists discuss how safety outcomes from CARTITUDE-1 revealed that most adverse effects, including cytokine release syndrome (CRS) and neurotoxicity, were manageable and reversible, even in advanced-stage patients.

Panelists discuss how the efficacy outcomes from CARTITUDE-1, including a substantial progression-free survival (PFS) benefit, highlight the transformative impact of deep, sustained minimal residual disease (MRD)-negative responses.

Panelists discuss how CARTITUDE-1 addressed an unmet need by targeting late-line, refractory myeloma patients with a fixed dose of chimeric antigen receptor (CAR) T-cell therapy for potential accelerated approval.

Panelists discuss how the baseline characteristics of CARTITUDE-1 participants underscore the trial’s focus on patients with heavily pretreated and refractory disease.

Panelists discuss how the CARTITUDE-1 trial was designed to evaluate cell therapy in relapsed/refractory multiple myeloma and the importance of long-term follow-up in understanding efficacy and safety.

Panelists discuss how the evolution of FDA approvals for multiple myeloma therapies reflects rapid innovation and increasing effectiveness, particularly with cell-based treatments.

Panelists discuss how advancements in treatment options, including chimeric antigen receptor (CAR) T-cell therapy, bispecific antibodies, and antibody-drug conjugates, are shaping the current multiple myeloma landscape.

Experts on multiple myeloma outline current challenges in determining the optimal treatment strategy for patients with relapsed/refractory disease who are eligible for bispecifics and CAR T-cell therapy.

The panel concludes its discussion with key takeaways on unmet needs and evolving treatment paradigms in relapsed/refractory multiple myeloma.

Experts on multiple myeloma outline current challenges in determining the optimal treatment strategy for patients with relapsed/refractory disease who are eligible for bispecifics and CAR T-cell therapy.

Shaji Kumar, MD, reviews data from cohort C of CARTITUDE-2 and a real-world study evaluating ide-cel in patients with relapsed/refractory multiple myeloma.

Following the presentation of a case of a patient with relapsed/refractory multiple myeloma, the expert panel reviews treatment options.

Shaji Kumar, MD, reviews data from cohort C of CARTITUDE-2 and a real-world study evaluating ide-cel in patients with relapsed/refractory multiple myeloma.