Surbhi Sidana, MD

Closing the program, Surbhi Sidana, MD, asks each panelist what has changed most in her practice this year.

Surbhi Sidana, MD, presents 2 practical scenarios: a patient 6 to 7 weeks post-infusion who develops a fever at a local emergency department 4 hours from the treating center, and a patient around 7 to 8 weeks post-infusion who develops facial droop, drooling, and behavioral changes noticed by a spouse.

Surbhi Sidana, MD, asks about 2 less common but important delayed toxicities: delayed neurotoxicity and immune effector cell enterocolitis.

Doris Hansen, MD, and Prerna Mewawalla, MD, discuss long-term monitoring, infection prophylaxis, and vaccination after ciltacabtagene autoleucel (cilta-cel) therapy for patients with multiple myeloma.

Day 28 after ciltacabtagene autoleucel (cilta-cel) infusion marks an important transition for patients with multiple myeloma from center-led care to shared care with the community oncology team.

Timing referral for chimeric antigen receptor (CAR) T-cell therapy is critical when patients with multiple myeloma experience relapse or progressive disease.

Effective community referral pathways can improve access to chimeric antigen receptor (CAR) T-cell therapy for patients with multiple myeloma.

Doris Hansen, MD, and Prerna Mewawalla, MD, discuss ciltacabtagene autoleucel manufacturing, disease debulking, and bridging therapy before CAR T-cell infusion in patients with multiple myeloma.

Referral barriers can limit access to chimeric antigen receptor (CAR) T-cell therapy for patients with multiple myeloma.

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.

The FDA’s decision on iberdomide is a “landmark approval” for those with multiple myeloma, according to Surbhi Sidana, MD.

The faculty discuss how to individualize the choice between chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies in relapsed multiple myeloma.

This opening segment introduces a discussion on ciltacabtagene autoleucel (cilta-cel) in multiple myeloma and frames the questions the program sets out to answer: how chimeric antigen receptor (CAR) T-cell therapy should be sequenced among the available options, and how care can be coordinated across a network spread between referring practices and treating centers.

Surbhi Sidana, MD, discusses how CELMoDs like iberdomide could complement CAR T and bispecific antibody therapies.

The availability of iberdomide as an easy-to-give, orally available drug “is tremendous” for patients with multiple myeloma, according to Surbhi Sidana, MD.

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.

Ongoing studies are evaluating teclistamab-based regimens in the frontline setting as well as smoldering multiple myeloma, according to Surbhi Sidana, MD.

A potential FDA approval of teclistamab/daratumumab would offer a “highly effective” option in multiple myeloma.

Panelists discuss the growing importance of early integration and collaboration between community oncologists and specialized centers in the evolving chimeric antigen receptor (CAR) T-cell therapy landscape for multiple myeloma, emphasizing timely referrals, coordinated care, and strategic sequencing with other immunotherapies to optimize patient outcomes.

Panelists discuss the essential role of supportive care following chimeric antigen receptor (CAR) T-cell therapy in multiple myeloma, emphasizing infection prevention through prophylaxis, immunoglobulin replacement, and vaccination strategies, along with the importance of coordinated long-term management between CAR T centers and community oncologists to ensure sustained survivorship care.