CAR-T vs Bispecific Antibodies in Second Line and Earlier-Relapse Relapsed/Refractory Multiple Myeloma
EP. 1: Relapsed/Refractory Multiple Myeloma: Setting the Stage for BCMA-Directed Treatment Strategies
ByThomas G. Martin, MD,Saad Z. Usmani, MD, MBA, FACP,Surbhi Sidana, MD,Peter Voorhees, MD,Hans Lee, MD,Gurbakhash Kaur, MD,Amrita Y. Krishnan, MD 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.
EP. 2: Relapsed/Refractory Multiple Myeloma: CARTITUDE-4 and the Evolving Role of BCMA CAR T-Cell Therapy
ByThomas G. Martin, MD,Saad Z. Usmani, MD, MBA, FACP,Surbhi Sidana, MD,Peter Voorhees, MD,Hans Lee, MD,Gurbakhash Kaur, MD,Amrita Y. Krishnan, 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.
