Case Discussion: Choosing Between CAR-T Cell Therapy and BCMA Bispecific Antibodies in Relapsed/Refractory Multiple Myeloma

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. Dr. Gurbakhash Kaur explains why CAR-T cell therapy would be the preferred approach for this patient, emphasizing the importance of disease control with appropriate bridging therapy while awaiting cell collection and manufacturing. The panel also discusses how disease tempo, patient preference, and logistical considerations influence treatment planning. Dr. Ridhi Gupta underscores the value of early referral to a CAR-T center before initiating BCMA-directed therapy to preserve treatment options and facilitate timely T-cell collection. The discussion concludes by highlighting the importance of identifying appropriate candidates early in the disease course, coordinating care between community and academic centers, and using periods of stable disease as an opportunity to optimize treatment planning for relapsed/refractory multiple myeloma.