Clinical Implications of Earlier CAR-T Therapy in Relapsed/Refractory Multiple Myeloma

Following the presentation of the CARTITUDE-4 trial, the faculty discuss how the study findings may influence treatment strategies for relapsed/refractory multiple myeloma (R/R MM). Dr. Harsh Parmar, Dr. Prashant Kapoor, Dr. Cesar Rodriguez, and Dr. Mansi Shah examine the advantages of introducing BCMA-directed CAR-T cell therapy earlier in the disease course, highlighting the benefits of improved T-cell fitness, lower disease burden, and longer treatment-free intervals. The panel emphasizes the importance of timely referral to specialized centers, patient education, and early treatment planning to optimize eligibility for CAR-T therapy. Faculty also review practical considerations surrounding bridging therapy during the manufacturing period, strategies for disease control before infusion, and factors influencing sequencing decisions between CAR-T cell therapy and BCMA bispecific antibodies. The discussion concludes with recognition that although earlier CAR-T therapy offers compelling clinical benefits, access limitations, caregiver requirements, and the increasing availability of off-the-shelf BCMA bispecific antibodies will continue to shape individualized treatment decisions in relapsed/refractory multiple myeloma.