
Opinion|Videos|January 13, 2025
Decision Points for Using CAR T-Cell Therapy in Early Lines of Treatment
Panelists discuss how, when considering earlier lines of CAR T-cell therapy for relapsed/refractory multiple myeloma, key institutional factors include patient fitness/age, cytogenetic risk status, prior therapy response duration, and BCMA expression levels. Manufacturing timelines, financial considerations, and center-specific outcomes data also influence timing decisions. For patients receiving early-line CAR T therapy, subsequent treatment options typically focus on novel agent combinations or clinical trials exploring additional cellular therapies, with choices guided by response duration to CAR T and the patient’s individual disease characteristics and treatment goals.
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Video content above is prompted by the following:
- What are the key factors that influence your institution’s decision to utilize CAR T therapy in earlier lines of treatment for relapsed/refractory multiple myeloma?
- If you choose to utilize CAR T in earlier lines of therapy, what might you do next and why?
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Related to this article

Hematologic specialists discussed where ciltacabtagene autoleucel fits in the treatment paradigm at first relapse and beyond in multiple myeloma.

Hans C. Lee, MD, discussed how community oncologists with limited access to MRD testing can think about the new IMS/IMWG definition of cure in myeloma.

Hans C. Lee, MD, discussed how he monitors patients with multiple myeloma who achieve deep, sustained MRD negativity after coming off therapy.
![“[W]e should strive to increase the [number] of patients…who enjoy long-term disease-free survival and possibly cure,” said Meletios Dimopoulos, MD.](https://cdn.sanity.io/images/0vv8moc6/cancernetwork/c7abebf9344f9b1be9aee80d9879d139c1655bcc-1200x1197.jpg?w=350&fit=crop&auto=format)
“[W]e should strive to increase the [number] of patients…who enjoy long-term disease-free survival and possibly cure,” said Meletios Dimopoulos, MD.

Pieter Sonneveld, MD, PhD, explained how sustained MRD negativity with DVRd in the PERSEUS trial may guide long-term outcome counseling in multiple myeloma.
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