Late-Line R/R: Treatment Landscape

Opinion
Video

Panelists discuss the transformative impact of chimeric antigen receptor (CAR) T-cell therapy on treating relapsed/refractory multiple myeloma (R/R MM) in real-world settings, emphasizing improved patient outcomes, the expanding role of real-world evidence, and the nuanced decision-making required in selecting among newly approved, highly effective immunotherapies.

This discussion centers on the use of CAR T-cell therapy for treating MM, especially in real-world settings that include patients often excluded from clinical trials. Experts from leading cancer centers convene to share their experiences, data, and perspectives on using this therapy in advanced cases of the disease. The conversation highlights the evolving nature of myeloma treatment and the growing importance of real-world evidence in shaping treatment decisions outside of traditional clinical parameters.

One key theme is the dramatic improvement in outcomes for patients with R/R MM, particularly those who have exhausted conventional therapies. Just a few years ago, such patients had very limited options, with progression-free survival and overall survival measured in mere months. The approval of 5 new immunotherapies, including 2 B-cell maturation antigen–targeting CAR T-cell products and 3 bispecific antibodies, has significantly transformed the treatment landscape. These therapies have shown remarkable efficacy and are now the preferred approach for patients who are triple- or even penta-class refractory.

The panel emphasizes that choosing the right therapy—whether CAR T-cell or bispecific antibodies—requires careful consideration of factors like toxicity, patient fitness, and logistics. Clinicians now face a new challenge: selecting from multiple highly effective treatments rather than working with limited options. The discussion is grounded in recent collaborative data that underscore the safety and effectiveness of CAR T therapies, even in populations not typically eligible for trials. This shift represents a major advancement in the care of MM, offering new hope and improved outcomes for patients with otherwise limited options.

Newsletter

Stay up to date on recent advances in the multidisciplinary approach to cancer.

Recent Videos
According to Benjamin J. Golas, MD, PIPAC could be used as a bridging therapy before surgical debulking or between subsequent large surgical operations.
“If you have a [patient in the] fourth or fifth line, [JNJ-5322] could be a valid drug of choice,” said Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD.
The trispecific antibody JNJ-5322 demonstrated superior efficacy vs approved agents in multiple myeloma in results shared at the 2025 EHA Congress.
“Dendritic cell vaccines, CAR T-cell therapy, and things of that nature are holding some promise,” said Andrew Brenner, MD, PhD.
Related Content