Navigating CAR T-Cell Therapy Use as a “Team Sport” in Multiple Myeloma

Delivering CAR T-cell therapy to patients with multiple myeloma resembles a “team sport,” according to Saad Z. Usmani, MD, MBA, FACP, FASCO.

In a conversation with CancerNetwork^®, Usmani detailed the key takeaways from a presentation he delivered at the 2026 National ICE-T (Immune Cell Effector Therapy) Conference in Charlotte, North Carolina, which focused on clinical outcomes and the real-world experience associated with the use of novel cellular therapies in multiple myeloma. His presentation specifically explored strategies for optimizing the use of idecabtagene vicleucel (ide-cel; Abecma) and ciltacabtagene autoleucel (cilta-cel; Carvykti) across these real-world settings.

A key point he emphasized in his presentation was how factors, including high-risk disease, high disease burden, and extramedullary disease, correlated with worse outcomes in real-world practice. Additionally, he noted that early identification of patients is critical for looping them into the CAR T-cell therapy pipeline and determining the logistics of their treatment.

Usmani is a multiple myeloma specialist, cellular therapist, and chief of the Myeloma Service at Memorial Sloan Kettering Cancer Center. He is also a member of the International Myeloma Foundation’s Scientific Advisory Board.

Transcript:

At the ICE-T meeting in Charlotte, I spoke about the clinical outcomes in the real-world experience with the 2 commercially available BCMA CAR [T-cell therapies] that we have. One is ide-cel, which was the first one that was approved. Then, cilta-cel came a little over a year later. Both these CAR [T-cell therapies] were originally approved in patients who had 4 or more prior lines of treatment; that was kind of the background.

Then, we walked through the data that led to the early approval of both these CAR [T-cell therapies]. Ide-cel got approved for [patients with 2 or more lines], and cilta-cel [after 1 or more prior lines]. There have been several efforts, both in the US and Europe, that have highlighted the fact that both these CAR [T-cell therapies] are effective for [patients with multiple] myeloma in the real world. Many of those real-world patients could not have received these therapies on clinical trials, so these were mostly [patients who were] clinical trial ineligible. Many had prior BCMA exposure as well. One of the things that I highlighted was the fact that high-risk disease, high disease burden, as well as extramedullary myeloma tend to be associated with low responses and shorter progression-free survival for these patients. Then, we also talked about some of the real-world adverse events that we’re observing and how we’re trying to mitigate those risks.

My key takeaway for colleagues is that this is a team sport, especially when we are trying to deliver a very effective product like CAR T-cell therapy. It requires a multidisciplinary approach and early identification of patients so that they can be hooked into the pipeline for CAR T-cell therapy and help with the logistics. It’s not just the health care team; patients do require social support and logistic support as well. It’s a very multidisciplinary kind of an approach that one needs to take. CAR [T-cell therapies] are very effective options, and the sooner we are able to evaluate patients, the better we’d be able to get the answers to our community colleagues.

Reference

Usmani S. CAR-T in multiple myeloma: clinical outcomes and real-world experience. Presented at: National ICE-T (Immune Cell Effector Therapy) Conference; April 18, 2026; Charlotte, NC.