Post-ASH Update: Real-World Evidence Informing CAR T vs Bispecific Sequencing in RRMM

In this post-ASH update, Dr. Krina Patel discusses her presentation of a real-world comparative analysis evaluating idecabtagene vicleucel and teclistamab in patients with triple-class–exposed relapsed or refractory multiple myeloma. She outlines the clinical rationale for conducting an indirect comparison in this difficult-to-treat population, where clinicians frequently face sequencing decisions between BCMA-directed CAR T-cell therapy and bispecific antibodies. Dr. Patel reviews the key efficacy findings, highlighting improvements in progression-free and overall survival observed with idecabtagene vicleucel after inverse probability of treatment weighting, and explains how sensitivity analyses addressed potential biases inherent to real-world data. The discussion then shifts to the implications for treatment sequencing, including considerations around timing of CAR T referral and patient selection in the third-line setting. She concludes by emphasizing how real-world evidence can complement clinical trial data to inform individualized decision-making in contemporary multiple myeloma practice.