Relapsed/Refractory Multiple Myeloma: CARTITUDE-4 Long-Term Outcomes and Treatment-Free Remission With Cilta-cel

Team Myeloma Mavericks presents the fifth abstract review, the updated long-term analysis of CARTITUDE-4 evaluating ciltacabtagene autoleucel against standard triplet therapy in earlier-relapse disease, framed by the durable remissions and cure signal seen in longer-term CARTITUDE-1 follow-up. The review highlights the extended follow-up, the marked and sustained progression-free survival advantage, an overall survival benefit, deep and durable MRD negativity at multiple sensitivity thresholds, and evidence that earlier use with better disease control and bridging lowers the risk of delayed neurotoxicity and Parkinsonism. The cross-team discussion, moderated by Dr. Martin, explores projections for the eventual cure fraction in an earlier-line population, the argument that a more intact immune system in early relapse may allow bispecific antibodies to perform closer to CAR T-cell therapy, the concept of reverse attrition as a rationale for moving these therapies earlier, and whether patients started on a bispecific at first relapse may achieve durable, potentially treatment-free remissions before ever needing a subsequent line. Fair-balance considerations frame the exchange, acknowledging that long-term treatment-free and cure data are more mature for CAR T-cell therapy while bispecific durability data continue to evolve.