Relapsed/Refractory Multiple Myeloma: Redefining Treatment at First Relapse

Dr. Ajai Chari and Dr. Rahul Banerjee discuss how the management of relapsed/refractory multiple myeloma (RRMM) is evolving as newer immunotherapy approaches challenge longstanding standards of care. Building on the discussion of functional high-risk disease, the faculty examine the limitations of historical triplet regimens in patients who experience early relapse following frontline treatment. Dr. Banerjee highlights emerging phase 3 data evaluating BCMA-directed therapies, including bispecific antibodies and CAR T-cell therapies, and reviews findings demonstrating substantial improvements in progression-free survival compared with conventional treatment approaches. The conversation also explores the growing evidence that these benefits may translate into overall survival improvements, reinforcing the value of introducing novel therapies earlier in the disease course rather than reserving them for later lines of treatment. Dr. Chari and Dr. Banerjee emphasize the paradigm shift occurring in RRMM, discussing how advances in T-cell–redirecting therapies and novel targets are reshaping treatment expectations and creating new opportunities to improve outcomes for patients experiencing relapse.