Relapsed/Refractory Multiple Myeloma: Sequencing CAR T-Cell Therapy and Bispecific Antibodies

Description - Dr. Ajai Chari and Dr. Rahul Banerjee discuss the increasingly complex treatment sequencing decisions facing clinicians in relapsed/refractory multiple myeloma (RRMM) as the number of highly active immunotherapy options continues to expand. The faculty explore practical considerations for selecting between CAR T-cell therapy and bispecific antibodies, emphasizing the importance of patient-specific factors, disease characteristics, treatment goals, and shared decision-making. Dr. Banerjee reviews the unique advantages of CAR T-cell therapy, including the potential for prolonged treatment-free intervals, while Dr. Chari highlights the importance of disease control, patient fitness, and timing of therapy when considering CAR T-cell approaches. The discussion also examines the role of talquetamab-based regimens within evolving treatment algorithms, including considerations surrounding prior BCMA exposure, infection risk, quality of life, and management of GPRC5D-related adverse events. Drawing on both clinical trial experience and real-world practice, Dr. Chari and Dr. Banerjee provide perspective on how clinicians may individualize sequencing strategies as additional data emerge and therapeutic options continue to evolve for patients with RRMM.