Sequencing CAR T-Cell Therapy and Bispecific Antibodies at First Relapse in Relapsed/Refractory Multiple Myeloma

Using a case-based scenario, Dr. Binod Dhakal and Dr. Carol Ann Huff explore treatment decision-making for a fit patient with relapsed/refractory multiple myeloma (RRMM) experiencing first relapse approximately 30 months after autologous stem cell transplantation.

The discussion focuses on a patient with prior anti-CD38 exposure but uncertain anti-CD38 refractoriness, highlighting the importance of accurately characterizing prior treatment response before selecting subsequent therapy.

Dr. Huff explains how factors such as remission duration, disease biology, patient age, treatment eligibility, and sequencing considerations influence her preference for CAR T-cell therapy in younger, fit patients with relatively early relapse.

The faculty also review scenarios in which BCMA-directed bispecific antibodies may be preferred, particularly when disease progression is rapid or logistical barriers limit access to cellular therapy.

Throughout the discussion, the panel emphasizes individualized treatment planning and examines how emerging data continue to inform sequencing decisions between CAR T-cell therapy and BCMA-directed bispecific antibodies in RRMM.