Treatment Selection Following Anti-CD38 Exposure in Relapsed/Refractory Multiple Myeloma

Dr. Binod Dhakal and Dr. Carol Ann Huff discuss how anti-CD38 exposure versus true anti-CD38 refractoriness influences treatment selection in relapsed/refractory multiple myeloma (RRMM).

Dr. Huff explains that patients who are exposed to, but not refractory to, anti-CD38 therapy may remain candidates for anti-CD38-containing combination regimens in the second-line setting.

She emphasizes the importance of assessing remission duration, disease aggressiveness, treatment eligibility, and prior therapeutic response when selecting subsequent therapy.

For patients experiencing earlier or more aggressive relapse, Dr. Huff discusses a preference for cellular therapy approaches when feasible, while BCMA-directed bispecific antibodies may represent an important option for patients who are not candidates for cellular therapy.

The discussion highlights the growing role of individualized treatment strategies in RRMM and underscores how biologic disease behavior, patient characteristics, and emerging clinical evidence can help guide sequencing decisions following anti-CD38 exposure.