What Does Practical CAR T Cell Use Look Like in Multiple Myeloma Care?

In the newest edition of Oncology On the Go, Joshua Richter, MD, and Marco Davila, MD, PhD, spoke about the current multiple myeloma treatment landscape and highlighted practical considerations for administering CAR T-cell therapy to patients. Their discussion touched upon several critical subtopics ranging from optimizing operational and referral workflows to dismantling barriers to treatment access in rural settings.

When it comes to navigating the multiple myeloma treatment algorithm, both hosts emphasized early evaluation to determine patient suitability for CAR T-cell therapy, which may help identify those who are most likely to experience the greatest responses with minimal toxicity. Regarding the question of sequencing different modalities, Richter pointed to data demonstrating the utility of administering CAR T-cell therapies prior to bispecific antibodies.

Acknowledging that the average patient enrolled on a clinical trial may not align with what is typically seen in real-world practice, the hosts discussed “reassuring” data that those who do not meet certain eligibility criteria may nevertheless benefit from CAR T-cell therapy. Additionally, on the topic of maintaining an effective referral relationship between community oncologists and CAR-T centers, Davila noted that academic cell therapy clinicians may have an incumbent responsibility to consider how to improve access to treatment and make it easier for others to refer patients to care.

“CAR T-cell therapy is now deeply entrenched in the world of relapsed multiple myeloma [and] soon to be likely entrenched in the newly diagnosed world. These are therapies that I think we're all going to need to embrace whether it's from an academic standpoint or a community standpoint,” Richter concluded. “Having that ongoing communication back and forth, especially as the field is moving so quickly, is absolutely key in providing optimal care for our patients.”

Richter is an associate professor of Medicine in the Division of Hematology and Medical Oncology at The Tisch Cancer Institute, as well as the director of Multiple Myeloma at the Blavatnik Family - Chelsea Medical Center at Mount Sinai. Davila is the senior vice president and associate director for Translational Research, a professor of Oncology, chief of Lymphoma/Multiple Myeloma Service, and Rustum Family Endowed Chair in Translational Research at Roswell Park Comprehensive Cancer Center.