CAR T-Cell Therapy Selection in Relapsed/Refractory Multiple Myeloma

In this segment, Dr. Peter Voorhees and Dr. Doris Hansen discuss how the findings from CARTITUDE-2 Cohort A relate to the randomized CARTITUDE-4 study and how these data inform consideration of CAR T-cell therapy in relapsed/refractory multiple myeloma. Dr. Hansen notes that, despite shorter follow-up for CARTITUDE-4, the study has demonstrated deep responses, substantial MRD negativity, and improvements in progression-free and overall survival. The discussion then shifts to clinical decision-making for patients with 1 to 3 prior lines of therapy. Dr. Hansen emphasizes that CAR T-cell candidacy should be considered separately from transplant candidacy and that patients should be evaluated for CAR T-cell therapy when appropriate. She also identifies circumstances that may influence treatment selection, including older age, significant comorbidities, and rapidly progressive disease, where a bispecific antibody may be considered. For patients who are appropriate candidates for CAR T-cell therapy, Dr. Hansen highlights the potential advantages of a one-time treatment approach, deep responses, and a period of time off continuous therapy.