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Panelists discuss how patients and caregivers considering late-line multiple myeloma therapies must navigate practical considerations including lengthy hospital stays for CAR-T cell therapy (typically two to four weeks), insurance approval challenges, travel to specialized treatment centers, the potential need for caregivers to take extended leave from work, management of posttreatment monitoring requirements, eligibility criteria related to organ function and performance status and planning for potential complications such as cytokine release syndrome or neurological toxicities that might require urgent care access.

Practical Considerations for Therapies Considered by the Patient and Caregivers in RRMM

Panelists discuss how patient involvement in multiple myeloma treatment decisions has evolved from a physician-directed approach to a collaborative partnership, with many patients now actively participating through researching options, joining support groups, asking questions about efficacy and side effects, and working with their health care team to balance quality of life considerations with treatment goals, though the degree of engagement varies based on patient preference, health literacy and physician communication style.

Patient’s Experience in Shared Decision Making in RRMM

Panelists discuss how treatment selection for late-line relapsed/refractory multiple myeloma (RRMM) balances multiple factors including patient fitness, prior therapy exposure, disease aggressiveness, side effect profiles, logistical considerations (with CAR-T requiring hospitalization while bispecifics can often be administered outpatient), financial accessibility and unique toxicity considerations (such as GPRC5D-targeting therapies affecting the skin and nails versus B-cell maturation antigen [BCMA]–targeting approaches), ultimately requiring a personalized approach weighing effectiveness against practical constraints on a patient-by-patient basis.

Clinical Factors Evaluated When Choosing Treatment in Late-Line RRMM

Panelists discuss how the current treatment landscape for patients with late-line relapsed/refractory multiple myeloma (RRMM) involves novel approaches such as bispecific antibodies, CAR-T cell therapies, antibody-drug conjugates and clinical trials of emerging agents, with treatment selection highly individualized based on prior therapies, resistance patterns and patient-specific factors like comorbidities, quality of life considerations and treatment goals.

Current Treatment Landscape for Late-Line RRMM

Panelists discuss how multiple myeloma patients often navigate through numerous treatment regimens over their disease course, frequently cycling through five to 10 different therapeutic approaches since diagnosis, with the greatest challenges being management of cumulative side effects, emotional fatigue from repeated relapses and maintaining hope while facing increasingly limited options as they progress to late-line therapy.

Linda’s Treatment History and Challenges in Coping With Multiple Relapses

Panelists discuss how the term “late-line” emerged organically in clinical practice to describe patients who had exhausted multiple treatment options, with most experts recalling its growing usage over the past decade as novel therapies expanded the treatment landscape and created a need to distinguish between patients with early and more heavily pretreated relapsed/refractory multiple myeloma (R/R MM).

Challenges in Managing Late-Line RRMM

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