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Panelists discuss how ciltacabtagene autoleucel (cilta-cel) demonstrates superior outcomes compared to real-world physician’s choice of therapy in patients with late-line relapsed/refractory multiple myeloma (RRMM), with significantly higher response rates, deeper remissions, longer progression-free survival and potentially improved overall survival, though they acknowledge the challenges of cross-trial comparisons and emphasize the importance of considering patient-specific factors such as fitness, prior therapy exposure and treatment goals when weighing this one-time cellular therapy against sequential conventional approaches.

Recent Updates in CAR-T Cell Therapy and Their Impact in Clinical Practice in RRMM

Panelists discuss how recent clinical trials have demonstrated promising outcomes in late-line relapsed/refractory multiple myeloma (RRMM) with bispecific antibodies targeting B-cell maturation antigen (BCMA) (teclistamab, talquetamab) and GPRC5D showing overall response rates of 60% to -70% even in heavily pretreated patients, while CAR-T cell therapies like ciltacabtagene autoleucel and idecabtagene vicleucel have produced deep responses with median progression-free survival extending beyond one year in some studies, and emerging combination approaches of these novel agents with traditional therapies are showing potential to overcome resistance mechanisms and improve durability of response.



Recent Updates in Bispecifics and Their Use in Clinical Practice

Panelists discuss how managing the logistics of multiple myeloma treatment often requires a comprehensive support network, with patients describing complex arrangements for travel to specialized cancer centers, securing temporary lodging near treatment facilities, coordinating caregiver schedules to ensure continual support during intensive therapy periods, navigating insurance and financial assistance programs, and utilizing hospital social workers, patient advocacy organizations and online communities to access resources that ease the burden of treatment-related logistics.

Managing Treatment Logistics: Navigating Travel, Lodging and Caregiver Support

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

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