My Treatment Approach Enhancing Treatment for Relapsed/Refractory Multiple Myeloma (RRMM): Converting Evidence to Effective Clinical Care

Panelists discuss how treatment selection for relapsed/refractory multiple myeloma hinges on the pace of disease progression, with options ranging from second autologous transplants to chimeric antigen receptor T-cell therapies and bispecific antibodies, each tailored to patient status, prior therapy, and urgency of intervention.

Panelists discuss how effective sequencing and bridging strategies for T-cell engaging therapies in (relapsed/refractory multiple myeloma (RRMM) rely on using chimeric antigen receptor T-cell therapy (CAR T) first when feasible, while carefully selecting bridging treatments—such as nonoverlapping bispecifics or selinexor regimens—to manage disease without compromising CAR T readiness or long-term immune function.

Panelists discuss how bridging strategies such as selinexor, immunomodulatory drugs (IMiDs), and, potentially, immune checkpoint inhibitors (ICIs) can preserve or enhance T-cell fitness prior to chimeric antigen receptor T-cell therapy (CAR T), offering a dual benefit of disease control and improved therapeutic response in relapsed/refractory multiple myeloma (RRMM) patients.

Panelists discuss how various treatment options, including selinexor-based regimens, B-cell maturation antigen (BCMA)–targeted therapies, bispecific antibodies, and CELMoDs, can be used to manage relapsed/refractory multiple myeloma following progression on BCMA-directed chimeric antigen receptor T-cell therapy (CAR T).

Panelists discuss how selinexor offers convenient oral administration, bispecific antibodies provide high response rates but may present toxicity risks, and cytotoxic chemotherapy is effective for aggressive disease but carries significant adverse effects and risks.

Panelists discuss how recurrent infections may influence the choice of selinexor over bispecific antibodies, with selinexor offering a safer option for patients with high infection risk, and dosing considerations such as once-weekly administration and potential dose reductions still providing clinical benefit.

Panelists discuss how the transition from chimeric antigen receptor T-cell therapy (CAR T) to bispecific antibodies depends on disease progression and clinical status, with the choice of bispecific antibody being guided by prior therapy and target antigen, preferring B-cell maturation antigen (BCMA) bispecifics for BCMA-exposed patients and GPRC5D bispecifics for those with BCMA-relapsed disease.

anelists discuss how the rapidly evolving treatment landscape for relapsed/refractory multiple myeloma requires personalized strategies, emphasizing the importance of patient-centric decision-making, effective therapy sequencing, and ongoing research to improve both efficacy and quality of life