Expanding Community Access to T-Cell Redirecting Therapies in Multiple Myeloma

Dr. Hans Lee and Dr. Prashant Kapoor discuss strategies to expand access to CAR T-cell therapies and bispecific antibodies for patients with multiple myeloma, particularly in community oncology settings. The panel emphasizes the value of early referral to experienced myeloma centers and coordinated care models in which step-up dosing and management of early toxicities are initiated at specialized centers before transitioning patients to their community oncologists. Dr. Kapoor highlights the importance of developing community expertise as bispecific therapies increasingly move into earlier lines of treatment, while recognizing the need for familiarity with unique infectious complications such as Pneumocystis jirovecii pneumonia and cytomegalovirus reactivation. The discussion also addresses evolving treatment approaches, including fixed-duration therapy and emerging trispecific antibodies, as well as the need for head-to-head studies evaluating complete treatment strategies and sequencing. Dr. Lee emphasizes that with appropriate toxicity mitigation, monitoring, and management plans, bispecific therapies can increasingly be administered in community practices, potentially improving geographic access and reducing the need for patients to travel to specialized centers.