Off-the-Shelf Therapies, Combination Strategies, and Patient-Centered Treatment in Relapsed/Refractory Multiple Myeloma

The panel discusses the practical advantages of off-the-shelf BCMA-directed therapies in relapsed/refractory multiple myeloma, particularly for patients with rapidly progressing disease or high disease burden who may not be able to wait for CAR T-cell manufacturing. Dr. Jing Christine Ye highlights how treatment access, insurance authorization, manufacturing logistics, disease aggressiveness, and the potential need for bridging therapy can influence the choice between BCMA-directed bispecific antibodies, antibody-drug conjugates, and cellular therapies. Dr. Paul Richardson then discusses the potential role of CELMoDs in combination strategies, including their potential to support fixed-duration approaches and optimize the use of BCMA-directed therapies. The conversation also addresses the importance of balancing efficacy with treatment-related toxicity, particularly infections and other complications associated with prolonged bispecific therapy. Dr. Richardson emphasizes the potential of combination strategies to achieve greater disease control while limiting exposure to individual therapies. The segment concludes with a discussion of the aspiration for functional cure and the importance of communicating this goal carefully and realistically with patients.