Relapsed/Refractory Multiple Myeloma: Early Referral for CAR T-Cell Therapy

Dr. Joshua Richter and Dr. Marco Davila discuss the growing importance of incorporating BCMA-directed CAR T-cell therapy earlier in the management of relapsed/refractory multiple myeloma (RRMM). Dr. Richter highlights the shift toward considering one-time cellular therapies earlier in the treatment journey and asks how this approach influences shared decision-making with patients. Dr. Davila emphasizes that timely referral to a cellular therapy specialist is essential to evaluate eligibility, identify potential barriers, and optimize patients for treatment before disease progression or other factors limit available options. He explains that early consultation allows clinicians to address practical considerations such as cell collection, bridging therapy, and logistical planning while assessing both clinical and personal factors that influence treatment suitability. Dr. Richter reinforces the value of adopting a proactive referral model, noting that early evaluation for cellular therapy should become an integral part of treatment planning, much like early referral for autologous stem cell transplantation in previous treatment paradigms.