Relapsed/Refractory Multiple Myeloma: Optimizing Early Referral and Care Coordination

Dr. Joshua Richter and Dr. Marco Davila discuss the ideal timing for referral to a cellular therapy specialist for patients with relapsed/refractory multiple myeloma (RRMM). Dr. Davila explains that referral strategies should be tailored to individual patient risk, with those who have high-risk disease potentially benefiting from evaluation even during maintenance therapy, while patients with standard-risk disease may be appropriately referred at biochemical relapse. He emphasizes that early consultation facilitates treatment planning, insurance authorization, cell collection, bridging therapy decisions, and coordination between community oncologists and specialized treatment centers. Dr. Davila also notes that the rapidly evolving field of cellular therapy continues to expand patient access through advances in outpatient treatment and toxicity management, making ongoing discussions with patients valuable even before they become eligible for CAR T-cell therapy. The faculty conclude that there is no disadvantage to referring patients early, reinforcing proactive multidisciplinary collaboration as a key component of individualized RRMM care.