Relapsed/Refractory Multiple Myeloma: Overcoming Access Barriers to CAR T-Cell Therapy

Dr. Joshua Richter and Dr. Marco Davila discuss a case of a patient with relapsed/refractory multiple myeloma (RRMM) who has high-risk, rapidly progressive disease but faces practical barriers to receiving CAR T-cell therapy, including travel distance, caregiver availability, and time away from home. Dr. Davila emphasizes that logistical challenges should not determine treatment selection or prevent patients from being evaluated for potentially beneficial cellular therapy. Instead, he describes strategies that specialized centers can use to improve access, including virtual consultations, early insurance authorization, coordination with referring oncologists, and regional cell collection sites that reduce travel burden. The discussion highlights how individualized care planning, timely referral, and multidisciplinary collaboration can help overcome geographic and logistical obstacles while maintaining treatment quality. The faculty reinforce that decisions regarding CAR T-cell therapy should be driven by patient goals and disease characteristics rather than access barriers, ensuring that eligible patients with RRMM have the opportunity to receive appropriate advanced therapies.