Sequencing in Early Relapse: Positioning Tec + Dara vs CAR T in Relapsed/Refractory Myeloma

This segment focuses on treatment sequencing in early relapse for relapsed or refractory multiple myeloma (R/R MM), with particular attention to the positioning of teclistamab plus daratumumab (Tec + Dara) relative to CAR T-cell therapy. Faculty discuss where bispecific antibodies fit within current treatment algorithms as CAR T-cell therapies are increasingly used in earlier relapse settings and combination strategies such as Tec + Dara demonstrate promising activity in patients who are not refractory to CD38-directed therapy.

The panel compares key factors that influence treatment selection between CAR T-cell therapy and Tec + Dara in the second-line or early-relapse setting, including depth and durability of response, differences in toxicity profiles, T-cell fitness, and safety considerations such as delayed neurotoxicity.

Real-world factors are also explored, including caregiver requirements, travel distance to specialized centers, inpatient hospitalization for CAR T-cell therapy, and the logistical considerations associated with continuous bispecific antibody dosing. Overall, the segment examines practical considerations that guide clinicians when selecting and sequencing T-cell–redirecting therapies in early relapsed or refractory multiple myeloma.