Treatment Considerations and Sequencing in Multiple Myeloma

Opinion
Video

The expert panel concludes their discussion with clinical insights on treatment sequencing and therapeutic decision-making for patients who have relapsed.

This is a video synopsis/summary of a Peer Exchange featuring Krina K. Patel, MD, MSc; Amrita Krishnan, MD; Caitlin Costello, MD; Saad Z. Usmani, MD, MBA, FACP; and Rafat Abonour, MD.

The discussion focuses on sequencing B-cell maturation antigen (BCMA)–targeted therapies. Continuing one BCMA bispecific antibody after progression on another may have limited efficacy due to outgrowth of BCMA loss mutations and T-cell exhaustion. A period of non-BCMA–directed therapy could help restore T-cell fitness before switching targets, like to GPRC5D with cibisatamab or teclistamab. More clinical and biologic tools are still needed to better understand resistance mechanisms among bispecific antibodies, antibody-drug conjugates, and CAR T-cell therapy to inform sequencing.

Off-the-shelf allogeneic CAR T-cell therapy could facilitate faster retreatment compared to autologous manufacturing. Continued research into optimal sequencing strategies is still needed and will be better informed by longer follow-up of currently available BCMA therapies.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.

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