My Treatment Approach Enhancing Treatment for Relapsed/Refractory Multiple Myeloma (RRMM): Converting Evidence to Effective Clinical Care - Episode 1
Exploring the Treatment Options for RRMM
Panelists discuss how treatment selection for relapsed/refractory multiple myeloma hinges on the pace of disease progression, with options ranging from second autologous transplants to chimeric antigen receptor T-cell therapies and bispecific antibodies, each tailored to patient status, prior therapy, and urgency of intervention.
Physician Summary: Current Treatment Options and the Role of Disease Progression in RRMM
For patients with relapsed/refractory multiple myeloma (RRMM), several advanced treatment options are available, and the rate of disease progression plays a critical role in guiding therapy selection.
Available Treatment Options:
- Second Autologous Stem Cell Transplant (auto-HSCT): May be considered as salvage therapy in patients with favorable performance status and a durable initial response.
- CAR T-Cell Therapy (CAR T):
- Idecabtagene vicleucel (ide-cel): Supported by data from KarMMa-3, demonstrating improved outcomes in triple-class–exposed patients.
- Ciltacabtagene autoleucel (cilta-cel): From CARTITUDE-4, showing significant responses in early relapsed, lenalidomide-refractory patients.
- Bispecific Antibodies:
- Agents such as elranatamab, teclistamab, and talquetamab offer off-the-shelf options with rapid onset of action and are particularly valuable in patients with rapidly progressing disease or those not eligible for CAR T.
Role of Disease Progression:
- Rapid progression favors use of readily available therapies, such as bispecific antibodies, due to urgency and shorter lead time.
- Slower progression allows consideration of CAR T therapy, which involves manufacturing time but offers potential for durable responses.
- Second auto-HSCT remains an option in select patients with late relapse and preserved functional status.
Therapy should be tailored based on disease kinetics, prior treatments, and patient-specific factors, with growing emphasis on sequencing and timely access to novel immunotherapies.
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