Darren Pan, MD

Panelists discuss how, when considering earlier lines of CAR T-cell therapy for relapsed/refractory multiple myeloma, key institutional factors include patient fitness/age, cytogenetic risk status, prior therapy response duration, and BCMA expression levels. Manufacturing timelines, financial considerations, and center-specific outcomes data also influence timing decisions. For patients receiving early-line CAR T therapy, subsequent treatment options typically focus on novel agent combinations or clinical trials exploring additional cellular therapies, with choices guided by response duration to CAR T and the patient’s individual disease characteristics and treatment goals.

Panelists discuss how, for second-line treatment of relapsed/refractory multiple myeloma (R/R MM), patients suitable for CAR T-cell (cilta-cel vs ide-cel) therapy typically have a poor prognosis with limited response to prior therapies. Institutional guidelines focus on factors such as prior lines of therapy, organ function, and cytogenetics. Non-medical factors, such as geographic access and financial constraints, also influence CAR T-cell therapy referral eligibility.