06/09/2025
Multiple myeloma
CAR-T therapies (BCMA-targeting) show durable remissions and survival benefit — long-term CARTITUDE-1 follow-up reports that a substantial minority (~one-third) of heavily pretreated patients remain progression-free years after a single ciltacabtagene autoleucel (cilta-cel) infusion; CARTITUDE-4 also showed PFS/OS benefit versus standard-of-care.
2. Idecabtagene vicleucel (ide-cel) validated in real-world and approved in broader uses — large real-world analyses reproduce high overall response rates and manageable safety similar to the KarMMa trials; ide-cel has recent regulatory updates expanding standard-of-care roles.
3. Bispecific antibodies (BCMA×CD3 and others) are effective with durable responses — teclistamab and elranatamab (among others) produce deep responses in triple-/penta-exposed patients; long follow-ups show sustained responses for many and guideline groups are issuing practice guidance for BsAb use.
4. Non-BCMA targets (GPRC5D, FcRH5, NK-engagers) expanding options — therapies targeting GPRC5D (e.g., talquetamab) or FcRH5, and NK-cell engagers (AFM26), are active in BCMA-exposed or refractory patients — offering routes after BCMA resistance.
5. Toxicity management improved but remains a key challenge — cytokine release syndrome (CRS) and immune effector neurotoxicity (ICANS/CRES) occur with CAR-T and bispecifics; step-up dosing and standardized CRS/ICANS protocols reduce severity and allow safer outpatient or earlier treatment.