What is the proper sequencing of immunotherapies to treat myeloma? 

The answer to this question is challenging due to the complexity of myeloma itself and the limited long-term data available on immunotherapies.

At one point, the only immunotherapies that were FDA-approved for multiple myeloma treatment all targeted CD38. However, now, with the next generation of immunotherapies (CAR T-cell and bispecific antibodies alike) using new targets such as BCMA, GPRC5D, FcRH5, and more, we have more opportunities to combine and sequence therapies to achieve greater success. 

Some myeloma experts think the ideal situation would be to have a BCMA-targeting CAR-T first, if possible, and then a bispecific antibody therapy with another target like GPRC5D if relapse were to occur. If the disease progresses after that, going back to a BCMA-targeted bispecific might be a viable option.

Every person with myeloma is different, so there is no one-size-fits-all approach to sequencing myeloma treatment and therapies. You and your specialist should work together to discover what works best for you, the risk and genetic profile of the disease, and the quality of life that you desire.  

Curious about what other immunotherapies are used in multiple myeloma treatment? Watch below (Video updated in April 2024).