Shifting the Paradigm: Evidence, Earlier Use, and Sequencing of BCMA-Targeted Therapies in Relapsed/Refractory Multiple Myeloma

In 'Shifting the Paradigm: Evidence, Earlier Use, and Sequencing of BCMA-Targeted Therapies in Relapsed/Refractory Multiple Myeloma,' the expert oncologists and oncology pharmacists explored the following questions:

How have B-cell maturation antigen (BCMA)-targeted therapies changed the treatment paradigm for relapsed/refractory multiple myeloma (RRMM)?

What evidence supports the use of BCMA-targeted therapies in earlier lines (2nd/3rd line) of treatment?

How might earlier use of BCMA therapies impact long-term disease control and sequencing strategies?

The panelists discussed how BCMA-targeted therapies have rapidly evolved from last-resort options for heavily pretreated patients to agents now considered earlier in the treatment continuum, driven by their remarkable response rates, depth of response, and improving survival outcomes. Zahra Mahmoudjafari highlighted key data supporting earlier use, including the DREAMM-7 and DREAMM-8 trials bringing belantamab mafodotin combinations to first relapse and beyond, ciltacabtagene autoleucel's approval as early as first relapse, and emerging teclistamab data in the second-line setting, while noting that operationalizing new workflows to accommodate these shifts remains a significant institutional challenge. Al-Ola Abdallah emphasized that the depth of response achieved with BCMA-directed therapies, including minimal residual disease (MRD) negativity and progression-free survival data now exceeding 3 years in some studies, has accelerated their move into earlier lines and is beginning to reshape sequencing strategies across the entire treatment continuum.

Throughout the conversation, the experts provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, 'From DREAMM-7 to DREAMM-8: Clinical Evidence, Conference Updates, and Managing Belantamab Mafodotin Adverse Events,' panelists continue their discussion on relapsed/refractory multiple myeloma and highlight the design and key efficacy and safety results from the DREAMM-7 and DREAMM-8 trials, the latest updates presented at the American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA) conferences, and best practices for monitoring severe thrombocytopenia and infections associated with belantamab mafodotin.