Treatment Sequencing in Patients who Progress Beyond CAR T in Early Relapse MM

EP: 1.The Evolving Treatment Landscape for Relapsed/Refractory Multiple Myeloma

EP: 2.Unmet Needs in the Management of Relapsed/Refractory Multiple Myeloma

EP: 3.Ongoing Studies for CAR T-Cell Therapy in RRMM

EP: 4.The Role of Stem Cell Transplantation in Relapsed/Refractory MM

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EP: 5.Treatment Sequencing in Patients who Progress Beyond CAR T in Early Relapse MM

EP: 6.Treating Relapsed/Refractory MM in the Community Setting

EP: 7.Future Perspectives on Relapsed/Refractory Multiple Myeloma

Case: A 60-Year-Old Woman with Later Relapsed/Refractory Multiple Myeloma

Clinical Presentation:

• A 60-year-old woman who was previously diagnosed 3 years ago with R-ISS stage 2/R2-ISS stage III IgG-lambda multiple myeloma presents to his oncologist after two prior treatment regimens.
  • Lives in a rural community

Prior Treatments:

• Patient received previous treatments with:
  • D-VRd followed by ASCT with lenalidomide maintenance.
  • Elo-Pd

Follow up and Clinical Workup at Relapse:

• Ca 12.5 mg/dL; SCr 2.5 mg/dL
• Hgb 8.2 g/dL; LDH 290 U/L; Albumin 2.8 g/dL
• Beta-2 microglobulin: 6 mg/dL
• BM Biopsy: 65% lambda light chain restricted.
• sIFE, IgG lambda present
• M protein 5.2 g/dL; sFLC kappa 5 mg/dL; sFLC lambda 560 mg/dL
• Lambda/Kappa ratio, 112
• Repeat Imaging:
  • PET/CT scan showed no additional lesions.
• ECOG PS
• After discussion with her clinical team, the patient begins evaluations for CAR T referral.
  • Patient ultimately proceeded to ide-cel CAR T-cell infusion.
    • Achieved stringent CR at day 30.

Video content above is prompted by the following question:

• How would you approach treatment sequencing in patients who progress beyond CAR T in early relapse MM?