CELL INTELLIGENCE · 肿瘤细胞治疗研究

The treatment landscape for multiple myeloma is evolving rapidly with the integration of novel B-cell maturation antigen (BCMA)-directed therapies. In the early-relapse setting (1-3 prior lines of therapy), several practice-changing phase 3 trials have reported results in the past 2 years, including chimeric antigen receptor T-cell therapies, bispecific antibodies, and antibody-drug conjugates. These studies offer exciting new options for clinicians but also introduce complexity due to differences in patient populations, trial designs, and real-world applicability. We synthesize data from trials exploring BCMA-directed immunotherapy in the early-relapse setting, explore nuances in trial characteristics and their implications for treatment selection, and discuss treatment decision determinants, including age, fitness, comorbidities, treatment exposure, and access to therapy. We subsequently discuss how emerging BCMA-directed therapy affects decision-making in several common scenarios. For each of these common scenarios, we explore applicability and limitations from the clinical trials, treatment access, and logistical considerations and the importance of shared decision-making.