CAR T vs BCMA-Directed Bispecific Antibodies: Multiple Myeloma Experts Share Sequencing Insights
Key Points
- Shared decision-making is key when selecting between chimeric antigen receptor (CAR) T-cell therapy or B-cell maturation antigen (BCMA)-directed bispecific antibodies.
- Considerations include disease progression, patient preference, logistics, and caregiver support.
- Emerging data from ASCO 2026 demonstrated that treatment sequencing may determine survival outcomes.
Oncology Brothers podcast cohosts Rahul Gosain, MD, MBA, of Wilmot Cancer Institute, and Rohit Gosain, MD, of Roswell Park Comprehensive Cancer Center, were joined by Ajai Chari, MD, of University of California, San Francisco Health; Binod Dhakal, MD, of the Medical College of Wisconsin; and Surbhi Sidana, MD, of Stanford University, for a Clinical Insights discussion on multiple myeloma coinciding with the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting.
The panelists emphasized that the choice between CAR T-cell therapy and BCMA-directed bispecific antibodies in the relapsed setting represents a key clinical decision point in the current treatment landscape.
Although both therapies provide survival benefits, treatment selection is based on several factors, such as patient disease progression and preference, logistical considerations, and family and caregiver support.
Patient preference may be influenced by chronic treatment-related adverse effects with bispecific antibodies versus the more acute but potentially serious toxicities associated with CAR T-cell therapy. Dr. Chari highlighted the importance of shared decision-making between patients and care providers.
Treatment sequencing may also affect outcomes. Data presented at ASCO 2026 showed that receiving CAR T-cell therapy before a BMCA-directed bispecific antibody was associated with better survival outcomes than the reverse treatment sequence.