Hematology / Cell Therapy 06/08/2026

How Community Oncologists Can Optimize CAR T-Cell Therapy for Patients With Multiple Myeloma

An engaging portrait of a smiling woman with long blonde hair, wearing a blue striped blouse, standing in a professional setting, representing leadership in oncology research and medical advancements. Danai Dima, MD Oncologist smiling in white coat, highlighting cancer research and treatment expertise, with a bow tie, in a bright medical setting. Rohit Gosain, MD

Key Points

  • Ciltacabtagene autoleucel (cilta-cel), a chimeric antigen receptor (CAR) T-cell therapy, has been approved for second-line treatment in relapsed or refractory multiple myeloma based on the CARTITUDE-4 study.
  • Community oncologists should work with tertiary centers to select and refer eligible patients for cilta-cel therapy as early as possible.

While the 2026 American Society of Clinical Oncology Annual Meeting (ASCO 2026) was underway, Rohit Gosain, MD, of Roswell Park Comprehensive Cancer Center, spoke with Danai Dima, MD, of Fred Hutchinson Cancer Center, to discuss the role of CAR T-cell therapies in multiple myeloma and recent updates for cilta-cel from the CARTITUDE-4 trial.

Cilta-cel was initially approved for relapsed or refractory multiple myeloma after at least 4 prior lines of therapy based on the CARTITUDE-1 trial. After the CARTITUDE-4 trial, the approval was updated to require only 1 prior line of therapy. Most recently, a subgroup analysis presented at ASCO 2026 showed cilta-cel offered a benefit in both high-risk and standard-risk patients. In real-world practice, Dr. Dima aims to use cilta-cel as early as possible for patients with adequate organ function and fitness who can manage the logistics of inpatient treatment. 

Given the growing amount of positive data, Dr. Dima said patients with multiple myeloma should be referred more often and earlier on for cilta-cel therapy, regardless of cytogenetic risk status. To that end, community oncologists should partner and communicate regularly with tertiary CAR T-cell centers to identify eligible patients, facilitate effective bridging therapy, and manage potential long-term toxicities. Optimizing bridging therapy is important, as greater disease control prior to CAR T-cell infusion was associated with lower likelihood of treatment-related parkinsonism, said Dr. Dima.