Hematology / Conferences 06/16/2026

The Growing Role of CAR T-Cell Therapies in Multiple Myeloma

A professional headshot of a young businessman in a navy suit and tie, smiling confidently against a neutral gray background. Sawyer Bawek, DO A bald man wearing a pink sweater and blue checkered bow tie, standing outdoors with blurred background in natural light. Hamza Hashmi, MD

Key Points

  • Chimeric antigen receptor (CAR) T-cell therapies have shown very favorable outcomes even as second-line therapies in patients with multiple myeloma.
  • Ongoing barriers to CAR T-cell adoption include limited clinics, insurance barriers, and individual patient characteristics and logistics.
  • Optimal sequencing of CAR T-cell and bispecific therapies is still under investigation, although data suggest extended treatment with bispecifics may hamper the efficacy of CAR T-cell therapy.

While the 2026 American Society of Clinical Oncology Annual Meeting was underway, Sawyer Bawek, DO, of Cleveland Clinic, interviewed Hamza Hashmi, MD, of Memorial Sloan Kettering Cancer Center, about the ongoing development of CAR T-cell therapies for patients with multiple myeloma. 

Dr. Hashmi highlighted long-term follow-up data from CARTITUDE-4 that showed ciltacabtagene autoleucel (cilta-cel) has yielded very deep and durable responses in both standard-risk and high-risk multiple myeloma, even when used as early as the second line. Based on the positive findings, Dr. Hashmi said he considers cilta-cel at first relapse for any patient with adequate health and performance status, slower-growing disease, caregiver support, and local access.

While cilta-cel and newer CAR T-cell therapies are entering the treatment paradigm for multiple myeloma, access remains an issue, including limited treatment centers and delays from insurance, said Dr. Hashmi. In addition, although notable toxicities like cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome have become more manageable, late-onset neurological side effects are a challenge that remain poorly understood. 

Dr. Bawek also questioned Dr. Hashmi about treatment sequencing in multiple myeloma. Sequencing of B-cell maturation antigen–directed CAR T-cell therapies and bispecifics remains an open question, although emerging data seem to suggest that extended use of bispecific T-cell engagers induces T-cell exhaustion, and may affect the efficacy of CAR T-cell therapies, said Dr. Hashmi.