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SOHO 2026 | Selecting BCMA-directed immunotherapies after 1-3 prior lines in multiple myeloma
Doris Hansen, MD, Moffitt Cancer Center, Tampa, FL, discusses factors influencing the selection of BCMA-directed immunotherapies for patients with multiple myeloma following 1-3 prior lines of therapy. Dr Hansen highlights disease biology, patient fitness, and logistical considerations as key drivers of treatment selection, emphasizing the importance of shared decision-making to align treatment with patients’ goals, circumstances, and lifestyle. This interview took place at the 14th Annual Meeting of the Society of Hematologic Oncology (SOHO 2026) in Houston, TX.
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Transcript
Certainly making a decision now in one to three prior lines of therapy is complicated. We’ve had a revolution in multiple myeloma with multiple immunotherapies available for our patients, which is truly wonderful. But I do think that there are certain considerations, as you mentioned, in terms of choosing the appropriate treatment for the individualized patients. For example, I don’t think that chronological age alone is usually a deciding factor...
Certainly making a decision now in one to three prior lines of therapy is complicated. We’ve had a revolution in multiple myeloma with multiple immunotherapies available for our patients, which is truly wonderful. But I do think that there are certain considerations, as you mentioned, in terms of choosing the appropriate treatment for the individualized patients. For example, I don’t think that chronological age alone is usually a deciding factor. Biggest drivers, I believe, are disease biology, urgency of relapse, as well as patient fitness and logistical and access considerations. If someone has rapidly progressive disease and cannot safely wait for CAR-T manufacturing, then we may favor an immediately available therapy off the shelf, such as a bispecific antibody combination, such, for example, teclistamab alone or teclistamab-daratumumab, depending on patient’s prior exposure and refractoriness. Conversely, for an appropriate patient who can’t access CAR-T and the opportunity for that one-and-done that treatment and time off therapy can be incredibly compelling for that particular patient. So this is where I believe shared decision-making becomes so important. Two patients with very similar myeloma may make completely different decisions based on their treatments, goals, as well as their disease characteristics and logistical circumstances. So increasingly, I think our role is to say, here are several very effective options for you, which one might be best in terms of disease, but also for a patient’s lifestyle and treatment considerations.
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