The 2022 Tandem Meetings | A look into the future of multiple myeloma treatment: T-cell redirecting therapies vs autoHSCT

So, this is an interesting debate, because autologous stem cell transplantation in myeloma is still the incumbent. There have been many trials trying to offset it in terms of responses and PFS benefit. And the role of autologous stem cell transplant continues to be important for the newly diagnosed setting. Now we have several promising CAR-T therapies. We have the bispecific antibodies that are showing very high response rates. And we are investigating those options or starting to do them in the frontline setting, but the debate that I’m going to have with Professor Kwee Yong is whether these T-cell redirection therapies are going to replace autologous stem cell transplant. I am assigned the role of saying, “No, that change will not happen in the next five years.” So, my job will be to share the wealth of data in favor of autologous stem cell transplant. And really, the key issues are we just don’t have data to say that this will bear fruit. We don’t know about the long-term safety, the off-target effects of these T-cell redirecting strategies. The other important aspect will be the applicability and scaling of these technologies to global myeloma care. So, autologous stem cell transplantation is not just relevant to the US, but it’s a fairly cheap intervention in taking care of our myeloma patients around the world. So, now you want to try to introduce more expensive treatments in this schema. And the challenge will be to bring down the cost of those treatments. So, those will be some of the arguments that I use in my debate. And let’s see what the audience thinks about it.