In this discussion, Sham Mailankody, MBBS, Memorial Sloan Kettering Cancer Center, New York, NY, and Jonathan Keats, PhD, Translational Genomics Research Institute, Phoenix, AZ, explore the growing complexity of sequencing therapies in multiple myeloma, particularly with expanding options such as CAR T-cells, bispecific antibodies, and targets including BCMA and GPRC5D. The experts emphasize the need for improved diagnostic tools to guide personalized treatment decisions and highlight strategies to determine the most effective therapy and modality for each patient, especially as resistance and antigen loss become more common. Additionally, Dr Mailankody and Dr Keats discuss evolving approaches, including bridging therapies, debulking prior to CAR-T, and the integration of genomic and immune profiling to improve outcomes and refine patient-specific care pathways.
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