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. Author manuscript; available in PMC: 2025 Jan 1.
Published in final edited form as: Transplant Cell Ther. 2023 Oct 31;30(1):17–37. doi: 10.1016/j.jtct.2023.10.022
Box 1. Questions addressing the role of CAR T-cells in earlier lines of therapy for myeloma
FAQ 1 What are the 2 currently approved CAR T-Cell therapies for Relapsed/Refractory Myeloma, and what studies and data led to their approval?
FAQ 2 What mitigation strategies can be utilized to try to decrease the risk of severe CRS and neurotoxicity after CAR T-cell therapy for myeloma?
FAQ 3 What other specific risks are seen with CAR T-Cell Therapy besides CRS and Neurotoxicity?
FAQ 4 What considerations will help us choose between one BCMA CAR T-cell product over another?
FAQ 5 Many patients don’t fit the eligibility criteria for the trials used for approval of CAR T-cells. What is the data for CAR T-cell therapy outside of the clinical trial setting?
FAQ 6 What are some bridging strategies for effective cytoreduction to mitigate risks or keep the myeloma under control in penta-refractory patients during product manufacturing?
FAQ 7 With multiple treatment options and modalities targeting BCMA (CAR T-cells, Bispecific T-cell engagers), what are some considerations for sequencing BCMA directed therapies?
FAQ 8 Are there T-cell markers predictive for poor outcome after CAR T-cell therapy, and what are the reasons that CAR T-cells may be more effective earlier in the course of disease?
FAQ 9 What are the studies being done, and what data has been reported from randomized trials to support moving CAR T-cells to 2nd or 3rd line therapy for myeloma?
FAQ 10 What studies are being done, and what data would be needed to move CAR T-cells to frontline therapy of myeloma?
FAQ 11 Will moving CAR T-cells to earlier lines of therapy for myeloma be cost prohibitive, and will the quality of life improvement with CAR T justify a cost difference?
FAQ 12 For patients relapsing after BCMA-directed therapy, what options do we have, and what data do we have for non-BCMA T-cell redirection therapies?