Multiply relapsed (triple-refractory) multiple myeloma off trial

Authored by Manni Mohyuddin, published on 2026-02-12 23:10:14.0

Off trial treatment algorithm for triple-refractory multiple myeloma off trial.* Do not delay bispecifics just because you think CAR-T has to be given first (or even collected). Many are harmed due to that belief.

  1. Triple refractory (but BCMA, GRPC5D naive) patient
    • Frailer Patient
      • BCMA Bispecific
    • Rapid Disease Progression (but Otherwise Fit)
      • Collect for CAR-T ASAP, Bridge with Talquetamab or Chemo, then Cilta-cel
    • Slower Disease Progression
      • Cilta-cel
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