Optimizing Selection of Bridging Therapies Prior to CAR-T Therapy Administration for Multiple Myeloma: Clinical Pearls From an Expert Roundtable.

Autologous chimeric antigen receptor T-cell (CAR-T) therapies have become a key component of the multiple myeloma (MM) treatment landscape. Most patients treated with CAR-T therapies for MM receive bridging therapy to reduce tumor burden prior to CAR-T administration. These treatments are highly individualized, with selection informed by disease characteristics and treatment history, among other factors. While pivotal clinical trials restricted use of bridging therapy to specific regimens, a wide variety of anti-myeloma therapies have been used in real-world settings. Given potential variability in use of specific bridging regimens, there is a need for expert guidance on selection and use of these therapies in patients receiving CAR-T therapy for MM. This review aims to provide an overview of key considerations influencing bridging therapy selection and to outline practical guidance for selection of bridging therapy across patient populations. With expanded indications and earlier referrals for patients to receive CAR-T therapy for MM, continued collaboration with experienced CAR-T providers will be instrumental in optimizing administration of bridging therapy and improving overall patient outcomes.