{
  "abstract": "Background\n\nSeveral B-cell maturation antigen (BCMA)-directed therapy (BDT) modalities have been approved by the US Food and Drug Administration (FDA) for relapsed-refractory multiple myeloma (RRMM). Ideal sequencing of these therapies remains unknown.Methods\n\nWe report one of the largest multicenter retrospective patient cohorts in this real-world analysis of patients receiving a BDT in both BDT-naïve and exposed settings at major academic centers.Results\n\nIn the BDT-naïve setting, which included 276 patients, 169 (61%) received chimeric antigen receptor T-cell therapy (CAR-T), whereas 107 (39%) received bispecific antibodies (BsAbs). Median progression-free survival (PFS) in the BDT-naïve setting was significantly longer with CAR-T than with BsAbs (16.1 vs. 13.5 months, p = 0.007) with a higher overall response rate (ORR) (87 vs. 68%). Multivariable Cox regression analysis revealed that receiving CAR-T (hazard ratio [HR] = 0.41), cytokine release syndrome (CRS) of any grade (HR = 0.50), achieving a best response of ≥very good partial response (VGPR) (HR = 0.12), and high-risk cytogenetic abnormalities (HRCA) (HR = 2.29) were all significant prognostic indicators of PFS. Similarly, HRCA (HR = 2.32), CRS (HR = 0.36), and a best response of ≥VGPR (HR = 0.16) were all independent prognostic factors of overall survival (OS). Of the 80 patients who received prior BDT, 22 received CAR-T (28%) and 58 (72%) received BsAbs. The median PFS was 6.3 months in the CAR-T group, with 64% ORR, vs. 4.4 months in the BsAb group, with 53% ORR (PFS HR, 0.93). Only the best response, ≥VGPR (HR = 0.20), achieved significance in the multivariable model.Conclusions\n\nCAR-T led to more durable responses in the BDT-naïve setting than BsAbs. Responses to either modality were weaker in the BDT-exposed setting. These results highlight the importance of sequencing BDT in RRMM.",
  "abstract_shown": true,
  "affiliations": [
    "School of Medicine, University of Jordan, Amman 11942, Jordan.",
    "Division of Hematology and Oncology, University of Cincinnati, Cincinnati, OH 45267, USA.",
    "St. John's Episcopal Hospital, New York, NY 11691, USA.",
    "Levine Cancer Center, Atrium Health, Wake Forest University School of Medicine, Charlotte, NC 28204, USA.",
    "Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA 52242, USA.",
    "Division of Hematology and Oncology, Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36688, USA.",
    "Division of Hematology and Cellular Therapy, Allegheny Health Network Cancer Institute, Pittsburgh, PA 15212, USA.",
    "Division of Blood Disorders, Rutgers Cancer Institute, New Brunswick, NJ 08901, USA.",
    "Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Westwood, KS 66160, USA.",
    "Division of Hematology, The Ohio State University, Columbus, OH 43210, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 22,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Osama M Younis",
      "orcid": "0009-0004-1027-554X"
    },
    {
      "affs": [
        1
      ],
      "name": "Sencer Goklemez"
    },
    {
      "affs": [
        2
      ],
      "name": "Carmel Awadallah"
    },
    {
      "affs": [
        3
      ],
      "name": "Shebli Atrash",
      "orcid": "0000-0003-4547-7534"
    },
    {
      "affs": [
        3
      ],
      "name": "Barry Paul"
    },
    {
      "affs": [
        4
      ],
      "name": "Hira Shaikh",
      "orcid": "0000-0001-5604-4166"
    },
    {
      "affs": [
        4
      ],
      "name": "Christopher Strouse"
    },
    {
      "affs": [
        4
      ],
      "name": "Andrew Vegel"
    },
    {
      "affs": [
        4
      ],
      "name": "Emily Struble",
      "orcid": "0000-0003-0660-3446"
    },
    {
      "affs": [
        5
      ],
      "name": "Anita Mazloom",
      "orcid": "0009-0009-7899-7078"
    },
    {
      "affs": [
        1,
        5
      ],
      "name": "Omar Alkharabsheh",
      "orcid": "0000-0002-5299-4233"
    },
    {
      "affs": [
        6
      ],
      "name": "Prerna Mewawalla",
      "orcid": "0009-0008-7464-6898"
    },
    {
      "affs": [
        7
      ],
      "name": "Mansi R Shah"
    },
    {
      "affs": [
        7
      ],
      "name": "Abhiraj Saxena"
    },
    {
      "affs": [
        8
      ],
      "name": "Zahra Mahmoudjafari",
      "orcid": "0000-0002-3168-2521"
    },
    {
      "affs": [
        8
      ],
      "name": "Jordan Snyder"
    },
    {
      "affs": [
        8
      ],
      "name": "Muhammad Umair Mushtaq"
    },
    {
      "affs": [
        8
      ],
      "name": "Jeries Kort",
      "orcid": "0000-0001-9182-3931"
    },
    {
      "affs": [
        8
      ],
      "name": "Alma Habib"
    },
    {
      "affs": [
        8
      ],
      "name": "Joseph McGuirk"
    },
    {
      "affs": [
        8
      ],
      "name": "Al-Ola Abdallah",
      "orcid": "0000-0002-6603-185X"
    },
    {
      "affs": [
        9
      ],
      "name": "Abdullah Mohammad Khan",
      "orcid": "0000-0003-2166-2583"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/aasyy9y23ksnb.bib",
  "cited_by": 0,
  "doi": "10.3390/cancers18193147",
  "fulltext_url": "https://europepmc.org/articles/PMC13664241",
  "id": "aasyy9y23ksnb",
  "issns": [
    "2072-6694"
  ],
  "landing_url": "https://europepmc.org/article/MED/42882842",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2720|Multiple Myeloma Research and Treatments"
    ]
  ],
  "openalex": "W7214713973",
  "pdf_url": "https://europepmc.org/articles/PMC13664241?pdf=render",
  "pmcid": "PMC13664241",
  "pmid": "42882842",
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/aasyy9y23ksnb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42882842",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42882842"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2072-6694",
      "subfield": "oncology"
    }
  ],
  "title": "Sequencing BCMA-Directed Therapies in Relapsed/Refractory Multiple Myeloma: A Real-World Comparison of CAR T-Cell Therapy and Bispecific Antibodies.",
  "title_text": "Sequencing BCMA-Directed Therapies in Relapsed/Refractory Multiple Myeloma: A Real-World Comparison of CAR T-Cell Therapy and Bispecific Antibodies.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/aasyy9y23ksnb",
  "venue": "Cancers",
  "versions": []
}