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4 treatment settings, 3 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.
Daratumumab or isatuximab with carfilzomib or pomalidomide and dexamethasone; belantamab mafodotin with bortezomib- or pomalidomide-dexamethasone (DREAMM-7, DREAMM-8); cilta-cel after one to three lines (CARTITUDE-4).
The CD38 antibody that turned triplets into quadruplets: adding it to standard induction roughly halves the risk of myeloma progressing.
Isatuximab is Sanofi's CD38 antibody, approved in frontline transplant-ineligible myeloma (IMROZ) and, from July 2026, as an under-the-skin injection.
Carfilzomib is a second-generation proteasome inhibitor with less nerve damage but more heart and blood-pressure effects.
The third-generation thalidomide analogue for myeloma that has failed lenalidomide, and since 2020 the first new drug for Kaposi sarcoma in two decades.
Dexamethasone is a long-acting glucocorticoid steroid that kills lymphoid cancer cells directly, which is why it sits in nearly every myeloma regimen and in childhood leukaemia and lymphoma protocols. It is also the standard drug for preventing chemotherapy sickness and for brain swelling and spinal cord compression; high blood sugar, insomnia, muscle wasting and infection follow prolonged use.
A myeloma ADC that was withdrawn in 2022 then came back in 2025 after strong trials in earlier lines.
Ciltacabtagene autoleucel is a one-time BCMA CAR-T for myeloma that, in CARTITUDE-4, cut the risk of death by about 45% compared with standard regimens.
PFS 36.6 vs 13.4 months, HR 0.41; OS HR 0.58.
PFS HR 0.52.
PFS HR 0.26; OS HR 0.55.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia (grade 3+) · CARTITUDE-4, n=188 | - | 95% |
| Infections (grade 3+) · CARTITUDE-4, n=188 | - | 24% |
| Hypogammaglobulinaemia · CARTITUDE-4, n=188 | 94% | 9% |
| Cytokine release syndrome · CARTITUDE-4, n=188 | 78% | 3% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
BCMA CAR-T (cilta-cel or ide-cel, KarMMa-3) where slots and fitness allow; BCMA bispecific (teclistamab, elranatamab, linvoseltamab) otherwise; teclistamab-daratumumab (MajesTEC-3).
Ciltacabtagene autoleucel is a one-time BCMA CAR-T for myeloma that, in CARTITUDE-4, cut the risk of death by about 45% compared with standard regimens.
Idecabtagene vicleucel was the first myeloma CAR-T (2021) and is now approved after two prior lines based on KarMMa-3.
Teclistamab was the first off-the-shelf bispecific for multiple myeloma, and is now approved after just one prior line of therapy.
Elranatamab is Pfizer's BCMA bispecific, given under the skin every week then every two weeks, for myeloma after four prior lines.
Linvoseltamab is Regeneron's BCMA bispecific, approved in July 2025 with the highest complete-response rate of the class in its pivotal study.
PFS 13.3 vs 4.4 months, HR 0.49.
ORR 98%; ~33% progression-free at 5 years without maintenance.
ORR 63%, ≥CR 39%.
36-month PFS 83.4% vs 29.7%; HR ~0.17.
ORR 70%, ≥CR 45%.
ORR 61%.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia (grade 3+) · CARTITUDE-4, n=188 | - | 95% |
| Infections (grade 3+) · CARTITUDE-4, n=188 | - | 24% |
| Hypogammaglobulinaemia · CARTITUDE-4, n=188 | 94% | 9% |
| Cytokine release syndrome · CARTITUDE-4, n=188 | 78% | 3% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Neutrophils decreased · MajesTEC-1 | 88% | 70% |
| Pneumonia · MajesTEC-1 | 24% | 15% |
| Neurologic toxicity · ICANS 6% | 60% | 6% |
| Musculoskeletal pain · MajesTEC-1 | 44% | 4.2% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Talquetamab against GPRC5D (MonumenTAL-1); selinexor combinations; CELMoDs and trispecifics in trials.
Talquetamab is the first drug against GPRC5D, a second myeloma target used after BCMA therapies stop working; taste and skin side effects are its signature.
Selinexor is a first-in-class pill that traps tumour-suppressor proteins inside the nucleus; approved in myeloma, it failed its endometrial cancer test in 2026.
Iberdomide is a far more potent successor to lenalidomide, now in phase 3 as post-transplant maintenance and in relapsed disease.
Mezigdomide is the most potent oral cereblon modulator, producing responses in about 40% of triple-class-refractory myeloma with dexamethasone alone.
ORR ~73%.
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Step-up dosing and tocilizumab for cytokine release syndrome, immunoglobulin replacement and antimicrobial prophylaxis on bispecifics, neurological monitoring after cilta-cel, ocular examinations on belantamab.
This setting names no product or technology record yet; the approach above is the standard as written. Ask your team which specific treatments they mean.
No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.
No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.
Add these to your appointment list, or take the full question set for this cancer.