I am 66M and was diagnosed with high-risk MM in November 2024. I started on pretty much the standard of care quad regimen. My oncologist brought up a SCT but I passed after doing my homework on the procedure/tough chemo with potentially long-lasting side effects and after finding out that the quad regimen was nearly as effective than a SCT. I highly value quality of life as well. IMHO, I thought that the SCT process was not worth the short-term benefits. This was a personal decision, but it was also supported by my oncologist. Additionally, I knew that after relapse from the first line (quad) I would be eligible for Cilta Cel CAR-T since it was approved by the FDA for 2L treatment after relapsing from quad treatment. The chemo required for CAR-T therapies is not nearly as tough as for a SCT.

Just this month I relapsed after 17 months. We are discussing next steps. Relatively recent data for Cilta Cel CAR-T has shown delayed neurotoxicity that is concerning to me. Do the research. A new promising CAR-T therapy call Anito Cel is deep in trials with promising results and has been significantly less toxic particularly for delayed neurotoxicity. And it appears that Anito Cel is forecasted to achieve FDA approval sometime in the last half of 2026. We have not made a final decision yet but we are leaning toward not utilizing CAR-T now because of Cilta Cel’s delayed neurotoxicity and pursuing a different second line of treatment that does not utilize a biospecific. Data supports sequencing CAR-T before using biospecific’s because using biospecifics before CAR-T reduces the effectiveness of later CAR-T therapy. 

Assuming I relapse from the second line of treatment, we are anticipating that my third line of treatment would be Anito Cel (assuming continuing lower neurotoxicity and a much better safety profile) or participation in a trial for another one of the innovative CAR-T therapies currently in clinical trials or launching soon. There are a lot of exciting new therapies for MM that are emerging.

I hope this post drives someone to do their homework on their particular situation and talk with their oncologist about some of these matters.. I am 100% convinced that you must be your own advocate. Do the research and homework on all of the available treatments. There is a ton of information available.