The Changing Landscape of Immunotherapy in Relapsed/Refractory Myeloma: Updates From ASH 2025

Updated iMMagine-1 data presented at ASH 2025 show that anito-cel delivers deep, durable responses in heavily pretreated multiple myeloma.

At ASH 2025, iMMagine-1 data showed that anito-cel has a favorable and durable safety profile with low rates of severe CRS, neurotoxicity, and infections.

Data presented at ASH 2025 suggest earlier-line use of cilta-cel leads to better outcomes in multiple myeloma because patients have fitter immune systems and less exhausted T cells, improving CAR T feasibility, expansion, and durability compared with later-line treatment.

Higher levels of CD4-positive naïve T cells in patients receiving CAR T-cell therapy for multiple myeloma are associated with longer PFS, suggesting T-cell composition may serve as a biomarker to guide patient selection.

While earlier-line BCMA CAR T-cell therapy in multiple myeloma offers superior efficacy and longer treatment-free survival, careful monitoring and further research are needed to manage rare but serious toxicities.

Teclistamab plus daratumumab delivers unprecedented progression-free survival benefits over standard of care in relapsed/refractory multiple myeloma, while raising important questions about how best to sequence bispecific combinations with CAR T-cell therapy.

Combining complementary targeted therapies for multiple myeloma has shown impressive efficacy, but safety, quality of life, and costs must also be considered.

Early phase 1 data suggest that in vivo, off-the-shelf CAR T therapy may be feasible in multiple myeloma, offering the promise of faster, less toxic treatment without lymphodepletion while raising important questions about durability, safety, and patient selection.

ASH 2025 data on KLN-1010 suggest that off-the-shelf, in vivo CAR T therapy could significantly expand access to cellular therapy in multiple myeloma by reducing manufacturing, treatment delays, and logistical barriers, provided toxicity remains manageable.

ASH 2025 immunotherapy data highlight the importance of treatment sequencing, real-world outcomes in high-risk populations, and the growing need to define when therapy can be safely de-escalated or stopped in multiple myeloma.