Drug development in hematology-oncology can sometimes happen at such a fast, paradigm-busting pace that the selection of treatments even 20 years ago can look like prehistory compared to what is available now. Few indications exemplify such rapid change more than multiple myeloma – where small molecule drugs that have long served as backbone treatments are going generic, new biologics with novel targets have rapidly become backbone treatments themselves, and other drugs with new mechanisms have struggled to gain widespread acceptance.
Not everything has been smooth sailing. While the two anti-BCMA CAR-T therapies approved for multiple myeloma – Bristol Myers Squibb Company/2seventy Bio, Inc.’s Abecma (idecabtagene vicleucel, ide-cel) and Carvykti (ciltacabtagene autoleucel, cilta-cel) from Johnson & Johnson’s Janssen Oncology division and Legend Biotech Corp. – have revolutionized treatment of the disease, they have done so only for those patients who manage to actually obtain them amid a large backlog of treatment slots
