Cilta-cel in RRMM: Real-world single-center experience and best practices

Real-world experience with ciltacabtagene autoleucel (cilta-cel) in 180 patients with relapsed/refractory multiple myeloma (RRMM) treated at the University of Kansas Cancer Center between 2021 and 2025 was reported in in Frontiers in Oncology by Shune et al. The report highlights practical approaches and best practices to support the safe and effective use of cilta-cel throughout the treatment continuum.

Key data: Rigorous multidisciplinary coordination and well-defined care pathways may help optimize clinical outcomes with cilta-cel. Key best practices include early referral to chimeric antigen receptor (CAR) T-cell therapy centers from community settings, ideally at first relapse, to support timely evaluation, reduce disease-related complications, and facilitate logistical planning. Comprehensive baseline assessments may reduce the risk of unanticipated complications, while structured monitoring and rapid intervention algorithms during the acute and post-acute phases may prevent escalation to high-grade toxicities. Proactive recognition and management of non-immune effector cell-associated neurotoxicity syndrome (non-ICANS) neurological events, supported by patient and caregiver awareness, longitudinal neurologic monitoring, and early neurology referral, may facilitate timely intervention and reduce morbidity. Long-term follow-up focused on immune reconstitution, infection prevention, and functional recovery may help optimize patients’ quality of life (QoL).

Key learning: This report outlines a proposed framework to optimize outcomes with cilta-cel in patients with RRMM, emphasizing early referral to a CAR T-cell therapy center, structured multidisciplinary workflows, and continued vigilance throughout treatment to support the translation of clinical trial outcomes into routine practice.