By 2025–early 2026, progress in multiple myeloma treatment is being driven mainly by CAR-T cell therapy. The biggest changes are:
- CAR-T is moving earlier in treatment, not only for late-stage disease
- Longer follow-up now shows that some patients stay in remission for years
- New CAR-T designs and new targets, especially GPRC5D, are expanding options for patients who relapse after BCMA therapy
Below is where the field stands today.
Where Standard BCMA CAR-T Stands Now
BCMA-directed CAR-T therapies are no longer experimental.
- Ide-cel (Abecma) and cilta-cel (Carvykti) are established treatments for relapsed or refractory multiple myeloma
- Phase 3 trials showed better progression-free survival compared with standard drug combinations
- Regulatory approvals have moved CAR-T earlier in treatment:
*Ide-cel: after 2 prior lines
*Cilta-cel: after 1 prior line (approved in 2024)
Long-term follow-up is now available:
- About 63% overall survival at 4 years
- About 37% progression-free survival at 4 years, even in heavily pretreated patients
- Side effects are still mainly cytokine release syndrome (CRS) and neurotoxicity, which are usually manageable in experienced centers
Using CAR-T Earlier in the Disease
A major shift is happening: CAR-T is being tested before multiple relapses.
- Trials like CARTITUDE-5 and CARTITUDE-6 are studying cilta-cel in:
*Newly diagnosed patients who are not transplant candidates
*Transplant-eligible patients, including direct comparison with autologous stem cell transplant after modern induction therapy
The logic is simple: healthier T cells may lead to deeper and longer responses
Some leading centers are also exploring CAR-T in:
- High-risk smoldering myeloma
- Very early disease states
These approaches are still experimental and available only in clinical trials.
Next-Generation BCMA CAR-T Therapies
New BCMA CAR-T products are already in clinical testing.
- One example is BMS-986354 (NEX-T platform)
- Early studies show:
*Overall response rates around 95%
*Complete responses in about 45% of patients
*Median response duration of roughly 11–15 months, depending on depth of response
The goals of these newer products include:
- Faster manufacturing
- Better CAR-T cell expansion and persistence
- Potentially less severe toxicity, making outpatient treatment more feasible
Early data suggest activity that is at least comparable to current BCMA CAR-T and bispecific antibodies.
New Targets Beyond BCMA: GPRC5D
BCMA is no longer the only target.
- GPRC5D is now the leading alternative CAR-T target
- Early trials of GPRC5D CAR-T therapies (such as MCARH109, OriCAR-017, and BMS-986393) show:
* High response rates
*Activity even in patients who previously failed BCMA-directed therapy
Why this matters:
- Some patients relapse because myeloma cells lose BCMA expression
- GPRC5D is strongly expressed on myeloma cells and has limited expression on normal tissues
- This allows meaningful anti-myeloma activity with a manageable safety profile
Key Research Directions for 2026
Several strategies are shaping the next phase of myeloma treatment:
- Multi-target approaches
*CAR-T cells targeting more than one antigen
*Sequential strategies (BCMA first, then GPRC5D at relapse) - Improved CAR-T design
*Armored CAR-T
*New co-stimulatory domains
*Allogeneic (off-the-shelf) CAR-T products - Better patient selection, aiming for longer remissions with less toxicity
The overall goal is clear: make deep remissions more durable and CAR-T safer and more accessible.
Read more CAR-T patient testimonials >
Publication date: Feb 2026.
Sources:
*nature.com: CAR-T cell therapy in Multiple Myeloma: current status and future challenges
*nature.com: Phase 1 clinical trial of B-Cell Maturation Antigen (BCMA) NEX-T® Chimeric Antigen Receptor (CAR) T cell therapy CC-98633/BMS-986354 in participants with triple-class exposed multiple myeloma
*science.org: GPRC5D is a target for the immunotherapy of multiple myeloma with rationally designed CAR T cells
*dana-farber.org: An Update on CAR T-Cell Therapy in Multiple Myeloma
*pubmed: Long-term follow-up of BCMA CAR-T cell therapy in patients with relapsed/refractory multiple myeloma
*pmc: GPRC5D as a novel target for the treatment of multiple myeloma: a narrative review
*myeloma.org: December 2025 and January 2026: What's New in Myeloma?
*frontiersin.org: Long-term follow-up of patients with relapsed/refractory multiple myeloma after BCMA CAR-T-cell therapy
*pubmed: GPRC5D-Targeted CAR T Cells for Myeloma
*onclive.com: Key Updates With CAR T-Cell Therapy in Myeloma From ASH 2025
