Extramedullary myeloma in the era of CAR T-cell and bispecific antibody therapies

Despite the significant advancements in multiple myeloma therapy over the last decade, current unmet needs include populations of patients who continue to have inferior outcomes, such as those with high-risk cytogenetics, elderly and frail patients, plasma cell leukemia, central nervous system involvement, and extramedullary disease. Though T-cell redirecting therapies have shown excellent efficacy in advanced multiple myeloma, the ability of these therapies to overcome high-risk disease such as extramedullary involvement in myeloma is an area of critical attention. In this review, we seek to examine the specific impact of currently available data of T-cell redirecting therapies, including approved and investigational chimeric antigen receptor T-cell and bispecific antibody therapies, on outcomes in patients with extramedullary myeloma.