BRIDGE-2M: Optimizing Bridging Therapy Prior to CAR-T Therapy in Multiple Myeloma: A Modified Double-Blind Delphi Panel of US Physicians
Year: 2026
Type: article
Abstract: INTRODUCTION: We aimed to achieve consensus on optimal bridging therapy (BT) selection for patients with relapsed/refractory multiple myeloma (RRMM) undergoing chimeric antigen receptor T-cell (CAR-T) therapy. METHODS: We conducted a double-blind, three-round modified Delphi panel among U.S.-based hematologist-oncologists/hematologists using CAR-T therapy for RRMM. RESULTS: Panelists (N = 15; all managing -60-100 patients with RRMM within the past year; > 5 years of practice: 86.7%) reached consensus on key attributes influencing BT selection (disease burden, aggressive disease, performance status, comorbidities, line of therapy, age, frailty). Unique patient attributes were linked to clinical objectives (≥ 65 years or frailty: disease stabilization [71% consensus]; poor performance status: end-organ function preservation; comorbidities: functional preservation; high disease burden: preventing clinical decline; aggressive disease: cytoreduction [all 100% consensus]). Goals of BT were to decrease disease burden and promote CAR-T efficacy and safety (100% consensus). While talquetamab was preferred for bridging in later lines (66.7%), 73.3% would consider earlier-line use if approved. CONCLUSION: This study synthesized expert physician perspectives to develop a consensus-based framework to optimize BT selection, linking five key patient attributes to clinical objectives, with goals extending beyond disease stabilization to enhancing CAR-T efficacy and safety. Graphical abstract available for this article 10.6084/m9.figshare.33016328.
Source: Advances in Therapy
Authors: Rahul Banerjee, Hamza Hashmi, Preet M. Chaudhary, Shebli Atrash, Kimberly Green, Sabyasachi Ghosh, Todd Bixby, Denise De Wiest, Matthew Perciavalle, David H. Vesole, Forat Lutfi, Waqas Jehangir, Gurbakhash Kaur, Adeel M. Khan, Rahma Warsame, Ashwathi Puravankara Menon, Mark A. Price, Guru Subramanian Guru Murthy, Danai Dima, Brian J. Carney, Zaina P. Qureshi, Saurabh Chhabra
Institutions: Fred Hutch Cancer Center, Memorial Sloan Kettering Cancer Center, University of Southern California, Levine Cancer Institute, Medical University of South Carolina, Johnson & Johnson (United States), Legend Biotech (United States), Hackensack Meridian Health, University of Kansas, The University of Kansas Cancer Center, Avera Health, Mount Sinai Hospital, Tisch Cancer Institute, Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Mayo Clinic, RTI Health Solutions, Medical College of Wisconsin, Beth Israel Deaconess Medical Center, Mayo Clinic Hospital
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
Funder: Legend Biotech
OpenAlex ID: W7203737490