Refractory multiple myeloma: Count refractory drugs, not lines of treatment!

Current approved immunotherapeutic agents such as CART cells are limited to patients with at least 3 or even 4 prior lines of treatment. However more and more patients become refractory to standard regimens in earlier lines. Mohyuddin et al. examined the inclusion criteria of current immunotherapeutic trials in myeloma and propose a change to put more emphasis on refractoriness to 3 or more agents and to omit a required number of lines of therapy in current and future protocols. Commentary on: Mohyuddin et al. Inclusion criteria of currently enrolling T-cell engaging trials in multiple myeloma: Should we be focusing on lines of prior therapy? Br J Haematol 2023;202:e1-e2.