Assuming all options for BCMA-directed therapy are available, how would you approach treatment for a patient with 4 prior lines of myeloma-directed therapy who is eligible for a BCMA-directed therapy?

Great question with no right answer. I note, for example, that the original question stem asks about overall therapy approaches while the subsequent poll asks about effectiveness. With regard to effectiveness in isolation, I think it's fair to say that cilta-cel (a CAR-T therapy) has the best track record to date. Updated results from the CARTITUDE-1 study show a median PFS exceeding 27 months (i.e., well over 2 years!). The CARTIFAN study of cilta-cel in a Chinese population likely will have a similar median PFS with longer follow-up, although there were some mortality signals in this trial that need further explanation from the authors. The outcomes of both of these trials surpass the median PFS even at the highest dose level of the KarMM...