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development of guidelines is mandatory, especially in the current complex therapeutic landscape of this disease.
It is crucial that priorities be clearly defined. Academic programs must be developed in order to: (i) reduce the high cost of CAR-T cells proposed by pharmaceutical companies; (ii) increase academic knowledge on CAR-T cell therapy; (iii) propose new collaborations with phar- maceutical companies; and (iv) design EU clinical trials based on the combination of CAR-T with current or new anti-myeloma strategies.
Educational programs for the use of CAR-T cells should be developed through the different European societies, such as the EMN, ESH, EHA, international societies like the International Myeloma Society (IMS), and the national societies or co-operative groups.
The definition of consensus guidelines and educational programs for autologous CAR-T cell therapy could be expanded to other immunotherapeutic approaches, such as bispecific antibodies, conjugates, NK-cell therapy or allo-CAR-T. Hopefully, in the near future, several strate- gies targeting BCMA and other plasma cell antigens will become available for the treatment of myeloma patients. The right time for each myeloma patient to use a CART or a bispecific antibody or antibody drug conjugate should be defined by clinical experts, and this will require in-depth knowledge of the disease. Educational programs under the guidance of myeloma experts will not only help improve the outcome of our patients, but also contribute to a more efficient use of the resources available.
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