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The next phase of blood cancer treatment will be defined less by any single new therapy and more by how quickly the most effective ones move earlier in care, and how many patients can actually reach them.
In a Harvard KOL Series discussion convened by Bank of America Global Research and Mass General Brigham, Noopur Raje MD and Jeremy Abramson MD MMSC examined how bispecific antibodies, CAR T-cell therapy, and a wave of next-generation approaches are reshaping the treatment of multiple myeloma and lymphoma.
A central theme was the movement of immune-based therapies earlier in the course of disease, from a last resort reserved for heavily pretreated patients toward second-line and, increasingly, frontline use.
That shift reflects a broader reckoning with access. The therapies work; the harder problem in hematologic oncology is reaching the patients who need them, and much of the discussion turned on how to close that gap.
In myeloma, BCMA-directed bispecific antibodies and CAR T-cell therapy, once reserved for late-line disease, are moving toward first relapse. Dr. Raje described BCMA-directed therapy becoming entrenched as a second-line standard, with newer data supporting use after just one to three prior lines, and expects continued movement as easier-to-administer bispecifics arrive.
The same pattern runs through lymphoma. Dr. Abramson noted that CAR T is the established second-line option in diffuse large B-cell lymphoma, while bispecific antibodies are advancing toward the frontline, where several large randomized trials are expected to reset first-line treatment. In mantle cell lymphoma, adding a BTK inhibitor upfront is already displacing autologous stem-cell transplant for younger patients.
Both clinicians returned repeatedly to the gap between what works and what reaches patients. Dr. Raje estimated that fewer than one in ten myeloma patients receive CAR T-cell therapy in the real world. Dr. Abramson put the figure below one in five for the lymphoma patients who should receive it at second line.
The barriers are logistical rather than scientific. An autologous cell product takes roughly three to four weeks to manufacture, disease can progress faster than that in aggressive lymphoma, and many patients would need to travel hours and relocate to a treating center to receive it. Referral patterns still treat these therapies as a last option. The result is that some of the most effective treatments in oncology remain underused, in the United States and worldwide.
Bispecific antibodies, available off the shelf with no manufacturing wait, already fill the gap for patients who cannot access or cannot wait for a cell product. Both clinicians expect that role to grow, particularly for older and frailer patients, who tolerate bispecifics notably well, in some cases better than traditional chemotherapy.
Further out, off-the-shelf cell therapies could extend that reach. Dr. Raje pointed to in vivo CAR approaches that avoid the wait and much of the toxicity of conventional manufacturing, a potential one-and-done alternative to continuous bispecific dosing. Dr. Abramson highlighted allogeneic CAR products that, if their durability holds up, could be delivered at regional hospitals autologous therapy has never reached.
As options multiply, the order in which they are given matters. Dr. Raje noted that prior bispecific exposure can make it harder to collect and deploy T cells for a subsequent CAR T. Outcomes appear tied to the interval between therapies, with better results when more than six months separate a bispecific from a subsequent CAR T; on current evidence, she leans toward CAR T first.
Duration is the parallel question. Rather than treating continuously for years, the field is moving toward fixed-duration strategies that stop once disease becomes undetectable, using measurable residual disease as a guide.
Progress is not only about efficacy. In advanced Hodgkin lymphoma, a checkpoint-inhibitor-based regimen has become the default, more effective and far better tolerated than the older chemotherapy standard, which left at least one in five patients with permanent nerve damage. In mantle cell lymphoma, better-tolerated BTK inhibitors are allowing many younger patients to avoid stem-cell transplant altogether.
That tolerability shift matters most in the community, where Dr. Raje and Dr. Abramson emphasized educating oncologists that these therapies are available at first relapse, and empowering community practices to deliver the early dosing safely rather than routing every patient to a major center. Oral immunomodulatory agents, familiar to those practices and free of the monitoring burden bispecifics carry, are likely to see the fastest uptake.
Blood cancer treatment is no longer only about developing more active therapies. The most effective options increasingly already exist; the defining work now is building the access models, community pathways, and off-the-shelf formats that let them reach every patient who could benefit.
That shift, from proving efficacy to delivering it at scale, is redefining what progress looks like in hematologic oncology. The clinical and commercial implications of that shift will be front and center at the 2026 World Medical Innovation Forum.
These are the strategic questions that will continue to shape oncology discussions at the Forum, where healthcare leaders decide what scales next.
The 2026 Forum convenes the center of healthcare innovation — senior industry executives, top investors, leading Harvard clinicians and scientists, entrepreneurs, and government officials. Candid dialogue and collaborative innovation accelerate progress and improve patient care.
Presented in Boston by Mass General Brigham in collaboration with Bank of America, the 2026 Forum takes place September 22–23 at the Westin Boston Seaport District. The theme, Innovation at Speed and Scale, will spotlight the technologies and people creating the newest therapies and care enhancements.
Explore what’s next in blood cancer treatment at the 2026 World Medical Innovation Forum.
Noopur Raje MD
Director, Center for Multiple Myeloma, Massachusetts General Hospital
Professor of Medicine, Harvard Medical School
Jeremy Abramson MD MMSC
Director, Jon and Jo Ann Hagler Center for Lymphoma, Massachusetts General Hospital
Professor of Medicine, Harvard Medical School
This discussion is part of the Harvard KOL Series, a program convened by Bank of America Global Research and Mass General Brigham in advance of the World Medical Innovation Forum. Similar topics will be examined at the Forum in Boston, September 22–23, 2026.
© 2026 Mass General Brigham Incorporated. All Rights Reserved
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