Saad Z. Usmani, MD, of Levine Cancer Institute, Charlotte, NC, discusses the KarMMa-4 trial in patient with high-risk, newly diagnosed multiple myeloma. In these patients, who may have more bone marrow reserve and healthy peripheral blood mononuclear cells, a less compromised immune status, and less extensive disease to debulk, earlier use of idecabtagene vicleucel may lead to improved outcomes compared with standard therapies. Dr Usmani suggests that this may provide an opportunity to replace transplant with CAR T-cell therapies.