Triple MAPK inhibition salvaged a relapsed post BCMA CAR-T cell therapy multiple myeloma patient with a BRAF V600E sub-clonal mutation

Multiple Myeloma (MM) is a progressive plasma cell neoplasm characterized by heterogeneous clonal expansion. Despite promising response rates achieved with anti-BCMA CAR-T cell therapy, patients may still relapse and there are currently no clear therapeutic options in post-CAR-T settings. In this report we present a case of a post BCMA CAR-T relapsed/refractory (RR) MM patient with skin extra-medullary disease (EMD) in which a novel MAPK inhibition combinatorial strategy was implemented based on next-generation sequencing and in vitro experiments.