Ciltacabtagene autoleucel (cilta-cel), a CAR-T cell therapy targeting BCMA, demonstrated substantial survival benefits in the CARTITUDE-4 phase 3 trial involving 419 patients with lenalidomide-refractory multiple myeloma who had received 1-3 prior treatment lines. The single infusion therapy showed superior overall survival compared to standard combination regimens of pomalidomide-bortezomib-dexamethasone or daratumumab-pomalidomide-dexamethasone. This represents a significant advance in treating one of the most challenging patient populations in multiple myeloma. The updated survival data reinforces CAR-T therapy's emerging role as a transformative treatment modality for hematologic malignancies, particularly for patients who have exhausted conventional options. Unlike traditional chemotherapy combinations that require continuous treatment cycles, the single-infusion approach offers potential for durable remissions with a discrete treatment event. However, CAR-T therapies carry unique toxicity profiles including cytokine release syndrome and neurotoxicity that require specialized monitoring and management capabilities. The trial's international scope across 81 sites strengthens the generalizability of findings, though real-world implementation remains constrained by manufacturing complexity and infrastructure requirements. This data likely solidifies cilta-cel's position in earlier treatment lines for eligible multiple myeloma patients.