Revlimid, an immunomodulatory drug (IMiD), and Velcade, a proteasome inhibitor (PI), play key roles as the backbone for combination regimens across various lines of therapy. These drugs have broad approvals in all markets, and the launches of lenalidomide and bortezomib generics in 2022 will, over time, exert substantial downward pressure on the MM market. 

The launches of BCMA-targeted therapies will play a pivotal part in future market dynamics over the next decade. Key anti-BCMA agents include the CAR-T therapies Abecma and Carvykti. Abecma is approved for third-line or later patients in the US, EU, and Japan, while Carvykti is approved in the US and EU for a larger population of second-line or later patients. In Japan, Carvykti is approved for fourth-line or later patients. All approvals were for triple-class exposed patients (previously treated with an IMiD, a PI, and an anti-CD38 antibody). Given the unmet need for effective therapies for heavily pretreated patients, demand has been high and manufacturing initially struggled to keep pace, but capacity is now growing.