Important advances in the treatment landscape of multiple myeloma (MM) had been 
seen over the past two decades leading to improved overall survival but despite 
the progress multiple myeloma is still considered incurable and the prognosis of 
the pentarefractory patients have been poor. The development of immunotherapy 
and in particular adoptive cell therapy with chimeric antigen receptor (CAR) T 
cells have dramatically improved the outcomes of heavily pretreated 
relapsed/refractory MM patients. The bulk of CAR T-cell constructs currently in 
clinical development target the B-cell maturation antigen (BCMA) and to date 
only idecabtagene vicleucel (ide-cel) is approved by the Food and Drug 
Administration (FDA) for commercial use in adult patients with relapsed or 
refractory MM based on the promising clinical responses and positive safety 
record shown in the pivotal KarMMa study. This review focus on the development 
of CAR T-cell therapy for multiple myeloma as well as a brief review of the 
mechanisms of resistance, toxicity and new approaches under development.